Am I Bipolar? Signs That You Have Bipolar Disorder
Bipolar disorder is a complex mental health condition characterized by fluctuations in mood, behavior, and energy levels. In order for a clinical diagnosis to be considered, an individual typically must meet a few key criteria—usually as outlined in the DSM. For both people with bipolar disorder and mental health professionals, understanding the warning signs of a manic or depressive episode can lead to timely detection, an accurate diagnosis, and proper treatment. When it comes to the various types of bipolar disorder—bipolar I disorder, bipolar II disorder, and cyclothymia—depressive and hypomanic or manic episodes are virtually always present. Read on to learn more about what characterizes these episodes so you can recognize them and seek professional support if they ever occur in yourself or a loved one.
Am I bipolar?: Definition and symptoms of bipolar disorder
Bipolar disorder is an umbrella term that encompasses the subtypes mentioned above. The symptoms for each tend to be similar but usually vary in severity from one to another. For example, bipolar I is usually characterized by manic episodes that last a week or more and may require hospitalization in some cases, whereas bipolar II is characterized by hypomanic phases—which are less severe episodes of mania—and depressive phases. Movements like World Bipolar Day aim to promote awareness of this mental illness and the available treatments.
Bipolar disorder mood episodes
The patterns of mood episodes can vary at times. In a pattern known as rapid cycling, an individual with bipolar disorder repeatedly swings between depressive, manic, or hypomanic episodes. Additionally, there are mixed episodes, in which someone with bipolar disorder experiences symptoms of both manic and depressive episodes simultaneously.
Contributing factors and mental health challenges in BD
While there is no unified theory of the cause of bipolar disorder, it is thought that genetics and alterations in brain structure and function are primary contributors. In addition to a family history of mood disorders, risk factors can include stressful events, drug misuse, and the existence of other mental health challenges, like attention-deficit/hyperactivity disorder, depression, or anxiety. Although bipolar disorder is typically a lifelong condition, through comprehensive, continuous treatment, its symptoms can be managed.
Three main subtypes of bipolar disorder
Below are descriptions of the three main subtypes of bipolar disorder—bipolar I disorder, bipolar II disorder, and cyclothymic disorder.
Bipolar I disorder
For a bipolar I diagnosis, an individual must have experienced a manic episode that lasts at least one week. Depressive episodes may be present but are less common in bipolar I. Episodes of mania are marked by elevated mood symptoms, including increased energy, decreased sleep, and racing thoughts. Psychotic symptoms (which may arise in a manic or depressive episode) are more common during manic phases.
Bipolar II disorder
Unlike in bipolar I, a major depressive episode must have occurred for bipolar II to be diagnosed. Major depressive episodes are characterized by lack of motivation, trouble engaging in everyday activities, feelings of hopelessness, changes in appetite, difficulty sleeping, waking up early, and several other mental and physical symptoms. Additionally, a hypomanic episode—a less severe manic period than the manic phase associated with bipolar I—must have been present for four consecutive days.
Cyclothymia
Also called cyclothymic disorder, cyclothymia is a mild subtype of bipolar disorder. With cyclothymia, shifts between hypomanic and depressive symptoms may be more frequent, but the episodes do not meet the diagnostic criteria for hypomania or depression.
Do I have bipolar? Eight common symptoms of bipolar disorder
Although it’s not uncommon for other mental health conditions to manifest simultaneously in someone who already has bipolar disorder—a term known as comorbidity—bipolar is its own unique, separate illness. Conditions like anxiety disorders, attention-deficit/hyperactivity disorder, and substance use disorder commonly co-occur with bipolar disorder. Bipolar disorder, for example, is present in an estimated 20% of people with attention-deficit/hyperactivity disorder.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
Properly distinguishing bipolar disorder symptoms from the indicators of other mental health conditions can be important, as this allows for appropriate treatment and management. For example, distinguishing between bipolar disorder and attention-deficit/hyperactivity disorder symptoms can be challenging, as both may include concerns like pressured speech, fidgeting, and irritability. That’s why getting familiar with the key signs and symptoms of bipolar disorders in general—that is, what characterizes manic and depressive episodes—can be helpful. This may be especially important for an individual with several risk factors (or their family members, who may be in a position to identify symptoms). See below for four key symptoms of each type of episode.
