The symptoms of bipolar disorder are characterized by extremes of mood from severe depression to hypomania, mania, and elation. These are far more severe than the mood swings that most people experience and each episode can last weeks or months. Some people have more episodes of depression than mania and vice versa, whereas some types of Bipolar feature a ‘mixed state’, which involves experiencing both mania and depression simultaneously. There is also a type of Bipolar known as ‘rapid cycling’ in which people will experience quicker transitions between the spectrum of depression and mania and won’t feel any stability with their mood.
When experiencing depression as part of Bipolar, a person can have any or all of the following symptoms:
feeling very low or easily irritated most of the time
- lacking energy and feeling tired
- difficulty concentrating and remembering things
- loss of interest in everyday activities
- loss of interest in relationships or friendships
- becoming withdrawn and isolated
- feelings of emptiness or worthlessness
- feelings of guilt and despair
- feeling ‘flat’ or not feeling anything
- self-doubt and having negative thoughts about yourself
- being delusional, having hallucinations (seeing or hearing things which aren’t really there) and disturbed or negative illogical thinking such as thinking they have committed a crime or atrocity when they haven’t. This is known as psychosis and can feel so real that it is hard for sufferers to understand other people’s concerns
- lack of appetite or overeating
- difficulty sleeping
- waking up early
- self-harming, or using drugs and alcohol to cope
- thinking of suicide and death
During the hypomania or mania phase, symptoms can include:
- feeling excessively happy, excitable, elated or overjoyed
- talking very quickly and changing topics frequently
- feeling full of energy
- experiencing grandiose thoughts and feelings
- feeling full of great new ideas and a sense of urgency to carry out important plans
- being easily distracted
- being easily irritated or agitated and feeling ‘jumpy’
- being delusional, having hallucinations and disturbed or illogical thinking. For example, thinking they are a celebrity, historical figure or religious icon.
- not sleeping
- not eating
- doing things that often have disastrous consequences – such as spending large sums of money or engaging in reckless sex
- making decisions or saying things that are out of character and that others see as being risky or harmful
- feeling that other people are being negative and unhelpful if they try to offer support or advice
- being rude and aggressive
- losing social inhibitions
- not caring about your safety; feeling that you are invincible and that nothing can hurt you
- feeling very over-confident and adventurous
During a hypomanic state, a person with Bipolar can feel many of the same symptoms as those presented in full mania, however, they can often feel easier to manage, pass more quickly and not include psychotic symptoms. It’s not the case that hypomania is less severe than mania however and the symptoms can still have a huge impact on a person’s life.
Someone experiencing a mixed state could feel different combinations of the depressed and manic moods listed above at the same time, for instance feeling extremely depressed but also full of energy. The juxtaposition of opposing emotions can make it extremely difficult for people to identify exactly how they feel and it can be a challenging and exhausting task to manage. It can feel impossible to ask for help and also to know what type of support to ask for. Also, it can be extremely dangerous in that someone could find that they now have the energy to act on any suicidal feelings they may be having.
The symptoms of Bipolar Disorder can be extremely difficult generally for a sufferer to identify themselves as often, the manic phase can be misinterpreted as a time of positivity, high functioning and enthusiasm for life. Many people only seek help for the symptoms associated with depression, so it can help to keep a record of your moods and note any periods of extreme highs. This will help your doctor to assess you accurately and avoid a mistake in diagnosis. Also, the contrast between the extreme highs and lows in mood can often enhance a person’s perception of depression; when compared with hypomania or mania, it can feel completely devastating and overwhelming and sometimes lead to a mistaken diagnosis of major depression instead of Bipolar Disorder.
Also, people with Bipolar symptoms can often use drugs or alcohol to ‘self-medicate’ or control their feelings, which can mask the fact that there is a serious illness underneath.
If are concerned or worried that you or someone you know may be suffering from Bipolar, it’s important to seek medical advice and get a proper diagnosis, as the symptoms can be well managed and controlled with the right treatment. Bipolar symptoms can often be confused with other mental health conditions, such as depression and schizophrenia and only a trained practitioner can make an accurate diagnosis.