Signs are the observable results caused by the symptoms of a disorder. The symptoms of bipolar disorder are fluctuations in mood from mania to depression. The signs of bipolar are therefore the behavioral manifestations of these moods. However, in mood disorders, such as bipolar, psychological factors such as personality influence the manifestation of a sign. Because of such factors, signs of bipolar vary greatly and are not applicable to every person. Common signs of bipolar, however, have been identified by the American Psychological Association through decades of extensive research.
Signs of a Manic Episode
Signs of a manic episode include excessive energy and a decreased need for sleep. During a manic episode a person just keeps going for days with little or no sleep. Constant physical agitation can be seen in persistent body movements such as hand-wringing, repeatedly adjusting clothing, fidgeting with small objects, tapping fingers or toe tapping. Speech becomes excessive, rapid and overly dramatic. Impulsive behaviors such as spur-of-the-moment spending become habitual.
Signs of a Depressive Episode
Signs of depression include complaints of unexplained fatigue, social isolation and reduced sexual behavior. An individual lacks participation in their usual activities. In stark contrast to a manic episode, in depression the need for sleep becomes marked, but insomnia often prevents or interferes with getting rest. During depressed episodes individuals will often report feeling guilt or shame over the smallest errors, and frequently find it difficult to recall information.
Signs of a Mixed Episode
The primary sign of a mixed episode is rapidly altering behavior. Not everyone with bipolar experiences mixed episodes, but for those who do the signs are a result of rapid mood shifts or "mixing" of mania and depression. Behavior will change from one extreme to the other, such as talking loudly and emphatically, only to fall into a depressed mood in which the person has nothing at all to say. During mixed episodes, the patient may find herself in the middle of some impulsive act, and immediately feel a paralyzing sense of shame.
Signs of a Hypomanic Episode
Signs of a hypomanic episode are similar to those of a manic episode, but with little or no negative consequences or impairment in functioning. Energy level is higher than usual, but this often results in increased productivity, efficiency and accomplishments as compared to previous non-depressed moods. Signs of a hypomanic episodes may signal the oncoming development of a full manic episode.
Signs of Cyclothymia
Cyclothymia is an often under-discussed form of bipolar. Mood fluctuations are less extreme than in other types. The signs are similar to those in a depressive, manic or mixed episode, but with less intensity. Speech and movement become slowed or more rapid than usual. Emotional intensity fluctuates unpredictably. There is a lack of congruence with social or work environments. The person may be more or less emotional or energetic than is socially or occupationally expected.
References
- "Diagnostic and Statistical Manual of Mental Disorders"; The American Psychological Association; 2000.
- "Abnormal Psychology"; James Hansell & Lisa Damour; 2005.
- "Bipolar Disorder: A guide for Patients and Families"; Francis Mark Mondimore, M.D 2002.
