Bipolar disorder is a mental illness marked by extreme mood swings from highs to lows and vice versa. Each of these extreme episodes can last hours, days, weeks, or months. The mood swings may even become mixed, so you might feel elated and depressed at the same time. Bipolar disorder can be hard to diagnose, but there are warning signs you can look for. Keep reading to learn more.
Although there are four recognized types of bipolar disorder, there are two types that are most commonly diagnosed:
This is the classic form of the illness. Bipolar I leaves no doubt as to whether someone is in a manic (extreme elation) phase, as their behavior quickly escalates until they’re out of control. The person could end up in the emergency room or worse if left untreated. To qualify as having bipolar I, a person must have manic or mixed episodes that last at least 7 days, or manic symptoms that are so extreme that the individual requires immediate hospital care.
Bipolar II is four times more common than bipolar I. It’s characterized by much less severe manic symptoms (also referred to as hypomanic symptoms). These signs are harder for people to see in themselves, and it's often up to friends or loved ones to encourage them to get help. Hypomania often becomes worse without proper treatment, and the person can become severely manic or depressed.
According to the National Institute of Mental Health and other psychiatric authorities, bipolar disorder may include these warning signs:
Seven Signs of Bipolar Mania
- Feeling overly happy, “high,” or elated for long stretches of time.
- Feeling easily agitated, some describe it as feeling jumpy or twitchy.
- Talking super fast, often accompanied by racing thoughts.
- Extreme restlessness or impulsivity.
- Impaired judgment.
- Unrealistic over-confidence in your abilities or powers.
- Engaging in risky behavior, such as having impulsive sex, gambling with life savings, or going on big spending sprees.
Seven Signs of Bipolar Depression
- Feeling sad or hopeless for long periods of time.
- Withdrawal from friends and family, and/or a loss of interest in activities that were once enjoyed.
- Significant loss or increase in appetite.
- Severe fatigue or lack of energy.
- Slow speech.
- Problems with memory, concentration, and decision-making.
- Thoughts or attempts of suicide, or preoccupation with death.
Bipolar disorder can be difficult to diagnose. Unless you have severe mania, in which case the signs are unmistakable, the symptoms can be hard to spot. People who have hypomania, a milder form of the manic side, may feel more energized than usual, more confident and full of ideas, and able to get by on less sleep — hardly anyone complains about that. You're more likely to seek help if you're suffering from depression, but then your doctor may not have opportunity to observe the manic side.
When doctors do suspect bipolar disorder, they may use a few different approaches to make the diagnosis:
- physical exam to rule out any other medical conditions that could cause symptoms, such as thyroid disease
- mental health evaluation, which may include a questionnaire and interviews with family members
- a mood charting diary to keep track of your sleep patterns and daily moods
- using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to compare your symptoms with the official criteria for bipolar disorder
If you're worried that you might have bipolar disorder, the best thing to do is educate yourself about the different types of mood disorders and their symptoms and then consult your doctor.
It can be harder to address if you’re concerned about a friend or loved one having bipolar disorder. Enlist the help of other friends or family members. People with bipolar disorder often tend to deny any problems, especially during manic episodes. Think of bipolar disorder as you would any other serious disease, and get professional help right away.
Once you have a diagnosis your doctor will decide on a treatment program that works best for you. Bipolar treatment may include:
- substance abuse treatment
- electroconvulsive therapy (ECT)
Treatment is usually managed by a licensed psychiatrist, but you may also have a social worker, psychologist, or psychiatric nurse involved in the treatment process.
Treatment for bipolar must be ongoing. When people stop taking their medication or meeting with their doctor, they will likely experience manic and depressive episodes again. However, with the proper treatment, bipolar disorder can be controlled and a person can go on to lead a healthy and productive life.