Formerly called “manic depression,” bipolar disorder was once misunderstood by doctors and psychologists. Now that psychology has advanced, people with bipolar can finally receive the help they deserve. Around 2.6% of Americans have this disorder.
But how do you know if you are bipolar? Although people need a professional diagnosis, they can identify some warning symptoms of it. Some people may overlook signs such as rapid heart rate and fatigue. If you want to learn the signs of bipolar disorder, read the symptoms and what to do if someone exhibits them.
In psychology, mania is a sustained period of an abnormal mood. Manias could involve irritability, anxiety, and grandiosity that could seem illogical to the average person. During manic episodes, patients may talk rapidly, move impulsively, or make poor decisions.
In extreme cases, manic episodes detach patients from reality. This psychological break, called psychosis, may require hospitalization. Most bipolar patients experience at least one manic episode in their lives. This symptom contributes to the mood swings that people recognize from bipolar people.
Hypomania, which means “under mania” in Greek, is a milder form of mania. Hypomania is a sustained period of emotion that lasts longer and feels more intense than usual, but it is not as destructive as mania. According to Harvard Health Publishing, this symptom lasts for at least four days.
Common hypomania emotions include agitation, talkativeness, over-confidence, depression, difficulty focusing, decreased need for sleep, and racing thoughts. Severe episodes may require medication to assuage. When assessing a patient, doctors may ask how long these emotions last and compare them to other symptoms.
Major Depressive Episodes
Major depressive episodes are different from mania in that they involve low energy and fatigue. Instead of feeling overly-energized, patients may feel sluggish, sad, or uninterested for long periods. These symptoms can socially isolate patients and worsen their symptoms.
It’s worth noting that major depressive episodes are different from major depressive disorder, although it’s easy to confuse the two. Most often, depressive episodes last a minimum of two weeks. Professionals need to analyze a patient’s mood episodes to make a proper diagnosis.
The Different Types Of Bipolar
Although bipolar disorder is a single disorder, it has several different stages, according to the Depression and Bipolar Support Alliance. Bipolar I patients have experienced one or more episodes of mania. Bipolar II patients have experienced more than one episode of mania and at least one episode of hypomania.
Cyclothymia is a less severe category of bipolar that lasts for at least two years. Plus, there’s rapid cycling, which cycles through at least four manic episodes throughout a year. If bipolar patients don’t fall into any of these categories, they are called Not Otherwise Specified (NOS).
Apathy Towards Activities That Were Once Fun
People with bipolar disorder may seem not to enjoy life anymore. The disorder may cause patients to have no interest in activities that they once enjoyed. According to a 2019 study in NeuroImage: Clinical, bipolar disorder changes physical circuits in the brain that may cause this symptom.
Psychologists divide this symptom into two categories: anhedonia, which is Greek for “without pleasure,” and apathy, Greek for “without emotion.” Bipolar people may feel emotionally withdrawn overall, or they may struggle to enjoy their hobbies. Both are cause for medical assistance.
Racing thoughts aren’t just thinking fast. They are a bombardment of thoughts that cannot be interrupted, no matter how hard a person tries. When people try to verbalize these thoughts, often leaping from one idea to the other, it is called flight of ideas.
In the case of bipolar disorder, racing thoughts often accompany pressured speech or flight of ideas, says psychiatrist Dr. Theodore J. Wilf. Some people experience racing thoughts every few days, while others have it daily. This symptom also arises from certain medications and major depressive disorder.
Rapid Heart Rate
Bipolar patients can experience anxiety, which affects the heart. According to the Frontiers in Neuroengineering, patients’ heart rate can increase rapidly throughout the day, depending on their mood. Heart rate variability, as its known, can help doctors diagnose mood disorders.
Some scientists believe that heart rate can distinguish between bipolar and depression. According to research in The World Journal of Biological Psychiatry, people with bipolar have a less rapid heart rate than those with depression. However, having a fast heartbeat once in a while doesn’t mean you have a mood disorder.
Insomnia Or Sleep Troubles
People with bipolar disorder may struggle to sleep. They may have an irregular schedule or simply not feel tired. In 2012, research in the Journal of Clinical Psychology concluded that “sleep disturbance is pervasive across the phases of bipolar disorder.”
