Bipolar disorder can be difficult to identify. If you’re concerned you or a loved one is struggling with bipolar tendencies, this page outlines the warning signs, symptoms, and causes of this disorder.
What are the Signs and Symptoms of Bipolar Disorder?
Bipolar disorder, also known as manic depressive disorder or manic depression, is a psychiatric disorder that causes extreme shifts in mood, energy, activity levels, and the ability to carry out everyday tasks. A person suffering with bipolar disorder experiences two extremes with distinct signs and symptoms:
- manic episodes (excessive excitement, energy or enthusiasm)
- depressive episodes
Symptoms of bipolar disorder can be severe and disabling, and frequently contribute to worsening symptoms of addiction or eating disorders in patients with co-occurring disorders. Bipolar episodes are different from the normal swings in feelings or moods that everyone goes through from time to time.
Both mood and behavioral changes can be signs indicating someone with bipolar disorder is experiencing a manic phase or episode:
- extended periods of feeling overly happy or outgoing
- extremely irritable mood, agitation, or jumpiness
- talking very fast, jumping from one idea to another
- being easily distracted
- increasing goal-directed activities
- little to no sleep for several days in a row without feeling tired
- having an unrealistic belief in one’s abilities
- behaving impulsively
- high-risk behaviors, such as spending sprees, impulsive sex, drug or alcohol use, and impulsive business investments
- suicide attempts
When a person suffering with bipolar disorder enters a depressive phase, the signs and symptoms create a stark contrast with the preceding manic episode:
- extended periods of feeling worried or empty
- isolation from friends and family
- loss of interest in activities once enjoyed, including sex
- feeling tired or slowed down
- having problems concentrating, remembering, and making decisions
- being irritable
- change in eating, sleeping, or other habits (including anorexia nervosa, bulimia, and other eating disorders)
- abuse of alcohol and drugs, especially cocaine
- dependence on sleeping pills
- thinking of death or suicide, or attempting suicide
During particularly severe episodes of either mania or depression, a person suffering with bipolar disorder may experience psychosis. Psychosis is the term for a state of detachment from reality, which may be either temporary or prolonged. Bipolar psychosis is characterized by two types of symptoms:
- Hallucinations: experiencing visions and sounds that don’t exist
- Delusions: strong attachment to incorrect but extremely compelling beliefs
What are the Effects of Bipolar Disorder?
The effects of bipolar disorder symptoms on a person’s life can range from minor disturbances to major disruption. This depends on whether the person receives an accurate diagnosis, including identification of any co-occurring disorders. For example, there is a very high rate of substance abuse or dependence co-occurring with bipolar disorder. The effects of bipolar disorder may include:
- damaged relationships
- poor job or school performance
- legal or financial consequences from impulsive decisions
- medical side effects from prolonged abuse of drugs, alcohol or prescriptions
- repetitive self-mutilation or other self-harming behaviors
- suicide, in extreme cases
The length of the manic and depressive episodes also takes a toll on the family, friends and co-workers of those who suffer with bipolar disorder. Weeks of unpredictable behavior by a person with manic depression make it difficult to rely on the sufferer to fulfill obligations, and often times loved ones struggle to maintain a sense of security.
What is the Connection Between Bipolar Disorder and Addiction or Substance Abuse?
Bipolar depression is often complicated by attempts to self-medicate both manic and depressive phases with addictive drugs, alcohol or prescription drug abuse. When substance abuse is combined with psychotropic medications commonly used to control depressive symptoms and stabilize the individual’s moods, symptoms may become even more erratic and dangerous.
An experienced psychiatrist can manage bipolar disorder and help people with this illness to lead full and productive lives. While in many cases bipolar disorder can be treated very effectively in an outpatient setting, it can also pose a grave challenge for suffers who also have symptoms of drug addiction, alcohol abuse or eating disorders, such as anorexia or bulimia. Sufferers of bipolar depression and co-occurring disorders or addictions will face a much more challenging path to recovery, and require more aggressive and integrated treatment. It is essential for both the bipolar disorder and the substance abuse disorder to be expertly addressed.
That’s why experts in bipolar disorder and addiction psychiatry may recommend inpatient or residential treatment when a person with bipolar disorder also shows signs of addiction. This allows them to cope with the effects of their manic and depressive episodes under the constant care of medical and clinical staff experienced at treating co-occurring disorders. It also allows mood disorder and addiction treatment staff to carefully monitor symptoms and avoid confusion among symptoms of bipolar disorder, symptoms of addiction, and signs of withdrawal from alcohol, drugs or prescriptions.
How is Bipolar Disorder in Women Unique or Different from Men?
Diagnosis and treatment of bipolar disorder, particularly in women with co-occurring disorders, addiction, or an eating disorder, requires careful understanding of gender differences in how bipolar symptoms present. Key differences between men and women with bipolar disorder are:
- Greater incidence of Bipolar II disorder: women with bipolar depression are less likely than men to experience extreme manic phases, an important symptom that many treatment providers look for in order to confirm a diagnosis of bipolar disorder.
- This can lead to an inaccurate diagnosis of major depression, and result in prescription of antidepressant medications that may worsen mood instability.
- Increased likelihood of rapid cycling: some researchers believe that hormonal differences cause women to experience more frequent manic and depressive episodes than men.
What are the Types of Bipolar Disorder?
Bipolar I Disorder is mainly defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, the person also has depressive episodes, typically lasting at least two weeks. The symptoms of mania (excessive excitement) or depression must be a major change from the person’s normal state.
Bipolar II Disorder is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes (low intensity mania), but no full-blown manic or mixed episodes.
Bipolar Disorder Not Otherwise Specified (BP-NOS) is diagnosed when a person has symptoms of the illness that do not meet diagnostic criteria for either bipolar I or II. The symptoms may not last long enough, or the person may have too few symptoms, to be diagnosed with bipolar I or II. However, the symptoms are clearly out of the normal range of behavior expected for the person.
Cyclothymic Disorder, or cyclothymia, is a mild form of bipolar disorder. People who have cyclothymia have episodes of hypomania that shift back and forth with mild depression for at least two years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.
What are the Causes of Bipolar Disorder?
While bipolar disorder can occur in childhood, most bipolar disorder diagnoses are made in a person’s late teens or early adult years. At least half of all cases start before age 25. Bipolar disorder is not easy to spot when it starts. The symptoms may not appear to be connected with each other. They are often mistaken for separate problems and not recognized as parts of a larger, connected problem. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life.
Bipolar disorder is a serious medical disease that requires coordinated psychiatric support from experienced treatment professionals. Timberline Knolls Residential Treatment Center is a leader in helping women with bipolar disorder overcome eating disorders, substance abuse and drug addiction, and other co-occurring disorders. Read more about our bipolar disorder treatment program.