Most people experience mood fluctuations from feeling "down" to feeling "charged." Bipolar disorder is a mood disorder associated with cycles of depressive and manic episodes. Bipolar disorder is distinctly characterized by extreme and often impairing mood swings and is classified in types based on frequency and length of cycles. Specific behaviors profoundly impact a person's daily functioning. In many cases, legal, financial or employment ramifications are a result of these behaviors.
Mania Signs and Symptoms
A manic episode must last at least one week, or any amount of time if hospitalization is required. Symptoms include:
•Extremely elevated mood, or expansive or irritable mood
•Decreased need for sleep (often three hours or less)
•Racing thoughts
•Flight of ideas
•Pressured or tangential speech
•Aggression; quick to react in anger often based in irrational thought processes
•Delusional thoughts
•Irritability or agitation
•Inflated sense of self, or grandiosity
•Lack of sound judgment
•Excessive engagement in pleasure activities: buying sprees, sexual encounters, substance abuse, foolish business investments
•Increased drive complete tasks, or goal-directed activities
•Distraction
Depression Signs and Symptoms
A depressive episode includes five or more symptoms present during the same two-week period and are a change from previous functioning; they must include depressed mood or loss of interest. Symptoms include:
•Extreme sadness
•Recurring suicidal thoughts and behaviors
•Increased anxiety: might include panic attacks, based in exaggerated or irrational worries
•Markedly diminished interest in daily activities
•Feeling worthless or hopeless
•Guilt or shame
•Insomnia or hypersomnia almost every day for most of the day
•Significant weight loss or gain
•Fatigue or loss of energy
•Problems concentrating, marked by distraction or slowed response
•Psychomotor agitation or irritability as observed by others
•Chronic pain with unknown cause
Types of Bipolar Disorder
Several types of bipolar disorder exist. Types are determined by criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Bipolar I Disorder: characterized by one or more manic episodes or mixed episodes, may also have one or more depressive episode.
•Single Manic Episode: to determine those experiencing first manic episode
•Most Recent Episode (Hypomanic, Manic, Mixed, Depressed, Unspecified): to determine what phase an individual most recently experienced
Bipolar II Disorder: characterized by one or more depressive episodes with at least one hypomanic episode.
Cyclothymic Disorder: a chronic fluctuation in mood with impairment that includes numerous depressive and hypomanic phases.
Caution
Lay persons often confuse general mood fluctuations with a bipolar disorder diagnosis. Highs and lows of this disorder cause significant disturbance to daily functioning. Other influences such as substance abuse, hormonal changes and major life events may elicit behaviors and moods that mirror the above symptoms. Even though symptoms might be similar in these instances to those of bipolar disorder, a person could be displaying appropriate responses.
If you think you or someone you know suffers from bipolar disorder, consult a psychiatrist or therapist to determine whether criteria has been met and for medical or behavioral approaches to treatment.
References
- Mayo Clinic: Bipolar Disorder
- "Synopsis of Psychiatry: Behavioral Sciences/ClinicalPsychiatry, 8th ed.;" Kaplan, H. and Sadock, B.; 1998.
- "DSM-IV-TR, 4th edition;" APA, 2000.