Experts still don’t know whether sleep disturbance is a symptom of bipolar or the other way around. Dr. Ellen Frank, who has researched sleep and mood disorders, says that bipolar episodes are more likely to occur after poor sleep. If this sounds like you, consult a psychologist.
One of the most noticeable symptoms of bipolar is pressured speech. This is rapid, almost frantic speech that seems entirely different from a patient’s usual mood. When the patient talks, they may sound incoherent, not make sense, or burst out at inappropriate times.
Pressured speech doesn’t just appear in bipolar disorder. It can also indicate ADHD or anxiety, says the Anxiety and Depression Association of America. Plus, patients may not notice that they have the symptom until others bring it up.
Some people with bipolar disorder occasionally feel larger than life. They believe that they can accomplish anything beyond reason. Psychologists call this symptom overconfidence or grandiosity, and it occurs during mood swings indicative of bipolar.
Why does this happen? According to Pakistani researchers, manic episodes create a series of chemical changes in the brain. These chemicals influence mood and may cloud peoples’ judgment. It’s worth noting that bipolar patients don’t feel overconfident or selfish all the time; it comes in waves. This symptom can easily be confused with narcissistic personality disorder.
Despite struggling to sleep, people with bipolar may frequently feel agitated. According to the Depression and Bipolar Support Alliance, agitation feels like a strong urge to move and act. Patients may wring their hands, pull their hair, pace, shuffle their feet, or clench their fists.
The constant restlessness may prevent patients from concentrating or interacting with others. When people make movements without meaning to, it is called psychomotor agitation. The Psychiatric Clinics of North America explains that this symptom arises from many mood disorders.
According to Neurology, around 42% of bipolar patients struggle to get out of bed in the morning. This is part of a common bipolar symptom: fatigue. Psychology Times states that people with mood disorders have longer sleep inertia, which is the time it takes for the brain to wake up. The result is more grogginess and lethargy than the average person.
Depressive episodes and a lack of sleep can also contribute to fatigue. However, lethargy could also result from certain medications, vitamin deficits, and other mood disorders.
According to WebMD, around 20% of patients who complain about depression symptoms actually have bipolar disorder. Bipolar patients experience prolonged bouts of hopelessness that can last weeks. The Journal of Affective Disorders noted that although most patients have felt hopeless, they experience it to different degrees.
Because of these hopeless states, bipolar patients are prone to suicidal tendencies, says Comprehensive Psychology. If you have experienced these kinds of episodes, consult a psychologist. It may not be bipolar disorder, but this dangerous symptom requires medical attention and possibly medication.
Struggles With Memory
Those with bipolar may struggle to remember things that they could recall before. In 2017, research in Frontiers in Psychology noted that bipolar patients struggle with memory before and after an episode, regardless of what mood they’re in.
Imaging tests show that bipolar disorder changes the structure of the prefrontal cortex, which assists with memory. However, memory loss can also result from certain medications and vitamin deficiencies. If someone has memory problems that interrupt their life, they may want to consult a professional.
Impulsive behavior is a noticeable sign of bipolar disorder. According to the International Journal of Bipolar Disorders, patients experience this symptom in waves. During depressive episodes, they are less likely to act impulsively. Other times, patients’ mania could have them make life decisions in an instant.
This ebb and flow of symptoms make bipolar disorder difficult to diagnose. The impulsiveness stems from manic episodes when a long emotional state dominates a person’s mood. Some researchers believe that people with trauma are more likely to develop impulsive behavior, although this requires more evidence.
When people struggle with bipolar disorder, they may withdraw from social life. Perhaps they don’t return calls, remain indoors, sleep for most of the day, or spend their free time alone. Unfortunately, these actions can make the symptoms of bipolar disorder worse.
In Japan, people who stay inside all day without working are called hikikomori. A 2016 study concluded that most hikikomori suffer from a mood disorder like bipolar. The symptom results from lethargy, disinterest, and “low” manic episodes that characterize the disorder.
