Bipolar Disorder: Symptoms and Diagnosis

Reviewed Oct 19, 2017

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Summary

  • Involves both depression and mania
  • Disrupts normal life
  • Mood swings can be severe
  • Is often misdiagnosed as depression

Mood changes are a part of life. Everyone goes through periods of ups and downs. A person with bipolar disorder has mood swings that disrupt their normal life. These mood shifts can cause problems at home, with relationships, at school, or at work. They can be mild. Other times, they can be quite extreme.

The low stages are much like classic depression. But people with it also have high periods called mania.

Symptoms of mania

Some of the signs include:

  • Boosts of high energy and activity
  • Hasty or aggressive behavior
  • Rapid thoughts and speech
  • Exaggerated ego
  • Raised irritability
  • Decrease in sleep
  • Restlessness
  • Being overly optimistic
  • Hasty and reckless actions
  • Overuse of drugs or alcohol
  • Distractibility
  • More talkative or pressure to keep talking

Mania may result in the abuse of drugs, alcohol, and sex. It may also cause a person to overspend money. Severe cases can include hallucinations or delusions. During the mania phase, a person is highly stimulated. He may enjoy this feeling for a while and not wish to seek treatment. He often does not know how it disturbs his life, or how it affects others. To qualify as a true manic episode, a phase needs to last at least seven days or result in a hospital stay.

Symptoms of depression

Some of the signs include:

  • Lack of energy and interest
  • Increased sadness
  • Eating too much or too little
  • Sleeping too much or too little
  • Low self-esteem
  • Trouble paying attention and making choices
  • Anger and worry
  • Withdrawal
  • Thoughts of suicide
  • Feelings of worthlessness or guilt
  • Being agitated or slowed down

Unhappy people often lose the ability to enjoy things that used to please them. This may include a lack of interest in hobbies, social involvement, and sex. They may also have increased thoughts of death and suicide. Sometimes people with depression do not complain of low spirits but have the other symptoms. At times, it is easier to say they are irritable than depressed.

Bipolar disorder differs from major depressive disorder because it also includes periods of mania. The mania states are most often shorter. These manic episodes may happen after many episodes of low mood. This is one reason why bipolar disorder is often mistreated as depression.

Mixed state

This includes a variety of symptoms that are depressive or manic or both. All are uncomfortable. The symptoms can be hard to deal with as people feel both depressed and anxious, and are unable to rest, relax, or enjoy anything.

Types of bipolar disorder

  • Bipolar I disorder is currently understood to be not just two polar opposites of mood, but a spectrum of abnormal mood, behaviors, activity, and thinking. On one end of the spectrum is mania and the other end is depression. There are mixtures of symptoms with some features of depression and some of mania. These mixed states are very uncomfortable. People can feel depressed but irritable, restless, and unable to relax or stop worrying. They may have trouble sleeping but unlike a pure manic state, they feel fatigued and drained. These mixed states can result in people making bad decisions, alienating loved ones, losing jobs, and in general feeling terrible.
  • Bipolar II disorder includes periods of depression along with a milder form of energized mood, known as hypomania.
  • Unspecified bipolar and related disorder cannot be classified as type I or II, but is still not considered normal behavior.
  • Cyclothymic disorder is a milder type. The mood elevations and changes are much less severe and most often do not affect daily functioning.
  • Rapid-cycling is when a person has four or more episodes of mania, depression, or mixed symptoms within one year.

Proper diagnosis

Besides depression, there are other illnesses that make the detection of bipolar disorder hard. Attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are among them. Severe cases are sometimes misdiagnosed as schizophrenia. Other social phobias and anxiety disorders often co-exist with it. Drug and alcohol use disorders can further complicate the diagnosis. Some medical illnesses such as thyroid disorders can mimic bipolar disorder.

A physical exam and lab tests are needed to rule out other possible illnesses. Next, an in-depth mental evaluation may be needed. Your doctor might send you to a psychiatrist. It’s important to give them a full list of symptoms and any family history of mental illness. It is a good idea to bring a loved one with you who can also give key information. Keeping a life chart of daily moods, sleep patterns, and life events can be helpful to keep track of symptoms. Your chart is key in helping you and your doctor correctly diagnose symptoms and provide the right treatment.

Resources

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance 
www.dbsalliance.org/

Mood Disorder Questionnaire
www.dbsalliance.org/MDQ

National Institute of Mental Health/Bipolar Disorder
www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Suicide Prevention Lifeline
Call the toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) to talk with a trained counselor.

