More than just mood swings, bipolar disorder symptoms range from elation or irritability to sadness and hopelessness, and back again. The periods of highs and lows are called episodes, with each rotation from one extreme to the other called a cycle.
Cycles can be widely spaced, with long episodes of depression followed by long episodes of mania. Or each cycle can be very short. Cycles can include long or short periods of wellness in which no symptoms are experienced.
In some cases, those with bipolar disorder experience both depressive and manic symptoms at the same time in what is called a “mixed state.”
Although many of the indicators of manic episodes appear to be pleasant, they are actually so exaggerated as to be inappropriate and leave you feeling out of control and even desperate.
What Are Mood Swings?
The mood swings of manic depression are alternating cycles of depression and mania—down and up and down and up and down and up…
In addition to typical bipolar disorder symptoms, severe episodes may be accompanied by hallucinations or delusions.
The Highs
A manic episode is indicated by an elevated mood or an irritable mood accompanied by several of the symptoms below. The medical professional who is performing the diagnosis is likely to ask many questions about your condition to determine their degree of severity.
Most of us have experienced most of these symptoms at one time or another. Someone who has manic depression, though, is likely to experience a number of these symptoms over a significant period of time, in combination, with significant intensity.
- Restlessness — high energy and activity level
- Racing thoughts and rapid talking
- Decreased need for sleep
- Euphoria
- Distractibility
- Agitation
- Grandiosity—inflated self-esteem
- Pursuit of reckless or pleasurable activities
- Increased interest in goal-oriented activities.
The Lows
A depressive episode is indicated by the occurrence of a depressed mood or a loss of interest or pleasure accompanied by many of the symptoms below. Again, these symptoms are indicative of manic depression only if they occur with some persistence and severity.
- Hopelessness or pessimism
- Guilt, worthlessness, or helplessness
- Fatigue
- Insomnia or hypersomnia (inability to stay awake)
- Decreased ability to concentrate or make decisions
- Restlessness or irritability, agitation
- Loss of appetite and weight, or weight gain
- Chronic pain not caused by physical disease
- Recurrent thoughts of death or suicide; suicide attempts.
What Is Hypomania?
Hypomania literally means “low/mild mania.” Often one of the first bipolar disorder symptoms, hypomania has all the characteristics of mania, but is usually not so problematic as to interfere with a person’s work or social life.
Because hypomania instills positive feelings, individuals often insist that they are fine when family and friends recognize the mood swings. Many bipolars often go off medication in an attempt to induce a hypomanic episode. Unfortunately this often results in severe mania or can swing into depression.
Types of Bipolar Disorder
In “classic” bipolar disorder, or bipolar I disorder, a person has long bouts of depression and long bouts of mania or mixed episodes. Suicide attempts are high, with 10 to 15 percent completed. Abuse and violent behavior is common. This is the most severe form of the disorder.
Those with bipolar II disorder experience hypomanic and depressive episodes, but never full manic or mixed episodes. Bipolar II disorder is often hard to recognize because the hypomania simply makes the individual feel happy and energetic. They often become more focused and productive.
Oftentimes, those with bipolar II disorder may overlook their episodes of hypomania and seek treatment only for their depression.
Cyclothymia produces irregular, short cycles of depression and hypomania. While the episodes are typically less severe than those of either bipolar I or II disorder, they may still interrupt work and social life.
With bipolar disorder not otherwise specified (NOS), the person experiences some of the symptoms of bipolar disorder, but doesn’t fit into any of the standard bipolar disorder classifications or any other category of mood disorder.
What Is Bipolar Rapid Cycling?
In bipolar rapid cycling, at least four cycles are completed in a twelve-month period. While mood changes with bipolar disorder typically occur gradually, with bipolar rapid cycling, however, a full cycle can be completed within days (some individuals even complete a cycle in hours).
This pattern of rapid cycling is seen in approximately 5 to 15 percent of patients with bipolar disorder and tends to develop late in the disorder.