In 2018, a study in the Australian & New Zealand Journal of Psychiatry recorded many symptoms that predict bipolar disorder. One of them was difficulty concentrating. The mood swings and long periods of depression make people struggle to focus.
Psychologist Russ Federman says that this symptom stems from “cognitive deficit” that appears in bipolar disorder. Patients often complain about forgetting what they just read or heard and struggling to organize or plan. Research suggests that between 15% and 60% of bipolar patients have difficulty concentrating.
Feeling Overly Elated
Although many associate bipolar disorder with depression, patients also experience long cycles of elation. These “high” periods make people feel happy and energized for a while until their mood plummets again. Like all manic cycles, it can last for days to weeks.
That said, not every bipolar patient experiences elation. According to the Journal of the American Academy of Child and Adolescent Psychiatry, around 10% to 15% of bipolar patients experience irritability without elation. Doctors need to examine other symptoms to determine bipolar disorder.
Drastic Change In Appetite
A radical change in appetite with no known cause could be a sign of bipolar disorder. During manic episodes, patients either have an increase or decrease in appetite, according to the journal Psychiatria Danubina. Bipolar patients may not feel the same hunger cues that they could before.
People with bipolar also have a higher chance of developing an eating disorder. During one 2010 study, researchers found that one in five bipolar people also have an eating disorder. Having multiple disorders makes bipolar disorder harder to diagnose.
Preoccupation With Death
Sadly, people with bipolar disorder are 20 times more likely to develop suicidal thoughts than the average person. A preoccupation with death and dying, known to scientists as rumination, can occur occasionally. Patients tend to ruminate during depressive and manic episodes, says the journal Biology of Mood & Anxiety Disorders.
People who experience these thoughts should consult a professional or call a national prevention hotline. Many hotlines provide anonymous texting and messaging to relieve anxiety in patients. Rumination cannot be tackled alone.
Believe it or not, 60% of bipolar patients also struggle with substance abuse, according to Substance Abuse Treatment, Prevention, and Policy. Scientists still don’t know why people with bipolar disorder also struggle with substance abuse. It is more prevalent in bipolar I than bipolar II.
Research in the British Journal of Psychiatry suggests that substance abuse causes “sensitization.” It creates mood episodes and damages the brain, both of which could result in mood disorders. However, bipolar disorder doesn’t rely on substance abuse and vice versa.
When To See A Doctor
Unfortunately, people with bipolar disorder may not realize that anything is wrong. They may even feel fine during episodes of elation. However, if you experience a depressive or otherwise unusual episode for over two weeks, you may want to see a professional.
Some episodes may require immediate medical attention. If someone struggles with suicidal thoughts, or if they have the urge to hurt themselves or others, then they may want to visit the emergency room or call 911. National hotlines also aid people during these episodes.
If You Think You Have Bipolar Disorder
Unfortunately, bipolar disorder can go untreated for a long time, especially in children and teenagers. Symptoms can overlap with ADHD and major depressive disorder, and some people have multiple mood disorders. For this reason, it’s essential to NEVER self-diagnose.
If you believe you have bipolar disorder, consult a doctor. You may want to visit a family physician first, or you can consult a mental health professional if you have access to one. The doctors will ask questions about symptoms, medication, and family history.
How Long Does Diagnosis Take?
Most of the time, bipolar diagnosis takes more than one appointment. Because many symptoms last for weeks or months, doctors will want to track your habits and moods. The average person may undergo months of therapy to rule out similar mood disorders such as depression.
If you want to streamline the process, track your habits and emotions. Printable “life charts” and phone apps can help you track sleep schedules, mood, appetite, and possible suicidal thoughts. Since bipolar episodes occur in patterns, it’s crucial to examine symptoms over time.
The Steps Of Diagnosis
Diagnosis doesn’t only involve a psychological assessment. Doctors may also conduct a physical assessment, where they exam medications, substance abuse, genetic history, and nutrient deficits. All of these could create symptoms that are similar to bipolar disorder.
Bipolar diagnosis also requires a psychiatric assessment. Psychiatrists will compare symptoms to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which defines mood disorders. Again, this is why people should not self-diagnose. Many mood disorder symptoms overlap, and psychology professionals can distinguish between these diseases.