If you’re just moody, or if your emotional highs and lows result from a more serious mental condition, it can be difficult to find out. Here are some common signs of bipolar disorder you should know.
What is bipolar disorder?
There are many forms of bipolar disorder, a mental condition marked by severe changes in mood and fluctuations in energy, concentration, and the ability to perform everyday tasks. Individuals with bipolar I have depression combined with severely elevated mood, or what is called mania. Bipolar II is much more common and is characterized by less depressive symptoms, called hypomania.
Bipolar disorder symptoms occur in a continuum ranging from fairly mild to severe, and good or bad moods can result from temporary events or conditions rather than a mental illness, so it may be difficult to diagnose bipolar disorder. Also, it is very important to remember that only a mental health professional can diagnose a person with a psychiatric illness, but here are some signs and symptoms of bipolar disorder.
A depressed bipolar person may have the same symptoms as someone who’s experiencing depression alone. “They’ll have insomnia, tiredness, trouble concentrating, and decreased appetite,” says Mauricio Tohen, MD, professor, and chairman in the department of psychiatry and behavioral sciences at the University of New Mexico Health Sciences Center in Albuquerque.
What differentiates a bipolar diagnosis is the period of mania, or elevated mood, that follows the depression. Discussing mood fluctuations with your therapist or doctor is crucial, since treatment for depression may be different from treatment for bipolar disorder, Dr. Tohen says.
“Prescribing an antidepressant alone in a patient with bipolar depression isn’t recommended because it might send the patient into mania,” says Dr. Tohen. “It’s not as common as once thought, but it does happen.”
You get distracted easily
Concentration difficulties, a tendency to jump from task to task, or being generally unable to complete projects can be attributed to flightiness, stress, or other factors, such as an attention deficit disorder. But if you’re so distracted that you can’t get something done, and it interferes with your job or relationships, you might have signs of bipolar disorder, Dr. Murthy says.
You can’t sleep
It’s normal to have periods of insomnia on the horizon because of stress or anticipation of something exciting. But to days at a time, anyone in a manic phase of bipolar disorder may need substantially less sleep than normal (sometimes none at all)—and still feel energized, Dr. Tohen says.
“It’s not just the lack of sleep, but more importantly it’s the decreased need to sleep.” An individual can sleep for more than normal during a depressive phase. It is especially important for people with bipolar disorder to maintain a daily sleep schedule, Dr. Tohen says.
You’re unusually irritable
“This is one of the trickiest symptoms to recognize since it’s a natural reaction to frustration or unfairness,” says James Phelps, MD, director of the Mood Disorders Program at Samaritan Mental Health in Corvallis, Oregon, and co-author of Bipolar, Not So Much: Understanding Your Mood Swings and Depression.
It’s relatively common to get angry about someone cutting you off on the highway, for example. “Anger out of proportion to the situation, rising too fast, getting out of control, lasting for hours, and shifting from one person to another, would differentiate the behavior as a possible bipolar symptom,” he says.
You’re in a really, really great mood
Who wouldn’t love being in such a good mood? And why should anyone find it as a sign of mental illness? “These phases of the disorder may actually be enjoyable to the individual because they allow for increased productivity and creativity that they normally might not experience,” says Smitha Murthy, MD, a psychiatrist and assistant professor in the department of psychiatry at The University of Texas at Austin Dell Medical School in Austin, Texas.
But if the mood elevation is extreme, there is no clear reason for it, it lasts for a week or longer, or occurs in combination with other symptoms, it may be mania, one of the symptoms of bipolar disorder. In reality, mania is dangerous; it can cause people to make critical decisions that they would not otherwise make — financially, emotionally, even in their relationships.
And it may also lead to psychosis, a break from reality that can involve hallucinations and delusions. Hypomania, which is typical of bipolar II, is more subtle and can be more difficult to discern from a generally good mood because the symptoms are milder. Look for a combination of elevated mood with other bipolar symptoms, especially in a repetitive cycle that alternates with depression.
You talk—and think—fast
Many people talk fast and it is not unusual, says Dr. Phelps. “But talking so fast that others can’t keep up or understand—especially in phases with other bipolar symptoms, may be hypomania,” he adds.
In a manic state someone just can’t let anyone else get a word in. This type of rapid-fire speaking— known as pressure speech — is particularly worrying if a person normally does not speak this way. Similarly, it may be indicative of mania to racing thoughts or ideas that come so fast that others–and even you –won’t be able to keep up.
You’re extremely confident—but don’t make good decisions
High self-esteem is usually a positive thing. Excessive confidence in a person with bipolar disorder may lead to poor decision making. Bipolar patients feel grandiose while they are in a manic condition, and tend to forget about consequences. It can encourage you to take chances and engage in unusual behavior that you usually wouldn’t do, like having an affair or spending thousands of dollars on something you can’t afford.
“That’s why it’s important for someone with bipolar disorder to appoint someone—their spouse or a parent, for example—to take care of their finances when they’re manic,” says Dr. Tohen.
Drug and alcohol use
“People with bipolar disorder have a higher than average rate of a co-occurring substance or alcohol use,” says Dr. Murthy. During a manic phase, they may attempt to calm their symptoms of bipolar disorder with alcohol or drugs or use them to cheer up during a depressive period.
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