Understanding Symptoms Of Bipolar Disorder
Manic Depression, or bipolar disorder, affects roughly 4.4% of adults in the United States. It’s marked by periods of intense mood swings of mania and depression, and when untreated, it can have a seriously negative impact on the patient’s daily life.
Understanding the symptoms of bipolar disorder begins with understanding its causes and types.
Causes and risk factors of bipolar disorder
While the exact cause of bipolar disorder is unknown, experts believe it stems from a combination of biology and genetics marked by various risk factors.
Biological Contributors- Bipolar disorder appears to be associated with an imbalance in the brain of dopamine, serotonin, and/or noradrenaline.
Genetic Contributors- Although researchers are still looking for a “bipolar gene,” it appears more frequently when the patient has a biological first-degree relative with the disorder, like a sibling or parent.
Traumatic, Stressful Events- While not a cause, traumatic events like the death of a loved one, natural disaster, and incidents of abuse can initiate bipolar episodes.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Drug/Alcohol Abuse- Frequent use of drugs and/or alcohol may also spark bipolar episodes if the individual is already predisposed to the condition.
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Symptoms of bipolar disorder
Bipolar disorder can occur at any age but is primarily diagnosed in the mid to late teens and early 20s. Like all mental health disorders, the symptoms of Bipolar disorder often change with time and circumstance and vary between individuals.
Depressive episodes
Depressive episodes can last for weeks or even months, and their symptoms are often severe enough to significantly impact daily activities and relationships. Depressive episodes usually include five or more of the following symptoms:
- Loss of energy, fatigue
- Extreme sleep patterns (either sleeping too much or insomnia)
- Restlessness or sluggishness
- Drastic weight fluctuations without dieting
- Low feelings of sadness, emptiness, and hopelessness
- Feelings of excessive, inappropriate guilt, worthlessness
- Trouble concentrating
- Loss of interest in activities that ordinarily bring pleasure
- Suicidal thoughts, plans, or attempting suicide.
If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7. If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Manic/hypomania episodes
Although they discuss symptoms, manic episodes are typically more severe than hypomania, causing more dramatic problems in daily life. In its most intense form, a manic episode can initiate delusions and hallucinations severe enough that it requires in-patient intervention.
Manic and hypomanic episodes usually feature three or more of the following symptoms:
- Extreme increase in energy and activity
- Racing thoughts, distractibility
- Abnormally agitated or upbeat
- Insomnia
- Excessively talkative, disorganized communication
- Intense euphoria, exaggerated feelings of self-confidence
- Unusually impulsive, risky behaviors
Mixed episodes
While people without bipolar disorder can experience depressive and manic episodes, mixed episodes are unique to bipolar disorders. During a mixed episode, the individual may experience the symptoms of depression and mania at the same time or in rapid succession.
Types of bipolar disorder
While there are Bipolar disorders associated with medical conditions like Multiple Sclerosis, stroke, Cushing’s disease, and the physiological effects of certain drugs or alcohol- there are three primary types of Bipolar:
Bipolar I
Episodes of mania associated with Bipolar I are usually more intense and more likely to include instances of psychosis. This type of bipolar disorder includes at least one manic episode interspersed among episodes of hypomania and/or major depression.
Bipolar II
Bipolar II includes at least one episode of major depression and a hypomanic episode. The diagnosis for Bipolar II excludes manic episodes.
Cyclothymic disorder
Patients with Cyclothymic disorder experience at least two years of depressive symptoms (less severe than major depression) and several periods of hypomania. Children and teens are diagnosed after one year of symptoms.
Diagnosing bipolar disorder
If left unaddressed, the symptoms of Bipolar disorder can worsen and increase the likelihood of comorbidity with conditions such as anxiety and conduct disorders. Substance Use Disorder (SUD) is the most common, affecting 61% of patients with Bipolar I and 48% with Bipolar II.