Symptoms of bipolar disorder manic episode
A manic episode in bipolar disorder is a period in which an individual experiences a greatly heightened mood, usually along with other symptoms as outlined below. Manic episodes can last for a few days, a week, or longer, depending on the type of bipolar disorder a person has. Symptoms of bipolar disorder mania can include:
Increased energy from extreme mood swings
Manic episodes are perhaps most easily identifiable through the spike in energy they usually cause. This can manifest in several different ways, including simple energy changes (feeling more awake or energized), or rapid, out-of-control thoughts and behaviors not unlike those produced by an adrenaline rush.
A decreased need/desire for sleep
During manic episodes, people often feel as though they do not need as much sleep as normal. This decreased need can result in their functioning at what seems to be an optimal level after only a few hours of sleep. In severe cases, a person may stop sleeping entirely during this period.
Impulsive behavior
This type of behavior may increase during manic episodes of bipolar disorder. It’s not necessarily always problematic, but it does have the potential to lead to dangerous or high-consequence decisions like engaging in reckless spending, risky sexual behaviors, criminal activity, and more.
Racing thoughts, heart rate, and speech patterns
During manic episodes, people with bipolar disorder may feel as though their thoughts are moving incredibly quickly and are difficult to stop or sort through. An individual’s heart rate might be similarly elevated, a combination that can lead to unusual speech patterns as well—such as speaking extremely quickly, jumping from topic to topic, or no longer making sense.
Symptoms that can indicate a depressive episode
A bipolar disorder depressive episode is essentially the opposite of a manic episode. It’s generally characterized by a prolonged period of sadness, disinterest, and/or low energy. Depressive episodes often last longer than manic episodes—typically between one and three weeks, though in cyclothymic disorder and bipolar II disorder, they can last even longer. Common symptoms include:
Loss of interest in activities once enjoyed
Depression—both major depressive disorder and depressive episodes in bipolar disorder—can often be recognized by the symptom of apathy, which can manifest as a loss of interest in activities previously enjoyed. This loss of interest can also translate to everyday tasks, potentially making even things like getting out of bed and preparing food difficult.
Insomnia and/or loss of energy (but not a decreased need for sleep)
A depressive episode can result in an increased need for sleep, but a decreased ability to sleep. This can lead to a significant loss of energy and an even more depressed mood.
Feelings of guilt
People a depressive episode might experience intense and overwhelming feelings of guilt or low self-worth, which can be further compounded by the presence of other bipolar disorder symptoms that make daily functioning difficult. This could also lead to a tendency toward social isolation, which may compound symptoms even further.
Extreme sadness
The depressive episodes of bipolar disorder can result in feelings of extreme sadness, numbness, and overwhelm. Each of these can, in turn, intensify the other symptoms of the disorder. The extreme nature of some depressive episodes can lead to an individual experiencing despair, feeling pessimistic about the future, or struggling to care for themselves.
Learning how to recognize and then manage these core symptoms is usually a key part of bipolar disorder treatment. This process may take time since the right treatment methods can vary somewhat from person to person, but it is entirely possible for an individual with bipolar disorder to live a stable, fulfilling, autonomous life.
Potential treatment and support options
Treatment for bipolar disorder typically involves a combination of medication and psychotherapy.
Therapy can help participants identify the sources of bipolar symptoms, develop useful coping skills, and address potential comorbid conditions (e.g., attention-deficit/hyperactivity disorder). Cognitive behavioral therapy, interpersonal and social rhythm therapy, and other talk therapy options may help an individual learn to manage symptoms. In many cases, medications like antidepressants, mood stabilizers, and antipsychotics can also help lessen the frequency and severity of symptoms.
