By: Kassie Love, MFT, MPH
Kassie Love is a psychotherapist specializing in more intensive mood and emotional regulation needs, as well as unusual thoughts and experiences. You can visit kassielove.com to learn more and schedule a free consultation.
Understanding the symptoms of Bipolar Disorder is an important part of accurately treating this mental health condition. In this blog post, we will cover:
Manic symptoms and hypomanic symptoms in Bipolar Disorders
Bipolar depressive symptoms
How to Find Bipolar Disorder Treatment
An Overview of the Bipolar Disorder Spectrum
Whether you or a loved one has Bipolar Disorder, or you’re simply exploring whether the condition fits your experience, understanding the signs of Bipolar Disorder will help guide your understanding of Bipolar Disorder treatments. The signs of Bipolar Disorder will vary across Bipolar Type I and Type II, commonly referred to as Bipolar 1 and Bipolar 2. Interestingly, Bipolar manic symptoms and Bipolar can be thought of as occurring along a spectrum.
The predominant mood symptom of Bipolar disorder is related to a mood often described as high, elevated, expansive, up, euphoric, and even irritable. “Mania” is the collective term given to describe these experiences, when occurring in Bipolar 1 (Type )I. “Hypomania” describes the mood symptoms experienced in Bipolar 2 (Type II) or cyclothymia; which are simply ”manic-like” symptoms that last for a shorter duration than mania. Let’s take a closer look at the mood symptoms experienced in each of these Bipolar spectrum disorders. Please note that Cyclothymic Disorder occurs when symptoms of Bipolar 2 are present for a period of time, but do not meet the criteria for Bipolar 2 Disorder.
Bipolar 1 Disorder Symptoms (Bipolar Disorder Type I)
By definition, this disorder is characterized by the presence of several of the following symptoms which must be present for a minimum of 7 days.
Importantly, a diagnosis of Bipolar 1 Disorder involves elements of both a change in mood, as well as increased activity. Thus, the criteria of Bipolar Disorder discussed below, which explains increased goal-directed activity, has important significance when considering whether a Bipolar Disorder diagnosis is the best fit.
Distractibility: characterized by an inability to sustain attention, which often appears as racing thoughts, inability to have a conversation, or inability to stay on task. Individuals experiencing distractibility may have trouble completing even small tasks, finishing a conversation, or even completing sentences in more extreme episodes of mania.
Impulsivity: involves reckless behavior characterized by indiscretion. Individuals often make high-risk decisions, such as drug use, gambling, making large purchases, having more sex partners than usual, or even investing in risky business decisions. The decisions around impulsive behavior in Bipolar Disorder are often some of the most detrimental to this condition, leading to ruined relationships, financial burdens, or loss of a job.
Grandiosity: characterized by thoughts of grandeur. An extreme example of this symptom would involve an individual thinking they are a king, president, or company CEO—then accordingly taking steps, such as changing their name or showing up at a business or government office. A milder version of this manic symptom may involve an individual thinking they are above laws or rules in society or the workplace, making comments of superiority, and similar behavior. This symptom may also involve having an unrealistic belief in one’s potential, performance, or abilities.
Flight of Ideas: involves thoughts racing through the mind, making it difficult to stay on any specific topic of discussion.
Increase of Goal-Directed Activities: the presence of increased activity that is purposefully goal-directed is considered a hallmark of mania. In fact, goal-directed activity is so integral to diagnosing a manic episode, that it is considered the keystone element of mania. Goal-directed activity consists of an activity that is meant to accomplish something, such as a project. For instance, during a mania, people may start major projects, such as home remodeling, opening a new business, or writing a book during a manic state.
Decreased Sleep: this symptom of Bipolar Disorder refers to the often decreased need for sleep seen during a manic episode. It’s not uncommon for someone in a manic state to go days or even weeks with only a couple of hours of sleep at night. Importantly, the decreased need for sleep is characterized by not feeling tired or sleepy, even though a person has only had minimal sleep.
Talkativeness: involves what is often described as rapid speech, and may feel like a “pressured” feeling to continue talking. During rapid speech, individuals may find it hard to interrupt. Because this manic symptom involves a noticeable behavior change, it is often more easily noticed by family and friends.
Bipolar 1 Disorder is the only condition along the Bipolar spectrum that does not have to include Bipolar depressed symptoms for a diagnosis. However, these depressive mood changes most often occur at some point after a manic episode. Such depressed moods, known as Major Depressive Disorder, are discussed below in further detail.
Bipolar 2 Disorder Symptoms (Bipolar Type II Disorder)
A key distinction between the symptoms of Bipolar 1 Disorder and Bipolar 2 Disorder is the difference between the experience of manic symptoms discussed above. While Bipolar 1 Disorder requires a variety of these symptoms for at least 7 days, a diagnosis of Bipolar 2 Disorder only requires the presence of these “elevated” symptoms for 4 days. Thus, the “elevated” mood phase in Bipolar 2 Disorder is known as hypomania—quite literally meaning “less than mania.”
Now that we have discussed the difference in manic symptoms present in each condition, let’s explore how depressed mood symptoms may present.
Major Depressive Disorder
A combination of the below criteria must be present for a minimum of 2 weeks to qualify for a diagnosis of MDD.
Depressed mood or lack of interest or pleasure in activities
Changes in sleep (sleeping more or less than usual)
Changes in appetite, resulting in significant weight loss or gain
Changes in activity level, such as decreased motivation, restlessness, and agitation.
Difficulty concentrating
Feelings of worthlessness or guilt
Suicidal thoughts or behaviors
Cyclothymic Disorder
Cyclothymic Disorder is included in the Bipolar spectrum. Cyclothymic Disorder occurs when an individual experiences periods of hypomania and depressive moods, but does not meet the criteria for Bipolar 2 Disorder. These symptoms must last a minimum of 2 years.
Why Seeking Treatment for Bipolar Disorder is Important
If you or a loved one relate to any of the experiences described above, you likely already know that these mental health challenges can greatly interfere with life, relationships, and employment. Psychotherapy, sometimes called talk therapy, is an effective and evidence-based treatment for improving mental health, especially Bipolar spectrum conditions. Many people feel most supported when using a combination of medication and therapy. The right therapist will be able to help you recognize the unique mood events that signal when a change in your mood is occurring. By being able to recognize these symptoms, you can better be prepared to utilize the coping skills that you and your therapist develop for these mood changes.
If you’re interested in learning more about Bipolar Disorder or want to find additional resources, check out the resources below, or do not hesitate to contact me.