Highs And Lows: Understanding Symptoms Of Manic Depression

Updated August 28, 2020

Medically Reviewed By: Debra Halseth, LCSW

Depending on your age and the company you keep, you might not have heard much about manic depression lately. However, it’s still out there – it’s just more commonly referred to as “bipolar disorder” these days.

While most of us hear quite a bit about bipolar disorder on advertisements or see representations of it in the media, it’s hard to know what the condition really feels like. This is particularly worrying if you think that you or someone that you care about might have it.

Generally, the symptoms of bipolar disorder are mood shifts between depressive episodes and manic episodes. But there’s more to it than that. Let’s take a closer look.

Causes Of Manic Episodes

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Your brain works through a series of chemical messengers called neurotransmitters. There are two main classes of neurotransmitters, namely stimulants and depressants. When your brain chemistry shifts in favor of stimulants over depressants, it can trigger a manic episode.

This happens for some reasons that we’ll discuss more deeply throughout the article. Conditions like bipolar disorder are the most common, though stress, substance use, and in some cases, seasonal change can also cause manic episodes.

If your healthcare provider determines that a mental health condition is causing your manic episodes, he or she may prescribe prescription medication. Most of these prescription medications work by balancing your brain chemistry to limit episodes or reduce their severity.

There are some things that you can do to help to manage manic episodes without medication, including diet and lifestyle changes. Some people also find that counseling or talk therapy helps them to recognize and manage their manic episodes.

However, if your manic episodes are caused by a mental health condition like bipolar disorder, these measures may not be enough on their own.

Depression And Mania

Depression and mania are conditions that we can look at as opposites – with both being bad.

People experiencing depression may feel a low mood, lack of energy, or apathy. People experiencing mania may feel high energy, inability to focus, and may experience anxiety or trouble sleeping.

Both mania and depression can be experienced by people with conditions other than a bipolar disorder – or by people with no condition at all. For example, depressive episodes can be triggered by an event like the loss of a loved one or losing a job. Manic episodes can be caused by elevated stress. Both can be caused by situations that combine stress and a feeling of loss, like moving to a new town.

Few people experience depression and mania regularly. For most people, particularly people with bipolar disorder, they are experienced as isolated “episodes.” How an individual experiences these episodes can vary drastically, however manic episodes tend to be relatively short (a few days). In contrast, depressive episodes can be comparatively long (two weeks or more).

Depressive Episodes

As mentioned above, depressive episodes can last for weeks or even months. They are characterized by low mood, lack of energy. However, depression can also come with physical symptoms, including trouble maintaining a healthy weight and disturbances in sleep patterns.

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People may experience depressive episodes without having bipolar disorder due to a variety of other contributing factors, including life events, age, and other depressive disorders, including seasonal affective disorder.

Manic Episodes

Manic episodes are typically shorter than depressive episodes. During a manic episode, people usually experience high energy, but they may also have difficulty focusing, or experience anxiety. Physical symptoms often include decreased appetite and trouble sleeping. People experiencing a manic episode may also engage in uncharacteristic or irrational and impulsive behavior.

While it is rare, people can experience manic episodes without having bipolar disorder. Other conditions that can cause manic episodes to include sudden lifestyle changes, conditions that cause prolonged disrupted sleep patterns, substance abuse, and a rare psychological condition called hypomania.

Mixed Episodes

While people without bipolar disorder can experience depressive and manic episodes, mixed episodes are unique to bipolar disorders. In fact, they’re so unusual that not even all people that have bipolar disorder experience them.

During a mixed episode, the individual may feel the urge to do things but lack the physical energy. Alternatively, they may experience high energy but not know what to do.

Manic Episodes As A Result Of Bipolar Disorder

Bipolar disorder is characterized by a shifting back-and-forth between manic episodes and depressive episodes. Unfortunately, bipolar disorder implies that there is a “normal” somewhere in the middle. While some people with bipolar disorder can recognize this normal in themselves, other people see the shift back and forth between mania and depression as normal for them.

As a result, some people who live their entire lives with bipolar disorder – notably milder cases – may not realize that they have the condition because it feels normal for them. Just because something feels normal doesn’t mean that it is healthy. People who undergo treatment for bipolar disorder often find it easier to do things like maintain relationships and keep steady employment.

