How to Understand When Your Symptoms Could Be Signs of Bipolar Disorder

Mood swings are part of life. But when are they signs of bipolar disorder? After all, everybody experiences emotional ups and downs from time to time, and that’s not necessarily a sign there’s something serious going on. For some people, though, those emotional ups and downs are more persistent, extreme, and debilitating—and they could be a sign of a mental health condition like bipolar disorder¹.

Sometimes referred to as manic-depressive disorder, bipolar disorder is a condition that causes drastic shifts in mood, energy, and activity levels. While the disorder is characterized by emotional ups and downs, symptoms can vary depending on the type of bipolar disorder someone has. Some people experience milder symptoms that don’t drastically disrupt their daily lives, while other people with the condition have more severe forms of bipolar disorder that can significantly interfere with their day-to-day functioning¹.

If you’re experiencing signs of bipolar disorder, it’s important to talk to a medical provider who can diagnose and treat the condition and educate you about the disorder. Bipolar disorder can be complicated to treat, but luckily, there are several effective treatment options. When you find the right ones for you, it’s possible to live a healthy, full life.

What is bipolar disorder? | Types of bipolar disorder | Signs and symptoms | Depression | Mania | Mixed | Treatment

Bipolar disorder is a mental condition characterized by dramatic mood swings including emotional lows (called depressive episodes) and emotional highs (manic or hypomanic episodes), according to the Mayo Clinic². While bipolar disorder, by definition, includes depression, the disorder is distinct from clinical depression because it involves another component. “The difference between major depressive disorder and bipolar disorder is mainly the fact that bipolar patients can get elevated,” Po Wang, M.D., director of the Stanford Bipolar Disorders Clinic, tells SELF. This “elevation” isn’t referring to simply coming out of a depressive episode—it means having an unusually high level of mood and energy.

Bipolar disorder may be partially caused by genetics, but certain environmental factors, such as stress, might contribute to its onset⁴. People generally have bipolar disorder symptoms in early adulthood, between 18-20 years of age, though some studies suggest bipolar disorder’s onset usually occurs later (older than age 25). Dr. Wang says people often start experiencing extreme changes in mood when they’re young and then develop distinct episodes of depression and mania or hypomania during adolescence or their early 20s. In some cases, children can experience symptoms of bipolar disorder¹.

Bipolar disorder, in general, causes emotional ups and downs, but it can manifest in different ways depending on the type of bipolar disorder someone has. Here are the four types of bipolar disorder:

According to Paula Zimbrean, M.D., associate professor of psychiatry at Yale University School of Medicine, bipolar I is the most severe type of bipolar disorder. It includes more intense symptoms that last longer. To be diagnosed with bipolar I disorder, you must have at least one episode of mania that lasts for at least one week or leads to a psychiatric hospitalization⁵.

Bipolar I disorder usually involves recurring episodes; 50% of patients with the disorder end up developing a second episode within two years of the first one⁴.

Bipolar II, says Dr. Wang, involves less severe depressive and manic episodes than bipolar I, although some people experience severe depression and hypomania, a milder form of mania.

To be diagnosed with bipolar II, Dr. Zimbrean says someone has to have at least one episode of hypomania lasting at least four days and one major depressive episode.

Bipolar II is milder than bipolar I, but you shouldn’t confuse it as a form of bipolar I disorder because it’s a separate medical diagnosis². It’s also just as important to treat. People with bipolar II may not experience extreme mania or do anything super risky, but they can be depressed for longer periods of time, which may interfere with their ability to function in daily life.

Cyclothymic disorder is another condition on the bipolar spectrum. However, people with cyclothymic disorder don’t have full-blown mania or depression, so they can’t be diagnosed with bipolar disorder⁷. “Their mood is basically constantly fluctuating between mild depression and periods of elevated mood, but it’s not severe enough to be incapacitating or recognized as very abnormal,” Francis Mondimore, M.D., director of the Johns Hopkins Mood Disorders Clinic and associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, tells SELF. “When it is diagnosed, these mood fluctuations are very treatable and often very responsive to treatments with medication.”

Sometimes, a person can exhibit symptoms of bipolar disorder but don’t meet the criteria for having bipolar disorder. For example, Dr. Wang says illicit drug use can complicate bipolar symptoms, making it difficult to tell if depression and mania stem from the drug use, from the person’s genetics, or both.

Because there’s not just one type of bipolar disorder, people’s symptoms and the severity of those symptoms can be different. That said, all types of bipolar include episodes of mania or hypomania and depression, potentially resulting in distress and difficulty functioning in everyday life². Mood episodes can vary in duration, but symptoms usually last every day for most of the day, for as long as several days or weeks.

It’s also important to note that a person’s bipolar disorder signs and symptoms can change over time. For example, bipolar symptoms can occur only in pregnancy or change when the seasons change². And some people may also experience anxiety in addition to their mood episodes.

