What Are the Signs of Bipolar Disorder?

Bipolar disorder (sometimes called manic depression) is a mental illness that causes unusual changes in mood and energy, and greatly affects decision-making abilities. There are three main types of bipolar disorder: Bipolar I disorder, Bipolar II disorder and Cyclothymic disorder. All three types involve episodes of mania or depression.

A manic episode involves periods of extremely “up,” elated, irritable or energized behavior, while an episode of depression involves feeling very “down,” sad, indifferent or hopeless. Less severe manic periods are known as hypomanic episodes.

Symptoms of Bipolar Disorder

Here is a more in-depth look at each type of bipolar disorder:

  1. You may have Bipolar I disorder if: You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger psychosis or a break from reality.
  2. You may have Bipolar II disorder if: You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.
  3. You may have Cyclothymic disorder if: You’ve had at least two years—or one year in children and teenagers—of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).

Bipolar II disorder is not a milder form of bipolar I disorder, but simply a different form of bipolar disorder. While the manic symptoms of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods.

Mania and Hypomania

Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and in relationships. Mania may also trigger a break from reality (psychosis) and require a hospital stay.

Both a manic and a hypomanic episode include three or more of these symptoms:

  • Abnormally upbeat or jumpy
  • Increased activity, energy or agitation
  • Excessive sense self-confidence (euphoria)
  • Decreased need for sleep
  • Talkativeness
  • Racing thoughts
  • Easily distracted
  • Poor decision-making—for example, going on buying sprees, taking sexual risks or making foolish investments

Major Depressive Episodes

A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in work, school or relationships. An episode includes five or more of these symptoms:

  • Depressed mood
  • Marked loss of interest or feeling no pleasure in usual activities
  • Significant weight loss when not dieting, weight gain or a decrease or increase in appetite
  • Either insomnia or sleeping too much
  • Either restlessness or slowed behavior
  • Fatigue or loss of energy
  • Feelings of guilt
  • Decreased ability to think and concentrate
  • Thinking about, planning or attempting suicide

Other Effects of Bipolar Disorder

Signs and symptoms of bipolar I and bipolar II disorders may include other effects, such as anxiety, melancholy, psychosis and more. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. Also, bipolar symptoms may occur during pregnancy or change with the seasons.

When To See a Doctor

Despite the mood extremes, people with bipolar disorder often may not recognize how much their emotional instability disrupts their lives and the lives of their loved ones.

Some people with bipolar disorder enjoy the feeling of euphoria and bursts of productivity. However, this euphoria is always followed by an emotional crash that can leave a person depressed and perhaps in financial, legal or relationship trouble.

If you have any symptoms of depression or mania, see your doctor or mental health professional. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.

When To Get Emergency Help

Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room or call a suicide hotline number. In the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Causes

The exact cause of bipolar disorder is unknown, but several factors can be considered, such as:

  • Biological differences. People with bipolar disorder appear to have physical changes in their brains.
  • Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition.

Risk Factors

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

  • Having a first-degree relative with bipolar disorder
  • Periods of high stress, such as the death of a loved one or other traumatic event
  • Drug or alcohol abuse
signs of bipolar disorder

Complications

Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:

  • Drug and alcohol use
  • Risk of suicide
  • Legal or financial problems
  • Damaged relationships
  • Poor work or school performance

Co-occurring Conditions

If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:

Prevention

Generally, there’s no sure way to prevent mood disorders. However, getting treatment at the earliest sign of a mental health crisis can help prevent bipolar disorder or other mental health conditions from worsening.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).

If you’ve been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:

  1. Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them.
  2. Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
  3. Take your medications exactly as directed. You may be tempted to stop treatment—but don’t. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.

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