By Kevin Rizzo
Source: National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; Depression and Bipolar Support Alliance, www.dbsalliance.org/site/PageServer?pagename=home; National Library of Medicine National Institute of Health, www.nlm.nih.gov/medlineplus/ency/article/000926.htm; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

Summary

  • Involves both depression and mania
  • Disrupts normal life
  • Mood swings can be severe
  • Is often misdiagnosed as depression

Mood changes are a part of life. Everyone goes through periods of ups and downs. A person with bipolar disorder has mood swings that disrupt their normal life. These mood shifts can cause problems at home, with relationships, at school, or at work. They can be mild. Other times, they can be quite extreme.

The low stages are much like classic depression. But people with it also have high periods called mania.

Symptoms of mania

Some of the signs include:

  • Boosts of high energy and activity
  • Hasty or aggressive behavior
  • Rapid thoughts and speech
  • Exaggerated ego
  • Raised irritability
  • Decrease in sleep
  • Restlessness
  • Being overly optimistic
  • Hasty and reckless actions
  • Overuse of drugs or alcohol
  • Distractibility
  • More talkative or pressure to keep talking

Mania may result in the abuse of drugs, alcohol, and sex. It may also cause a person to overspend money. Severe cases can include hallucinations or delusions. During the mania phase, a person is highly stimulated. He may enjoy this feeling for a while and not wish to seek treatment. He often does not know how it disturbs his life, or how it affects others. To qualify as a true manic episode, a phase needs to last at least seven days or result in a hospital stay.

Symptoms of depression

Some of the signs include:

  • Lack of energy and interest
  • Increased sadness
  • Eating too much or too little
  • Sleeping too much or too little
  • Low self-esteem
  • Trouble paying attention and making choices
  • Anger and worry
  • Withdrawal
  • Thoughts of suicide
  • Feelings of worthlessness or guilt
  • Being agitated or slowed down

Unhappy people often lose the ability to enjoy things that used to please them. This may include a lack of interest in hobbies, social involvement, and sex. They may also have increased thoughts of death and suicide. Sometimes people with depression do not complain of low spirits but have the other symptoms. At times, it is easier to say they are irritable than depressed.

Bipolar disorder differs from major depressive disorder because it also includes periods of mania. The mania states are most often shorter. These manic episodes may happen after many episodes of low mood. This is one reason why bipolar disorder is often mistreated as depression.

Mixed state

This includes a variety of symptoms that are depressive or manic or both. All are uncomfortable. The symptoms can be hard to deal with as people feel both depressed and anxious, and are unable to rest, relax, or enjoy anything.

Types of bipolar disorder

  • Bipolar I disorder is currently understood to be not just two polar opposites of mood, but a spectrum of abnormal mood, behaviors, activity, and thinking. On one end of the spectrum is mania and the other end is depression. There are mixtures of symptoms with some features of depression and some of mania. These mixed states are very uncomfortable. People can feel depressed but irritable, restless, and unable to relax or stop worrying. They may have trouble sleeping but unlike a pure manic state, they feel fatigued and drained. These mixed states can result in people making bad decisions, alienating loved ones, losing jobs, and in general feeling terrible.
  • Bipolar II disorder includes periods of depression along with a milder form of energized mood, known as hypomania.
  • Unspecified bipolar and related disorder cannot be classified as type I or II, but is still not considered normal behavior.
  • Cyclothymic disorder is a milder type. The mood elevations and changes are much less severe and most often do not affect daily functioning.
  • Rapid-cycling is when a person has four or more episodes of mania, depression, or mixed symptoms within one year.

Proper diagnosis

Besides depression, there are other illnesses that make the detection of bipolar disorder hard. Attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are among them. Severe cases are sometimes misdiagnosed as schizophrenia. Other social phobias and anxiety disorders often co-exist with it. Drug and alcohol use disorders can further complicate the diagnosis. Some medical illnesses such as thyroid disorders can mimic bipolar disorder.

A physical exam and lab tests are needed to rule out other possible illnesses. Next, an in-depth mental evaluation may be needed. Your doctor might send you to a psychiatrist. It’s important to give them a full list of symptoms and any family history of mental illness. It is a good idea to bring a loved one with you who can also give key information. Keeping a life chart of daily moods, sleep patterns, and life events can be helpful to keep track of symptoms. Your chart is key in helping you and your doctor correctly diagnose symptoms and provide the right treatment.

Resources

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance 
www.dbsalliance.org/

Mood Disorder Questionnaire
www.dbsalliance.org/MDQ

National Institute of Mental Health/Bipolar Disorder
www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Suicide Prevention Lifeline
Call the toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) to talk with a trained counselor.