If you are experiencing symptoms of Bipolar disorder, it’s essential to contact your doctor so they may determine if you have it and begin a treatment plan. Your doctor will probably start with a physical exam, lab tests, and a thorough review of your family and medical history.
If your doctor determines that your symptoms aren’t caused by another physical issue, they’ll likely refer you to a psychiatrist for an evaluation. The psychiatrist will probably request a psychological self-assessment and ask you about your mental health status, including your behavior patterns, thoughts, and feelings. They may also ask you to keep a daily journal of your mood, behavior patterns, sleep patterns, etc. With your permission, they may request an interview with close friends and loved ones to gather information about your symptoms.
Once your psychiatrist is confident in a diagnosis of Bipolar disorder, they will cross-reference your symptoms with the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) published by the APA. From here, they will determine the best treatment for your unique situation.
Treatments
Bipolar Disorder is usually treated with a combination of psychotherapy and medication. In addition to the below treatments, your therapist will likely provide educational guidance about the disorder to help you and your loved ones understand the causes, symptoms, and treatment options. Becoming educated about the condition will also help you devise strategies for potential relapses and disruptions of therapy.
Psychotherapy
Psychotherapy techniques for Bipolar disorder include Cognitive Behavioral Therapy (CBT), interpersonal and social rhythm therapy (IPSRT), and family therapy.
Even though psychotherapy is one of the most vital parts of treatment, the nature of its symptoms can sometimes create barriers to treatment for people with Bipolar disorder. For example, commuting to and from an office during a potentially dangerous manic episode. Or feelings of deep depression that make it difficult to get out of bed, much less travel to an office and interact with other people in person. Online therapy is an excellent solution to such barriers for people with a wide range of mental health issues, including Bipolar disorder. Platforms like BetterHelp match patients with licensed mental health professionals from various backgrounds and expertise.
Several studies have shown that online therapy is as effective as in-person therapy. Research shows that online therapy is also effective for treating bipolar depression.
Medications
Antipsychotics, antidepressants, and mood stabilizers are commonly prescribed to help the patient manage symptoms. Your doctor will review the side effects, risks, and benefits associated with the medications. Remember that it often takes time to determine which medications are best for your unique physiology, and you may have to try different combinations before you find what works for you. Don’t start or stop taking your medications without directions from your doctor.
Long-term, continuous treatment
While there may be times between episodes when a person feels fine, a long-term, ongoing treatment plan can reduce the severity and frequency of mood swings.
Electroconvulsive therapy
Electroconvulsive therapy (ECT) is sometimes prescribed for patients who aren’t responsive to medications or can’t take them.
Managing symptoms of bipolar disorder in daily life
It’s important to understand that Bipolar disorder doesn’t go away with time or get better on its own. Treatment is symptom-centric and is usually ongoing and lifelong.
But in addition to medical treatment, there are lifestyle habits that can help better manage the symptoms:
Establish healthy habits
Keep a regular sleep schedule, follow a nutritious diet, and get regular exercise approved by your doctor. Keeping your doctor in the loop about your diet before beginning a new exercise program or if you have sleep problems is essential. Also, always consult your doctor before taking other medications or over-the-counter supplements.
Quit drinking/recreational drug use
Substance use disorder is one of the most frequent comorbidities of Bipolar disorder and one of the biggest concerns because of its strong association with risky behaviors. If you have trouble quitting, speak to your doctor.
Cultivate a support group
Keep close relationships with people who can provide positive, compassionate support and help you recognize when Bipolar symptoms arise.
Takeaway
Can you have highs and lows with depression?
Yes, individuals with depression can experience periods of highs and lows, and this pattern is sometimes referred to as "mood cycling" or "cycling depression." While depression is often associated with persistent depressed mood, energy loss, and feelings of hopelessness, some people with depression may also have episodes of increased energy, heightened mood, and restlessness.