Mental health services with professionals
Certain lifestyle changes—such as eating a balanced diet, exercising regularly, getting sufficient sleep, and writing in a mood journal—can also help people with bipolar disorder improve symptoms of manic or depressive episodes. While you generally cannot prevent bipolar disorder, utilizing mental health services early can lead to positive treatment outcomes. Reaching out to a qualified healthcare professional for evaluation is typically the first step if you feel you may be experiencing symptoms of a mental illness like bipolar disorder.
Online therapy
If you’ve been advised by a doctor or psychiatrist to seek therapy to help manage symptoms of bipolar disorder, you can usually choose between in-person and online sessions. For those who find traveling to and from in-person appointments to be inconvenient, difficult, or impossible, online therapy is another option to consider. Research suggests that online therapy can be effective in helping those with bipolar disorder manage their symptoms, so this format may be worth considering if it’s more convenient for you. With a platform like BetterHelp, you can meet with a licensed therapist via phone, video call, and/or in-app messaging from the comfort of home, if you prefer these to the in-office session format.
Takeaway
At what age does BD start?
Symptoms most often begin to manifest in a person’s late teens or early 20s. These signs can sometimes be mistaken for a major depressive episode or particularly intense mood swings, especially in teens, but the development of cyclical patterns can often tip professionals off to a diagnosis.
Undiagnosed people may appear to experience severe mood swings quickly and without warning (a sign of a cycle type called rapid cycling). These mood swings may include intense depressive symptoms up to and including suicidal ideation or intense manic symptoms including hallucinations and delusions.
What triggers this condition?
Although it is thought that bipolar disorder does have some genetic contributing factors, life events such as trauma or substance abuse disorders can sometimes trigger the onset of the condition.
A person with BD may appear to have extreme mood swings, often moving from extreme mania to extreme depression within the span of a few days or even a few hours during rapid cycling. They may exhibit symptoms such as restlessness, delusions, and reckless behavior while in a manic episode and extreme fatigue, listlessness, and self-criticism during a depressive episode.
Could you have bipolar disorder that is mild?
In some people, the BD mood swings can include more subtle symptoms and be harder to detect, though this does not make their condition any less impactful on their life and they should still seek treatment.
There does not appear to be a significant statistical difference between the onset ages of the disorder for men and women. The typical onset age for BD for both men and women is in the late teens and early twenties.
Symptoms can increase in severity with age, though appropriate management can help those living with this and related disorders maintain their lifestyle and personal health over time.
People with BD symptoms may be misdiagnosed with anxiety disorders, major depression, or another mental health condition that doesn’t appropriately cover both sides of the mood cycle, which can make it difficult for them to receive the help they need.
Bipolar episodes can be triggered by strong emotional stimuli, stress, hormonal changes, and trauma, among other things. For example, a manic or hypomanic episode may be triggered by severe stress, which can lead to extended periods of sleeplessness, which can in turn worsen symptoms.
It’s important to note first that “high-functioning” bipolar disorder is not a categorization recognized by the DSM-V. BD is broken into three subcategories: Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder.
Those with Bipolar I Disorder typically experience a manic episode or hypomanic episode (hypomanic episodes tend to be less severe than a typical manic episode) more often than they experience the depression symptoms of the condition. Those with Bipolar II Disorder experience the prototypical extreme mood swings and cycles of manic and depressive episodes regularly (this form of BD was once called manic depression, though manic depression is no longer considered the correct name of the condition).
Those with Cyclothymic Disorder are typically considered to have a milder form of the condition than those with Bipolar I or II. This is because the mood swings are not as intense as they are in the other two forms of the disorder. This being said, the cycles are still constant and life-affecting. Cyclothymic Disorder may be called “high-functioning” BD, though this moniker is not necessarily accurate, as anyone with any type of BD can live a full, functional, and independent life with appropriate treatment.
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