Bipolar 1 disorder, also known as manic depressive illness, is a condition that causes extreme shifts in mood, activity level and functioning. To be diagnosed with bipolar 1 disorder, a person must have met the criteria for at least one major depressive episode and one manic episode. The symptoms of depression and mania characteristic of bipolar 1 disorder are far more extreme than the mood changes that everyone experiences from time to time.
Mood Changes in a Manic Episode
Two noticeable and extreme mood changes are characteristic of a manic episode. One is an abnormally and persistently elevated and expansive mood with increased feelings of euphoria and optimism that lasts at least one week. The other is a prolonged period (at least one week) of severe irritation or agitation. Elevated mood and increased irritability also can be signs of mania.
Behavior Changes in a Manic Episode
When a person experiences a manic episode, he displays behaviors that appear extreme or excessive to others, though he may not have the insight at the time to recognize his behaviors as such. During a manic episode, a person may exhibit an overstated self-esteem or grandiosity. He may need very little sleep or feel rested after only a few hours of sleep. He may also tend to talk fast, feel pressure to keep talking, experience "racing thoughts" or jump from one idea to another quickly. He may show a tendency to be easily distracted or have his attention drawn too easily to stimuli that are not important. Additional behavior changes he may exhibit include an increase in goal-directed activity or physical activity and engaging in uncontrolled behaviors that are risky and/or dangerous, such as impulsive sex, excessive gambling or spending sprees, foolish business investments or hazardous use of drugs or alcohol.
Mood Changes in a Depressive Episode
In contrast to mania, depression is characterized by a general slowing. When a person enters a depressive episode, she may experience a period of feeling empty, sad, hopeless or worried for at least two weeks. She may also lose pleasure in activities she formerly enjoyed and have no interest or energy to perform the activities.
Behavior Changes in a Depressive Episode
A person in a depressive episode tends to isolate and pull away from his family and friends. Other behavior changes will be apparent as well, such as a depressed mood most of the day, nearly every day, to include tearfulness or feeling sad and empty. He may have little to no interest in the activities he used to enjoy and indecision or difficulty thinking or concentrating may plague him. Similarly, he may notice he is more easily fatigued or have less energy than usual. He may also sleep more than usual or have difficulty sleeping. He may lose or gain a significant amount of weight in a relatively short period of time or notice a change in appetite (increase or decrease) almost every day. He may also notice feelings of restlessness or of being slowed down as well as feelings of worthlessness, anxiety or guilt. Finally, suicidal thoughts or self-harming behaviors sometimes develop during the depressive episode.
References
- National Institute of Mental Health: What are the Symptoms of Bipolar Disorder?
- Mayo Clinic: Bipolar Disorder Symptoms
- "Diagnosic and Statistical Manual of Mental Disorders (Fourth Edition)"; American Psychiatric Association; 2000
