What are the signs and symptoms of bipolar disorder?

What are the signs and symptoms of bipolar disorder?

The defining sign of bipolar I disorder is a manic episode that lasts at least one week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes.

But many people with bipolar disorder experience both hypomanic/manic and depressive episodes. These changing mood states don’t always follow a set pattern, and depression doesn’t always follow manic phases. A person may also experience the same mood state several times — with periods of euthymia in between — before experiencing the opposite mood.

Mood changes in bipolar disorder can happen over a period of weeks, months and sometimes even years.

An important aspect of the mood changes is that they’re a departure from your regular self and that the mood change is sustained for a long time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression.

The severity of the depressive and manic phases can differ from person to person and in the same person at different times.

Signs and symptoms of manic episodes

Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; others may experience them only rarely.

Signs and symptoms of a manic episode include:

• Excessive happiness, hopefulness and excitement.
• Sudden and severe changes in mood, such as going from being joyful to being angry and hostile.
• Restlessness.
• Rapid speech and racing thoughts.
• Increased energy and less need for sleep.
• Increased impulsivity and poor judgment, such as suddenly quitting your job.
• Making grand and unattainable plans.
• Reckless and risk-taking behavior, such as drug and alcohol misuse and having unsafe or unprotected sex.
• Feeling like you’re unusually important, talented or powerful.
• Psychosis — experiencing hallucinations and delusions (in the most severe manic episodes).

Most of the time, people experiencing a manic episode are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger — some people become suicidal in manic episodes, not just depressive episodes.

If a person is having an intense manic episode, especially if they’re experiencing hallucinations and delusions, they may need to be hospitalized to protect themselves and others from possible harm.

Signs and symptoms of hypomania

Some people with bipolar disorder have milder manic-like symptoms. This is called hypomania. With hypomania, you may feel very good and find that you can get a lot done. People with hypomania can often function well in social situations or at work.

You may not feel like anything is wrong during a hypomanic episode. But your family and friends may notice your mood swings and activity level changes and think that they’re unusual for you. After hypomania, you might experience severe depression.

Signs and symptoms of depressive episodes

The symptoms of depressive episodes in bipolar disorder are the same as those of major depression. They include:

• Overwhelming sadness.
• Low energy and fatigue.
• Lack of motivation.
• Feelings of hopelessness or worthlessness.
• Loss of enjoyment of things that were once pleasurable for you.
• Difficulty concentrating and making decisions.
• Uncontrollable crying.
• Irritability.
• Increased need for sleep.
• Insomnia or excessive sleep.
• A change in appetite, causing weight loss or gain.
• Thoughts of death or suicide (suicidal ideation).

If you’re experiencing suicidal ideation (thoughts of suicide), it’s important to seek immediate care. Call 911 or the National Suicide Prevention Lifeline at 1.800.273.8255. Someone will be available to talk with you 24 hours a day, seven days a week.

Signs and symptoms of a mixed episode

The symptoms of a mixed episode include both manic and depressive symptoms together. During a mixed episode, you have the negative feelings and thoughts that come with depression but also feel agitated, restless and high energy.

People who experience mixed episodes often describe it as the worst part of bipolar disorder.