It is common for people to have mood swings and tiredness during their daily routines. However, based on the degree and severity, it can be normal to an abnormal mood disorder. Mental illnesses are of several types, but if we have to talk about mood disorders specifically, it can be a bit tough to identify and pinpoint that a person has bipolar disorder. Symptoms usually appear in the early adults and late teens. Occasionally children can also have bipolar disorder. Women are more prone to this disorder over men.
Bipolar is a complex disorder and can be of different types based on the symptoms. The types can range from mild to severe. It is difficult to diagnose the disorder so do not overlook the warning signs. The most important signs, which imply a quirky and difficult personality associated with bipolar mood disorder, are discussed below.
What are the types of bipolar disorder?
The most characteristic sign of bipolar disorder is the dramatic and unpredictable difficulties in the person’s mood. These appear in the form of episodes of mania followed by depression. However, depending on the degree of each of these episodes, the disorder is of several types.
- Bipolar I: If you have encountered at least one episode of extreme mania, which has led to hospitalization. It can break you from reality and disrupt your quality of life.
- Bipolar II: if you have mood swings between high and low but the ups have never reached its fullest to disrupt your life. This can lead to difficulties in areas of your life.
- Rapid Cycling: if you experience four or more episodes of ups and downs in a single year.
- Mixed bipolar: if you have both mania and depression at the same time or if the swings are at a very high sequence unlike in most forms of the disorder.
- Cyclothymia: if your mood disorder is not full-blown, i.e., if you have relatively very mild symptoms.
One of the main differences between bipolar I and bipolar II is that bipolar II experiences hypomania and not mania like that in type I bipolar. The signs of manic and hypo-manic episodes:
The person in the manic and hypo-manic episodes
- feels excessively happy, elated, and excited for long stretches of time
- is extremely restless and impulsive
- has flight of thoughts and talks excessively
- has impaired judgment
- has an inflated self-esteem of his/her abilities and powers
- is easily agitated and irritable
- engages in risky behaviors such as foolish business investments, gambling, and sex.
These symptoms are not due to alcohol or drug use, or medication or any medical condition in both the maniac and hypo-maniac patients.
Each manic episode with the above signs lasts for at least one week. To be considered as a manic episode, the signs should be severe enough to disturb your activities at work and school, disturb your relationships, or require you to be hospitalized to prevent you from harming others or yourself. Few people can also have a complete detachment from reality during the manic phase.
Each hypo-manic episode with the above signs lasts for at least four continuous days. If the above symptoms are not very severe to affect your work at the office or school, then it may be considered as a hypo-manic phase. Hypomania is a less severe form of mania and does not require hospitalization. In a hypomanic state, the person is in a high-energy state but does not lose grip on reality.
Signs of depressive episode
The person in the depressive episode
- feels hopeless and sad for long stretches of time in a day
- has a significantly low or high appetite; loses or gains weight even when not dieting
- has severe fatigue and feels very weak
- either has an excessive sleep or sleep deprivation for several days
- has problems with decision making, memory, and concentration
- is preoccupied with the thoughts of death and suicidal attempts
- withdraws from family and society
- has a slowed down speech
- is not interested in activities which were once very joyful
These symptoms are not due to alcohol or drug use, medications or medical condition, nor due to the grief of losing someone.
If at least 5 of the above symptoms are shown by a person for more than 2 weeks, it implies a change in functioning and mood. To be considered as a depressive episode, these symptoms should severely affect your daily work in school or office, relations.
When to see the doctor?
Bipolar disorder does not get well by itself. So you should consult a doctor as soon as possible if you notice the symptoms of mania and depression. Otherwise, it can lead to complications such as self-injury or self-harm, harm to others, etc. to cope up with the overpowering negative emotions. This is not done as a single attempt, but it can usually be a repetitive act.
Suicidal thoughts and attempts are the biggest risk in nearly 10-15% people with bipolar disorder. If your suicidal thoughts are growing stronger and you are almost on the verge of making an attempt, then you need an emergency medical help. Make sure that someone stays with you always in such situations. You may contact a friend or a family member to make an appointment with the doctor.
How is the diagnosis made?
Diagnosis of bipolar disorder is not possible unless the stage has reached to a severe mania. When your doctor suspects that you have bipolar disorder, he/she adopts a different approach to diagnose and confirm your condition.
- A physical examination is performed to eliminate the other related conditions with similar symptoms such as a thyroid test.
- A questionnaire to evaluate your mental status, which may be answered by you or your caretaker.
- A diary to chart your sleep patterns and changes in your moods.
- Comparison of your symptoms with the symptoms provided by the DSM-5 criteria for a mood disorder.
Don’t feel reluctant to seek medical attention. You may initially enjoy the stage of euphoria but do not forget that this will be followed by the depressive stage. If you think that you or your friend or a family member might be having the disorder, then learn the symptoms more precisely and consult your doctor for treatment and management of the condition.
- Miller C and Bauer MS. Excess mortality in bipolar disorders. Curr Psychiatry Rep.Nov 2014; 16(11): 499.
- Latalova K. Suicide in bipolar disorder: a review. Psychiatr Danub.2014 Jun; 26(2): 108-14.