Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. The “mood swings” between mania and depression can be very quick.
Do you experience dramatic mood swings, ranging from being extremely ‘high’, to feeling very depressed, sad and hopeless. Do you move back again to the ‘high’ state, often with some periods of normal mood in between. Besides these mood changes, there can also be severe changes in energy and behaviour.
In most people with bipolar disorder, there is no clear cause for the manic or depressive episodes.
The following may trigger a manic episode in people with bipolar disorder:
- Life changes such as childbirth
- Medications such as antidepressants or steroids
- Periods of sleeplessness
- Recreational drug use
The periods of highs and lows are called episodes of mania and depression, which have very different and recognizable symptoms:
Symptoms of mania in Bipolar Disorder
Signs and symptoms of mania and/or a manic episode can include:
- An increased level of energy and activity, often restlessness
- Excessively ‘high’, overly good and euphoric mood
- Extreme irritability
- ‘Racing’ thoughts, talking very fast, moving from one idea to the other
- Difficulties in concentrating, easily distracted
- Reduced need for sleep
- Unrealistic beliefs in own abilities and powers
- Poor judgement
- Periods of spending large amounts of money
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol and sleeping medications
- Provocative, intrusive or aggressive behaviour
- Patients deny that something is wrong
Symptoms of depression in Bipolar Disorder
Signs and symptoms of depression (or a depressive episode) can include:
- Lasting sad, anxious or empty mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in activities once enjoyed, including sex
- Decreased energy, a feeling of fatigue or being ‘slowed down’
- Difficulties in concentrating, remembering things or in making decisions
- Restlessness or irritability
- Sleeping to much, or not able to sleep
- Changes in appetite and weight loss or gain
- Chronic pain or other symptoms that are not caused by physical illness or injury
- Thoughts of death or suicide, or suicide attempts
What is hypomania?
Hypomania means that the level of mania is mild to moderate. People with hypomania often feel good and may be associated by them with better functioning and productivity. As a result, even when the family recognises the symptoms of bipolar disorder, the person may deny that anything is wrong. However, without proper treatment, hypomania can become severe mania, or can turn into depression.
Psychosis can be a symptom of bipolar disorder
Severe episodes of mania or depression can include the symptoms of psychosis. People may have hallucinations: they hear or see or sense the presence of certain things that are not actually there. Another symptom is delusions: patients have false but strong beliefs that can not logically be explained.
The type of psychotic symptoms reflects the mood of the patients. During a manic episode, they may believe to be a person with special powers or wealth. During depressive episodes, they can believe to be worthless, or to be ruined or to be guilty of some crime.
It is important to note that people with bipolar disorder suffering psychosis are often incorrectly diagnosed as suffering schizophrenia, another severe mental illness.
Obviously, when patients suffer psychotic symptoms, urgent intervention of a doctor is required.
Bipolar disorder: mixed bipolar state
Sometimes, the symptoms of depression and mania may happen together. This is called a mixed bipolar state.
Patients often are agitated, have troubles in sleeping, sometimes even suffer psychosis or have suicidal thoughts. They may the one hand feel sad but at the same time feeling very energetic.
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