Bipolar disorder causes dramatic mood swings - from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.
Signs and symptoms of mania (or a manic episode) include: - Increased energy, activity, and restlessnes
- Excessively "high," overly good, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one idea to another
- Distractibility, can't concentrate well
- Little sleep needed
- Unrealistic beliefs in one's abilities and powers
- Poor judgment
- Spending sprees
- A lasting period of behavior that is different from usual
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
If some of these symptoms are present most of the day, nearly everyday for at least one week, a diagnosis of Manic Episode may be made.
Signs and symptoms of depression (or a depressive episode) 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 of being "slowed down" - Difficulty concentrating, remembering, making decisions - Restlessness or irritability - Sleeping too much, or can't sleep - Change in appetite and/or unintended weight loss or gain - Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury - Thoughts of death or suicide, or suicide attempts
If some of these symptoms are present most of the day, nearly everyday for at least 2 weeks, a diagnosis of a Depressive Episode may be made.
A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can become severe mania in some people or can switch into depression.
Sometimes, severe episodes of mania or depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the President or has special powers or wealth, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness.
It may be helpful to think of the various mood states in bipolar disorder as a spectrum or continuous range. At one end is severe depression, above which is moderate depression and then mild low mood, which many people call "the blues" when it is short-lived but is termed "dysthymia" when it is chronic. Then there is normal or balanced mood, above which comes hypomania (mild to moderate mania), and then severe mania.
In some people, however, symptoms of mania and depression may occur together in what is called a mixed bipolar state. Symptoms of a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. A person may have a very sad, hopeless mood while at the same time feeling extremely energized.
Bipolar disorder may appear to be a problem other than mental illness—for instance, alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships. Such problems in fact may be signs of an underlying mood disorder.
Descriptions offered by people with bipolar disorder give valuable insights into the various mood states associated with the illness:
Depression: I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless…. [I am] haunt[ed]… with the total, the desperate hopelessness of it all…. Others say, "It's only temporary, it will pass, you will get over it," but of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think or care, then what on earth is the point?
Hypomania: At first when I'm high, it's tremendous… ideas are fast… like shooting stars you follow until brighter ones appear…. All shyness disappears, the right words and gestures are suddenly there… uninteresting people, things become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria… you can do anything… but, somewhere this changes.
Mania: The fast ideas become too fast and there are far too many… overwhelming confusion replaces clarity… you stop keeping up with it—memory goes. Infectious humor ceases to amuse. Your friends become frightened…. everything is now against the grain… you are irritable, angry, frightened, uncontrollable, and trapped.
Medications for bipolar disorder are prescribed by psychiatrists. While primary care physicians who do not specialize in psychiatry also may prescribe these medications, it is recommended that people with bipolar disorder see a psychiatrist for treatment, as this can be somewhat complicated. Medications known as "mood stabilizers" usually are prescribed to help control bipolar disorder. Some of these medications include Lithium, Depakote (valproate), and Tegretol (carbamazepine).
The Bipolar Spectrum Scale Please read the following sentences and consider if they relate to you:
Some individuals notice that their mood and/or energy levels shift drastically from time to time.
These individuals notice that at times, their mood and/or energy level is very low, and at other times, very high.
During their low phases, these individuals often feel a lack of energy, a need to stay in bed or get extra sleep, and have little or no motivation to do things they need to do.
They often put on weight during these periods.
During their low phases. these individuals often feel “blue”, sad all the time, or depressed.
Sometimes, during these low phases. they feel hopeless or even suicidal. Their ability to function at work or socially is impaired.
Typically, these low phases last for a few weeks, but some times they last only a few days.
Individuals with this type of pattern may experience a period of “normal mood” in between mood swings, during which their mood and energy level feels “right” and their ability to function is not disturbed.
They may then notice a marked shift or “switch” in the way they feel.
Their energy increases above what is normal for them, and they often get many things done they would not ordinarily be able to do.
Sometimes, during those “high" periods, these individuals feel as if they have too much energy or feel "hyper".
Some individuals, during these high periods, take on too many activities at once.
During these high periods. some individuals may spend money in ways that cause them trouble.
They may be more talkative, outgoing or sexual during these periods.
Sometimes, their behavior during these high periods seems strange or annoying to others.
Sometimes, these individuals get into difficulty with co-workers or police during these high periods.
Sometimes, they increase their alcohol or nonprescription drug use during these high periods.
Now that you have read this passage. please check one of the following four boxes:
This story fits me very well, or almost perfectly.
This story fits me fairly well.
This story fits me to some degree, but not in most respects.
This story doesn't really describe me at all.
Now please go back and check the box before each sentence that definitely describes you.
Scoring: Each sentence checked is worth one point. Add 6 points for Fits me very well, 4 points for Fits me fairly well, 2 points for Fits me to some degree, and 0 for Doesn't describe me at all. If you score 13 or above, you may be suffering from Bipolar Disorder, and should seek professional medical help.