The highs and lows of depression may be commonly seen in certain types of clinical depression or mental illness, such as bipolar disorder. Bipolar disorder involves alternating periods of depression and mania or hypomania. In these cases, the individual may experience depressive episodes characterized by the typical symptoms of low mood, changes in sleep, anxious distress, and appetite, and they may lose interest in things they used to enjoy. They may also have manic or hypomanic episodes, which involve elevated mood, increased energy, impulsivity, and sometimes, a decreased need for sleep.
What kind of depression has highs and lows?
A type of depression that involves both depressive episodes and periods of heightened mood or energy is known as bipolar disorder. There are different subtypes of bipolar disorder, and they are characterized by the specific nature and duration of mood episodes. The two main subtypes are Bipolar I Disorder and Bipolar II Disorder.
Bipolar I Disorder:
This subtype involves manic episodes, which are distinct periods of abnormally and persistently elevated, expansive, or irritable mood. Individuals with Bipolar I Disorder also experience depressive episodes. The manic episodes in Bipolar I Disorder are more severe and can significantly impact daily functioning.
Bipolar II Disorder:
Bipolar II Disorder is characterized by depressive episodes and hypomanic episodes. Hypomanic episodes are similar to manic episodes but are less severe in intensity and do not cause marked impairment in social or occupational functioning. Individuals with Bipolar II Disorder often experience more depressive episodes than hypomanic episodes.
Both Bipolar I and Bipolar II Disorders involve cycling between depressive and elevated mood states. The periods of depression in bipolar disorder are similar to those seen in major depressive disorder, and the highs (mania or hypomania) are distinctive features of bipolar disorder.
For some individuals, the lows may follow a seasonal pattern. This is called seasonal affective disorder (SAD), in which a person may feel depressed during particular times of year. These individuals may often experience depression in the winter due to lack of sunlight, or in summer if the heat is too intense to spend time outdoors.
Why is my mood so up and down?
Mood fluctuations, experiencing both ups and downs, can be influenced by a variety of factors. While occasional shifts in mood are a normal part of life, persistent and extreme mood swings may indicate an underlying issue. Here are several potential reasons why your mood might be fluctuating:
- Stress: Stressful life events, ongoing stressors, or major life changes can impact mood. High levels of stress may contribute to mood swings and emotional fluctuations.
- Sleep Patterns: Disruptions in sleep patterns, including insufficient sleep or irregular sleep schedules, can affect mood stability. Both sleep deprivation and excessive sleep can influence emotional well-being.
- Hormonal Changes: Hormonal fluctuations, such as those during the menstrual cycle, pregnancy, or menopause, can contribute to mood swings. After giving birth, hormonal fluctuations may cause postpartum depression making an person feel extreme highs and lows.
- Diet and Nutrition: Poor nutrition, irregular eating habits, or imbalances in blood sugar levels can influence mood. Nutrient deficiencies may affect the production of neurotransmitters related to mood management.
- Mental Health Conditions: Mood disorders, such as bipolar disorder, involve significant mood swings. Bipolar disorder is characterized by episodes of mania or hypomania (elevated mood) alternating with depressive episodes.
- Substance Use: The mis use of alcohol, drug abuse, or misuse of medications can affect mood stability. Substance-induced mood changes may contribute to fluctuations in emotional well-being.
- Medical Conditions: Some medical conditions, such as thyroid disorders, neurological conditions, or chronic pain, can impact mood. Addressing the underlying medical issue may help stabilize mood. In some people, premenstrual dysphoric disorder may cause depressed mood prior to menstruation.
- Environmental Factors: Environmental factors, including the quality of relationships, work stress, and living conditions, can influence mood. Negative or positive changes in the environment may impact emotional well-being.
How do I know if I'm bipolar?
Bipolar disorder is a mental health condition characterized by extreme mood swings, including episodes of mania or hypomania (elevated mood) and depressive episodes. If you are concerned that you might have bipolar disorder, it's important to seek the guidance of a mental health professional for a comprehensive assessment. Here are some signs and symptoms associated with bipolar disorder:
- Manic Episodes in Bipolar I Disorder: Involves at least one manic episode, which is a distinct period of abnormally and persistently elevated, expansive, or irritable mood. Manic episodes are severe and often accompanied by impaired judgment, impulsivity, and increased energy.
