Bipolar Disorder Symptoms This Emotional Life on PBS




The signs of bipolar disorder are periods of extreme emotional highs and lows.

There may be periods of normal mood and functioning in between, and people may have more depressive episodes than mania, or vice versa. Periods of mania and depression do not inevitably follow each other. The intensity of moods may vary between the highs and lows and from one time to the next. The cycles may last weeks or months. This unpredictability can make bipolar disorder very difficult to diagnose. What does define bipolar disorder is that these mood extremes interfere with your ability to function in daily life.

of mania

Signs of mania

During a manic episode, you may have increased energy and even euphoria. Initially it may feel great. However, things can quickly spin out of control. You may feel like can you do or take on anything and start recklessly acting on these feelings without considering the risks. You may also start to feel irritable, aggressive, and angry and start lashing out at others. Eventually, the gap between your emotional high and reality leads to poor decisions—things you normally wouldn’t do, like spending sprees, gambling, substance abuse, risky sexual activity, driving dangerously, quitting a job, and alienating others.

Signs of a manic episode may include:

  • Experiencing an extreme emotional high
  • Bursts of activity and energy
  • An inflated sense of self-confidence and self-esteem
  • Feeling unusually optimistic
  • Feeling extremely irritable, agitated, or aggressive
  • Grandiose beliefs about your abilities or importance
  • Feeling rested on only a few hours of sleep
  • Poor appetite and weight loss
  • Talking rapidly and nearly constantly
  • Racing thoughts and ideas
  • Making ambitious, often unrealistic plans
  • Finding it very hard to concentrate and focus
  • Poor judgment
  • Increased sex drive
  • Reckless, impulsive behavior and risk-taking
  • Drug and alcohol abuse
  • Delusions, hallucinations, and hearing voices

Sources: National Institute of Mental Health; Depression and Bipolar Support Alliance;

of depression

Signs of depression

Signs of a depressive episode in bipolar disorder are very similar to the signs of major depression. In fact, bipolar disorder is often diagnosed when people seek help for depression. However, there are some differences. People with bipolar depression are more likely to feel restless, irritable, and have unpredictable mood swings. It is important to properly diagnose bipolar disorder in order to get the correct treatment. If bipolar disorder is incorrectly diagnosed as major depression, the depression can cycle into manic episodes.

Signs of depression include:

  • Feeling worried, empty, and sad for long periods of time
  • Loss of interest in activities
  • Feeling tired, sluggish, and slow
  • Having trouble concentrating and remembering
  • Feeling restless and irritable
  • Sleeping too much or too little
  • Weight gain or losing appetite
  • Slow speech and poor muscle coordination
  • Hopelessness
  • Feelings of guilt or worthlessness
  • Unexplained physical aches and pains
  • Thoughts of death or suicide

Sources: National Institute of Mental Health; Depression and Bipolar Support Alliance;

bipolar disorder

How bipolar disorder is diagnosed

Many people suffer for years before getting a diagnosis and treatment plan. It can be difficult to recognize bipolar disorder when it begins. The symptoms may seem like a different problem or separate problems. People and their loved ones may also be slow to get help because of the stigma that is still attached to mental illness. This is unfortunate, because early intervention helps avoid much of the disruption to people’s lives that can happen, especially during manic phases. If left untreated, bipolar disorder usually gets worse over time.

In some cases, a person who has not previously been diagnosed with bipolar disorder may be in crisis, such as having thoughts of suicide or a severe manic episode. If you or someone you love is hearing voices, having hallucinations, behaving dangerously, or thinking of suicide or self-injury, please call for help immediately. Call 911 or the National Suicide Prevention Lifeline, 1-800-273-8255.

For someone who is not currently in crisis, the first step in getting help is a physical examination. A doctor can rule out other physical problems that may have similar symptoms, such a stroke, heart disease, thyroid disorder, or other conditions.

The next step is a mental health evaluation. A healthcare provider will take a complete history, asking you about your family’s health history, your symptoms, and your mood patterns. The doctor will listen as you describe your thoughts, emotions, and concerns about your health. It is helpful if the doctor can also talk with close family members; he will only do this with your permission.

A healthcare provider will also pay attention to any other conditions that you may have.

Some of the conditions that commonly co-occur with bipolar disorder:

  • Addiction and substance abuse
  • Anxiety disorders such as posttraumatic stress disorder and social phobia
  • Attention deficit hyperactivity disorder
  • Schizophrenia
  • Self-injury, such as cutting
  • Thoughts of suicide

Your doctor will be sure to get a complete picture of your health in order help stabilize your moods and work with you on the best possible long-term treatment plan for you.

Sources: National Institute of Mental Health; Mayo Clinic; WebMD

Suicide risk

The risk of suicide

If you or someone you love has bipolar disorder, it is important for you to know that one of the symptoms is feeling hopeless or worthless. People with bipolar disorder are at an increased risk of suicidal thinking, suicide attempts, and suicide. Researchers estimate that as many as 25% to 50% of people with bipolar disorder attempt suicide at some point in their lives; 15% do commit suicide. Remember that feelings of hopelessness and despair are not the truth. They are the illness talking, and help is available to get you through the darkest times.

Steps you can take to help yourself if you have bipolar disorder:

  • Remember that suicidal thoughts are not reality—your illness is lying to you; suicidal thoughts and feelings are not facts, and they are temporary
  • Connect with people; isolation can contribute to suicidal thinking; a strong social network contributes to well-being
  • Avoid drugs and alcohol, as they can reduce inhibitions and increase impulsive and risky behavior
  • Practice safety by not keeping medications or weapons available
  • Try journaling to stay in touch with your thoughts and feelings and notice when to talk with someone about them

If someone you love has bipolar disorder, these are some things to know about suicide:

  • You cannot make someone suicidal by bringing the topic up in a caring, straightforward way and asking questions; it may be a relief to your loved one to know that you are someone he can talk to about this
  • Immediately take any comments about death or suicide very seriously and seek help
  • Don’t promise confidentiality; instead, promise your support and help
  • Express concern and understanding that suicidal thinking can be a symptom of your loved one’s illness
  • Describe specific behaviors and changes that worry you
  • Try to help your loved one overcome feelings of guilt and shame
  • Remind your loved one that his life is important to you and others

Some of the warning signs of suicide:

  • Talking or thinking about suicide
  • Talking or thinking about death
  • Making comments about being hopeless, helpless, or worthless, such as “Everyone would be better off if I wasn’t here” or “I want out”
  • A sudden switch from being very sad to being very calm or appearing to be at peace
  • Having a "death wish," or tempting fate by taking risks that could lead to death, like reckless driving
  • Taking care of business, tying up loose ends, writing a will
  • Mentally rehearsing how to commit suicide and taking steps such as hoarding pills or buying a weapon

Source: Depression and Bipolar Support Alliance

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