Here are some of the most common symptoms of depressive, manic, and mixed bipolar episodes that can occur with bipolar disorder.

One of the primary features of bipolar disorder is periods of depression. Depressive episodes in bipolar disorder can look a lot like major depressive disorder⁷, which includes symptoms such as:

• Persistent sadness
• Hopelessness
• Pessimism
• Irritability
• Loss of interest in activities
• Loss of energy
• Trouble concentrating
• Memory issues
• Changes in appetite
• Changes in sleep habits
• Suicidal thoughts

A few key things to know about some of these symptoms: While other types of depression can cause people to eat and sleep less, Dr. Wang says bipolar depression usually causes increased appetite, increased sleep, and weight gain. And, to emphasize, for some people, Dr. Mondimore says, depression associated with bipolar disorder can result in suicidal feelings. Severe depression can also lead to psychosis. All of these are examples of why bipolar disorder is so important to diagnose and treat.

According to the Mayo Clinic², manic and hypomanic episodes are periods of mood elevation that usually manifest in:

• Needing less sleep
• Feeling irritable
• Being overly confident
• Risky behavior such as illicit drug use, spending a lot of money, or going on spontaneous trips.
• Feeling uncharacteristically upbeat
• Jumpiness
• Feeling euphoric
• Excessive energy
• Talking more than normal or talking faster than normal

Mania can cause people to act out of character; for example, they could normally be shy and suddenly become outgoing during a manic episode. Often, people don’t recognize the harmful effects of their out-of-character behaviors.

Dr. Mondimore says mania can also cause racing thoughts and an increased energy level. “If it gets to its most severe form, people can have distortions of thinking we call delusions, and they can also have hallucinations,” he says.

What does a bipolar mixed episode feel like?

Mixed mood episodes include symptoms of both depression and mania. For example, you might feel depressed and also have periods where you’re jumpy or speak rapidly⁵. Or, you may feel sad and hopeless and have a lot of energy.

Usually, Dr. Wang says, people experience mixed episodes later in the course of their illness, between ages 30 and 50. Mixed episodes are also linked with illicit substance use.

What are the signs of bipolar disorder in teens and children?

Generally, people are diagnosed with bipolar disorder as teens or adults, but children can also develop symptoms. Teens and children with bipolar disorder can have manic, depressive, or mixed episodes, and the symptoms in adults and adolescents are very similar. However, it can be hard to tell whether your child has bipolar disorder or another condition affecting younger people, like an anxiety disorder or attention-deficit/hyperactivity disorder, because they have some common symptoms, according to the National Institute of Mental Health⁹. Bipolar disorder can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional. If you think your kid might have bipolar disorder, it’s a good idea to talk to a trained child psychologist who is familiar with the subtleties of these mental health conditions and can accurately diagnose your loved one.

How to get treatment for bipolar disorder

If you think you may have bipolar disorder, you may feel overwhelmed. It can be difficult to reach out for help, and even if you know you need help, it’s hard to know where to start.

Recognizing your signs and symptoms is the first step toward feeling more like yourself. The important thing, Dr. Mondimore says, is to find a health care provider you trust for diagnosis and treatment and, just as importantly, to learn about the symptoms you’re experiencing. Some studies show that people with bipolar disorder who learn about and understand their condition have fewer relapses and ultimately, enjoy a better quality of life⁸. “Understanding one’s illness can help people recover from it,” says Dr. Mondimore. If you don’t already have a therapist, you can talk to your doctor about the best way to find a specialist who is experienced with bipolar disorder. Or, you can reach out to an organization like the National Alliance on Mental Illness, which offers guidance on how you can find help through email, an instant chat, or hotline.

Although bipolar disorder is considered a lifelong condition, finding the right treatment can help you feel more in control of your life. According to Dr. Wang, bipolar disorder treatment is most effective when it includes a combination of medication—sometimes, more than one kind—and psychotherapy. If those aren’t enough to help manage bipolar disorder, other treatments can help to reduce the severity of certain symptoms.

If you’re in crisis or you’re experiencing thoughts of suicide, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day and 7 days a week.

Sources:

1. National Institute of Mental Health, Bipolar Disorder Definition
2. Mayo Clinic, Bipolar Disorder
3. Stanford, Po Wang, M.D.
4. StatPearls, Bipolar Affective Disorder
5. National Institute of Mental Health, Bipolar Disorder
6. StatPearls, Cyclothymic Disorder
7. National Institute of Mental Health, Depression
8. Psychological Medicine, Psychoeducation for Bipolar Disorder and Risk of Recurrence and Hospitalization
9. National Institute of Mental Health, Bipolar Disorder In Children and Teens

Related:

• What the Pandemic Taught Me About Managing My Bipolar Disorder
• 5 Things That Can Help When You Feel Irritable and Depressed
• 7 Tips for Managing Depression and Relationships