By Kevin Rizzo
Source: National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; Depression and Bipolar Support Alliance, www.dbsalliance.org/site/PageServer?pagename=home; National Library of Medicine National Institute of Health, www.nlm.nih.gov/medlineplus/ency/article/000926.htm; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

Summary

  • Involves both depression and mania
  • Disrupts normal life
  • Mood swings can be severe
  • Is often misdiagnosed as depression

Mood changes are a part of life. Everyone goes through periods of ups and downs. A person with bipolar disorder has mood swings that disrupt their normal life. These mood shifts can cause problems at home, with relationships, at school, or at work. They can be mild. Other times, they can be quite extreme.

The low stages are much like classic depression. But people with it also have high periods called mania.

Symptoms of mania

Some of the signs include:

  • Boosts of high energy and activity
  • Hasty or aggressive behavior
  • Rapid thoughts and speech
  • Exaggerated ego
  • Raised irritability
  • Decrease in sleep
  • Restlessness
  • Being overly optimistic
  • Hasty and reckless actions
  • Overuse of drugs or alcohol
  • Distractibility
  • More talkative or pressure to keep talking

Mania may result in the abuse of drugs, alcohol, and sex. It may also cause a person to overspend money. Severe cases can include hallucinations or delusions. During the mania phase, a person is highly stimulated. He may enjoy this feeling for a while and not wish to seek treatment. He often does not know how it disturbs his life, or how it affects others. To qualify as a true manic episode, a phase needs to last at least seven days or result in a hospital stay.

Symptoms of depression

Some of the signs include:

  • Lack of energy and interest
  • Increased sadness
  • Eating too much or too little
  • Sleeping too much or too little
  • Low self-esteem
  • Trouble paying attention and making choices
  • Anger and worry
  • Withdrawal
  • Thoughts of suicide
  • Feelings of worthlessness or guilt
  • Being agitated or slowed down

Unhappy people often lose the ability to enjoy things that used to please them. This may include a lack of interest in hobbies, social involvement, and sex. They may also have increased thoughts of death and suicide. Sometimes people with depression do not complain of low spirits but have the other symptoms. At times, it is easier to say they are irritable than depressed.

Bipolar disorder differs from major depressive disorder because it also includes periods of mania. The mania states are most often shorter. These manic episodes may happen after many episodes of low mood. This is one reason why bipolar disorder is often mistreated as depression.

Mixed state

This includes a variety of symptoms that are depressive or manic or both. All are uncomfortable. The symptoms can be hard to deal with as people feel both depressed and anxious, and are unable to rest, relax, or enjoy anything.

Types of bipolar disorder

  • Bipolar I disorder is currently understood to be not just two polar opposites of mood, but a spectrum of abnormal mood, behaviors, activity, and thinking. On one end of the spectrum is mania and the other end is depression. There are mixtures of symptoms with some features of depression and some of mania. These mixed states are very uncomfortable. People can feel depressed but irritable, restless, and unable to relax or stop worrying. They may have trouble sleeping but unlike a pure manic state, they feel fatigued and drained. These mixed states can result in people making bad decisions, alienating loved ones, losing jobs, and in general feeling terrible.
  • Bipolar II disorder includes periods of depression along with a milder form of energized mood, known as hypomania.
  • Unspecified bipolar and related disorder cannot be classified as type I or II, but is still not considered normal behavior.
  • Cyclothymic disorder is a milder type. The mood elevations and changes are much less severe and most often do not affect daily functioning.
  • Rapid-cycling is when a person has four or more episodes of mania, depression, or mixed symptoms within one year.

Proper diagnosis

Besides depression, there are other illnesses that make the detection of bipolar disorder hard. Attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are among them. Severe cases are sometimes misdiagnosed as schizophrenia. Other social phobias and anxiety disorders often co-exist with it. Drug and alcohol use disorders can further complicate the diagnosis. Some medical illnesses such as thyroid disorders can mimic bipolar disorder.

A physical exam and lab tests are needed to rule out other possible illnesses. Next, an in-depth mental evaluation may be needed. Your doctor might send you to a psychiatrist. It’s important to give them a full list of symptoms and any family history of mental illness. It is a good idea to bring a loved one with you who can also give key information. Keeping a life chart of daily moods, sleep patterns, and life events can be helpful to keep track of symptoms. Your chart is key in helping you and your doctor correctly diagnose symptoms and provide the right treatment.

Resources

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance 
www.dbsalliance.org/

Mood Disorder Questionnaire
www.dbsalliance.org/MDQ

National Institute of Mental Health/Bipolar Disorder
www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Suicide Prevention Lifeline
Call the toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) to talk with a trained counselor.

By Kevin Rizzo
Source: National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; Depression and Bipolar Support Alliance, www.dbsalliance.org/site/PageServer?pagename=home; National Library of Medicine National Institute of Health, www.nlm.nih.gov/medlineplus/ency/article/000926.htm; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

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