Bipolar is a disorder of extremes in emotional states. These atypical states are called "mood episodes." Fluctuations from depressive to manic mood episodes are the defining characteristic of bipolar disorder. In depressed mood episodes, the common characteristics are the same as those of a person with depression. In manic episodes, the common characteristics are moods of enthusiasm or euphoria. Another common characteristic is the experience of "mixed episodes," which involves rapid fluctuations between depression and mania. The effect these moods have on behavior varies greatly among individuals.
Depressive Mood Episodes
The most prevalent characteristic of a depressive episode is a feeling of extreme sadness. This mood creates a loss of interest in activities that were once important. People report a loss of enjoyment in activities and lack the energy and motivation needed to participate. Other common characteristics include appetite and sleep disturbances. Unexplained tiredness and lethargy are typically part of these episodes, as well as excessive negative self-evaluations. During a depressive mood episode, interest in sexual behavior is decreased or nonexistent. People frequently have poor concentration and decreased social activity, along with thoughts of death or self-harm.
Manic Mood Episodes
The moods that characterize a manic episode are the exact opposite of those of depression. People have a feeling of great capability and hopefulness accompanied by an inflated sense of self-esteem. Enthusiasm is heightened and energy become limitless, with very little or no need for sleep. A manic episode brings a strong desire for social interactions. Although interest in and desire for activities and accomplishment are high, distractibility and overly optimistic assessments usually stand in the way of achieving any real goals.
Mixed Episodes
In a mixed episode, people experience rapid fluctuations between depressive and manic episodes. These fluctuations typically occur on a daily basis; moods shift from enthusiasm to extreme sadness quickly and sometimes several times in a single day. For example, the episode may bring a marked increase in social interest with organizing and planning, only to be followed by depression and complete isolation for the rest of the day.
Characteristic Behaviors
Depressive episodes primarily create social isolation and withdrawal from even one's closest friends. As the depressive mood escalates, the individual may stop eating and may sleep excessively. Complaints of unexplainable physical ailments, fatigue and discomfort are common. Typical behaviors during a manic episode include excessive work and making plans for extravagant and unrealistic projects. Speech is typically rapid and includes a dramatic presentation with exaggerated body language and facial expressions. In both mood episodes, decision-making skills are severely impaired; and unwise, unrealistic and even dangerous choices are often proposed to others.
References
- "Diagnostic and Statistical Manual of Mental Disorders;" American Psychological Association; 2000
- "Bipolar Disorder: A Guide for Patients and Families;" F.M. Mondimore, M.D.; 2002
- "Abnormal Psychology;" J. Hansell & L. Damour; 2005
