Signs & Symptoms of Bipolar Disease

According to the Mayo Clinic, it is possible that as much as six percent of the population has some form of bipolar disorder. Bipolar disorder is characterized by mood shifts between two states: mania and depression. The mood shifts can be severe and disrupt normal daily life. In some cases, patients may shift between the manic and depressed states with no break in between. In others, the patient may experience periods of relative normalcy before cycling back to one extreme or another. Bipolar patients may also experience something called mixed states, where they experience symptoms of both mania and depression at once. There is also a condition, called hypomania, where the patient experiences a mania significantly less severe than the standard bipolar mania.

Mania

As the name suggests, mania is characterized by physical and mental hyperactivity--speaking quickly and having racing thoughts. The patient may also sleep significantly less or even stay awake for days, without fatigue. During the manic phase, bipolar patients experience exaggerated optimism and self-confidence, which can lead to grandiose delusions and an inflated sense of self-importance. This manic overconfidence often leads to poor judgment and reckless and impulsive behavior. Mania can also lead to hyper-sexual behavior. If challenged about their behavior, bipolar patients can become irritable and aggressive. In severe cases, patients experience delusions and hallucinations. Bipolar mania is not like normal excitement or giddiness. Manic behavior is extreme, and patients often appear delusional with a "god" complex. Manic episodes can last for several weeks and often have no recognizable cause.

Depression

During the depressive phase, the patient experiences prolonged sadness and feelings of guilt and worthlessness. He may also experience significant changes in appetite--either eating too much or too little. The patient may sleep more and experience lethargy and unexplained aches and pains, making it difficult to get out of bed. Patients, in the depressive stage, withdraw from social activities and no longer take pleasure in activities they used to enjoy. Patients may also experience irritability and difficulty with concentration and decision-making. There may be a marked decrease in libido and loss of interest in sex. In extreme cases, the patient may experience recurring thoughts of death and even talk about suicide and dying. Bipolar depression is different from unipolar depression because it usually accompanies or follows a manic state. Depression, in general, is more severe than a normal case of "the blues" because it disrupts normal activities, may last for several days (or weeks) and often has no recognizable cause.

Hypomania and Mixed States

Hypomania and mixed states are often difficult to recognize because the patient may exhibit relatively normal behaviors and emotions.
During the hypomanic phase the patient will be productive and goal-directed. People with hypomania appear to be lucid, charismatic, confident and extroverted people. The only "red flag" may be that the person appears a little too "on" or may exhibit behavior that is slightly more intense than what is considered normal. The only clear indicator of hypomania is usually the depression that may occur once the hypomanic phase passes.
With mixed states, the patient experiences symptoms of mania (or hypomania) and depression at the same time. Mixed states are especially dangerous because they can lead to suicide--the patient is depressed enough to consider suicide and manic enough to act on the impulse. Mixed states can also lead to panic attacks and substance abuse, as the patient self-medicates to control his symptoms.