What is Bipolar Disorder?
Bipolar disorder is a mood disorder where individuals experience episodes of elevated mood states (manic or hypomanic), typically alternating with episodes of depression. Many people who are bipolar also experience elevated and low moods at the same time or in rapid sequence which is a mixed episode.
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| Click to enlarge chart showing High and Low Symptoms of Bipolar Disorder. |
Types of Bipolar Disorder
Bipolar I disorder
- Also known as manic depression, bipolar I disorder is diagnosed when a person has had at least one episode of extreme mania or mixed mania (symptoms of both mania and depression occur on the same day, and this pattern lasts at least a week), and one or more episodes of major depression.
- The manic symptoms of bipolar I disorder can be so severe that hospitalization may be required.
- People with bipolar II disorder typically experience a milder form of mania, called hypomania.
- Symptoms of hypomania are not as extreme as those of full-fledged mania.
- People with hypomania may feel very energetic and productive but not realize they are acting abnormally, even if others notice a difference.
- In bipolar II disorder, most people only recognize and complain about depression.
- Also called cyclothymia, this is a milder form of bipolar disorder, in which a person has numerous episodes of hypomania and mild depression during at least a two-year period.
- Some people have bipolar symptoms that don't meet the criteria for bipolar I or bipolar II disorder.
- While their behavior may be abnormal, they experience only a few of the typical bipolar symptoms, or their symptoms may not last as long.
- In such a case, the bipolar disorder diagnosis is BP-NOS.
Symptoms Of Bipolar Disorder
Manic Episode
People with mania commonly experience an increase in energy and a decreased need for sleep, with many people often getting as little as three or four hours of sleep per night. Some people can even go days or weeks without sleep. Attention span is usually very low, and a person in a manic state may be easily distracted. This is something that can have a real negative impact on a person’s employment. Judgment may be impaired, and sufferers may go on spending sprees or engage in risky behavior that is not normal for them. They may also indulge in alcohol or drug abuse. Their behavior may become aggressive, intolerant, or intrusive. They may feel out of control or unstoppable, or as if they have been "chosen" and are "on a special mission", or have other grandiose or delusional ideas. Many people also experience hypersexuality and watch a lot of pornography as well as seek out and engage in risky sexual behavior.
Hypomanic Episodes
Hypomania is a less severe level of elevated mood, characterized by increased energy, optimism, pressure of speech and activity, and decreased need for sleep. Hypomania does not usually inhibit functioning as mania does. Many people with hypomania are sometimes more productive than a person who is manic. Manic individuals have difficulty completing tasks due to having low attention spans. Many people that are hypomanic can demonstrate increased creativity while others demonstrate poor judgment. Hypersexuality is very common with people who are hypomanic.
Hypomania can feel great to the person who’s experiencing it. The level of creativity, energy, and optimism can feel wonderful. However, when family and friends recognize mood swings, the individual often will deny that anything is wrong. Being hypomanic if not accompanied by depressive episodes is often not seen as a problem, unless the mood changes are uncontrollable. A hypomatic episode usually lasts anywhere from a few weeks to a few months.
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| Click to enlarge. |
Depressive Episode
Symptoms of a depressive state for a person who has bipolar disorder include persistent feelings of hopelessness,anxiety,guilt,anger,isolation,social anxiety, slowed speech, muscle weakness, extreme fatigue, and loss of interest in activities that were once enjoyable. A person in a depressive state will also be lonely, lack motivation, have problems with concentration, have chronic pain, and have even have suicidal thoughts. A depressive episode can last for at least two weeks, and may continue for over six months
Mixed Episodes
In most forms of bipolar disorder, moods alternate between mania and depression over time. A person with mixed episodes experiences both mood "poles", mania and depression simultaneously or in rapid sequence. Mixed episodes of bipolar disorder are defined by symptoms of mania and depression that occur at the same time, or in rapid sequence. Typical examples of mixed episodes include feeling worthless during a manic episode or increased sexual thoughts during a depressive episode. Individuals experiencing mixed states may feel a lot of frustration that raises the risk of alcohol abuse, substance abuse, and suicide attempts making mixed states the most dangerous period of mood disorders.
To diagnose a mixed episode it must meet the diagnostic criteria for both a manic episode and major depressive episode nearly every day for at least a full week. Like most mental disorders, a mixed episode must be severe enough to cause distress or impairment in social, occupational, education or other important functioning and is not better accounted for by the physiological effects of substance use or abuse or a general. Mixed episodes are most associate with bipolar1.
Rapid-Cycling
A person who has four or more episodes of major depression, mania, hypomania, or mixed mania within a one-year period is considered to have rapid-cycling bipolar disorder. People with rapid-cycling bipolar disorder can feel on top of the world one day and then fall into a deep depression the next. Their moods can change so quickly that they may experience happiness and despair within a few hours. Many people with rapid-cycling bipolar disorder report that they feel as if they're on an emotional roller coaster. Rapid cycling can occur with any type of bipolar disorder, but it's more common in bipolar II.
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