- Hypomanic Episodes in Bipolar II Disorder: Involves at least one hypomanic episode, which is similar to a manic episode but less severe. Hypomanic episodes are characterized by an elevated mood, increased energy, and impulsivity.
- Depressive Episodes: Both Bipolar I and Bipolar II Disorders involve depressive episodes, during which individuals experience persistent low mood, changes in sleep and appetite, feelings of hopelessness, and loss of interest or pleasure in activities.
- Mood Swings: Individuals with bipolar disorder may experience rapid mood swings, with distinct shifts between periods of depression and elevated mood.
- Impaired Functioning: Bipolar disorder can significantly impact daily functioning, including relationships, work, and overall quality of life.
- Sleep Disturbances: Changes in sleep patterns are common during manic or hypomanic episodes, where individuals may experience a decreased need for sleep. Conversely, during depressive episodes, there may be excessive sleep.
- Impulsivity and Risky Behavior: Manic or hypomanic episodes may be characterized by impulsive and risky behaviors, such as excessive spending, substance abuse, or engaging in reckless activities.
What is the highest level of depression?
The severity of depression is often categorized into different levels based on the intensity and impact of symptoms. One commonly used classification system is the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The levels of depression severity include:
- Mild Depression: Presence of some symptoms that cause minor impairment in daily functioning. Individuals with mild depression may still be able to carry out daily activities but may find it challenging. When these symptoms persist over time, it may be called persistent depressive disorder.
- Moderate Depression: More pronounced symptoms that interfere with daily functioning. Individuals with moderate depression often find it difficult to perform regular activities and may require additional support.
- Severe Depression: Symptoms are significantly impairing, and individuals may struggle to complete even basic daily tasks. Severe depression may include a major depressive episode which can have a profound impact on various aspects of life, including work, relationships, and overall quality of life.
- Major Depressive Disorder with Psychotic Features: In some cases, severe depression may include psychotic symptoms or features such as hallucinations or delusions. This may be referred to as psychotic depression which is a more complex form of depression that requires treatment from a mental health specialist.
What are ADHD mood swings like?
Mood swings are not a core symptom of Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD primarily involves difficulties with attention, hyperactivity, and impulsivity. However, individuals with ADHD may experience emotional challenges, and their mood can be influenced by factors related to the condition.
Why do I keep crying for no reason?
Experiencing episodes of crying for no apparent reason can be a symptom of various underlying factors, including emotional, psychological, or physiological issues. While it's essential to consult with a healthcare professional for a thorough evaluation, here are some potential reasons why someone might find themselves crying unexpectedly:
- Emotional Distress
- Mood Disorders
- Hormonal Changes
- Medical Conditions
- Medication Side Effects
- Stress
- Trauma or Past Experiences
- Lack of Sleep
- Underlying Mental Health Conditions
- Grief and Loss
How do I know if I'm mentally ill?
If you are concerned about your mental health, it may be crucial to consult with a qualified mental health professional for a thorough assessment and guidance tailored to your individual situation. However, here are some general signs that might suggest you should seek professional help:
- Persistent Changes in Mood
- Difficulty Functioning
- Social Withdrawal
- Changes in Sleep Patterns
- Appetite Changes
- Intense or Persistent Fear or Worry
- Difficulty Concentrating
- Unexplained Physical Symptoms
- Changes in Behavior or Personality
- Substance Use Issues
Do I have bipolar or ADHD?
Both bipolar disorder and ADHD can have overlapping symptoms, such as difficulty with concentration and impulsivity. However, the nature of mood episodes distinguishes bipolar disorder from ADHD. Individuals with bipolar disorder experience distinct periods of mania or hypomania and depression, while ADHD is primarily characterized by persistent attention and hyperactivity issues.
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