Bipolar disorder (BPD) is a condition characterized by episodes of altered mood. In Bipolar I, the predominant mood disturbances are mania, with occasional episodes of depression. Bipolar II includes hypomania--manic symptoms that don't necessarily interfere with daily activities, accompanied by depression. These symptoms can have a marked effect on the patient, and many of these symptoms are required for a definitive diagnosis. Mania is a general mood disruption that consists of elevated mood and hyperactivity that can manifest in many different ways, such as the ones detailed below.
Flight of Ideas
This is a flow of speech that can be almost continuous at times, jumping from topic to topic. Usually the changes in topic can be based on apparent connections but sometimes cannot be discerned if very rapid in severe cases.
Grandiosity
This is when an individual has inflated self-esteem, such as believing she has special power, connections and relationships. These beliefs are often accompanied by feelings of euphoria and pleasure. Interference with these ideas can result in aggressive behavior.
Pressured Speech
This is one of the hallmarks of BPD. It's marked by speech that is virtually non-stop speech, which is loud and very hard to interrupt. It can be quite disruptive and cause significant social dysfunction.
Distractibility
This is the inability of the patient to focus or maintain attention. The patient may feel that her mind is "out of control," and as a result school/work productivity tends to decline and conversation subjects may change frequently.
Involvement in Dangerous Pleasurable Activities
Patients with these symptoms typically engage in extreme shopping sprees, promiscuous sexual activities and ill-advised business investments. Personal relationships and livelihoods can be damaged, and there is the risk of transmissible disease or possibly legal consequences.
Decreased Sleep
The patient's elevated mood, coupled with grandiose ideas, can result in an increase in goal-directed activities. This is not usually stopped by late nights, and patients have been reported to stay up for days working on "projects" or "ideas."
References
- "Massachusetts General Hospital Comprehensive Clinical Psychiatry, 1st Edition;" Stern; 2008
- "Rosen's Emergency Medicine, 7th Edition;" Marx; 2009