We’ve already talked about the symptoms of bipolar disorder, but it may make sense to talk about how to notice these symptoms on yourself. After that, we’ll talk about how to manage them and when it’s time to seek help.

Noticing Symptoms

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One great way to notice symptoms of bipolar disorder is to keep a diary. The more specific, the better. When you keep track of your feelings over time, it’s easier to notice patterns. If you’re not much of a writer or don’t think that you’ll be able to manage to keep a diary during a depressive episode, just make a mark on your calendar for days when you feel that you might be depressed and a different mark for days when you think that you might be manic. Don’t worry if you aren’t sure – if you decide to pursue treatment options, your care providers will help you figure things out.

If you’re more of a number’s person, keeping track of your finances can be an excellent way to quantify your moods. This was a thing that people used to do automatically when more of us used checkbooks. In this digital age, you can take your spending for granted if you don’t regularly itemize your expenses. So, start looking at the line items on your credit and debit cards, and even keeping receipts. Did you spend the usual amount on delivery one week and make any unusual big-ticket purchases the next week? This can be a significant indication that you might have bipolar disorder. Or that someone might have stolen your credit card.

Maintaining close relationships can be a good way of finding out that you might have a bipolar disorder from other people. Because our minds tend to ignore their own thought processes – a trend that we’ll return to in the next section – it can be hard to notice unusual behaviors in ourselves. Other people can be much more perceptive to when we might be acting strangely – provided that we are fairly open with them fairly regularly. This is another idea that we’ll return to in a moment.

Managing Manic Episodes

Some of the best ways to manage manic episodes are the same as the ways to identify them.

Maintaining close personal contacts with people can help you to stabilize your mood. If you live with a close friend or family members like a spouse, sibling, parent, or adult child, consider asking them to help monitor your behavior during manic episodes. This can help to reduce things like impulsive purchases.

Practicing good sleep hygiene can also help you to manage some of the physical impacts of manic episodes. Poor or disrupted sleeping patterns can both cause and worsen manic episodes, so doing things like trying to stick to a consistent schedule can help you to have fewer manic episodes and to make sure that the episodes that you do have take as small a toll as possible on your body.

Trying to use stimulants like caffeine in moderation can also help to limit manic episodes. During manic episodes, you may want to cut back even further, or even avoid caffeine altogether. Remember the neurotransmitters that we were talking about above? Caffeine works by clogging receptors that normally allow depressants to slow you down, tipping the balance in your brain in favor of stimulants. A little coffee can be a good way to start your day, but too much can kick start – or aggravate -a manic episode.

Finally, we mentioned above that our thoughts and feelings can easily get away from us. This can allow manic episodes to catch us by surprise and prevent us from living our best lives when they catch up with us.

Mindfulness is a practice that helps to train us to be more in touch with our thoughts and feelings. Practicing mindfulness between episodes can help to alert you to when an episode might be coming on. Practicing mindfulness during an episode can help to minimize stress and keep you from making decisions that you’ll regret later.

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When To Look For Help

A recurring theme through this article is determining when mood changes are the natural ebb-and-flow of life and when they’re symptoms of bipolar disorder. So, how can you tell the difference?

Thankfully, it’s not all up to you. To get medication for bipolar disorder and to make counseling and therapy more affordable, you’ll need a diagnosis. That usually comes from your primary care provider.

If you feel like your life is a constant swing between unmanageable lows and uncontrollable highs, talk to your care provider. They can help to determine whether you have bipolar disorder and what the best way to manage it is.

Whether you’re working through the diagnosis process with your care provider or looking to stabilize your own emotions without a diagnosis, talking to a therapist or counselor through an online platform can be a good first step. It’s convenient and personal, as well as more affordable for those paying without the help of an insurance provider. For more information on deciding whether an online counselor or therapist is right for you, visit BetterHelp.

Moving Forward

Whether or not you have bipolar disorder, managing emotions can feel like a full-time job in today’s hectic world. There are a couple of things that you can do on your own to control your feelings, but if this proves too much for you, there’s nothing wrong with seeking professional help.


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