Bipolar disorder is a form of depression, characterised by extreme mood swings. Unlike other forms of depression, bipolar patients experience both extreme highs and extreme lows, as well as periods of ‘normal’ mood. These can occur over any period of time, and a sufferer may feel normal for weeks or even years at a time before suffering a bout of major depression (the ‘down’ side of bipolar disorder) or ‘mania’ (the ‘up’ side of bipolar disorder). In some cases however the patient will not experience any periods of normality, in which case the condition is known as ‘rapid cycling’ bipolar disorder. To be diagnosed with bipolar disorder a patient should have experienced at least one ‘manic’ episode as well as one episode of major depression. In bipolar depression, the bouts of major depression will usually be longer lasting and more frequent than the manic episodes, though the opposite is possible.

Due to its nature, bipolar symptoms will vary depending on its stage with mania and major depression showing drastically different symptoms. To identify and understand bipolar disorder you need to understand both mania and depression and to recognise all bipolar symptoms.

Mania is generally less understood and recognised than depression. During manic episodes an individual will likely feel highly energised, very creative, be continuously inventing new ideas and taking up new interest in hobbies, have endless energy, experience an increased sex drive, feel intensely happy and optimistic, show unusual enthusiasm for life and be restless and hyperactive.

At first someone with mania may seem like good company – charming, upbeat and full of life. Over time however, mania can become difficult to handle and can make it difficult to operate as normal. Patients might be restless and irritable, have racing thoughts, be easily distracted and suffer from unusual thought patterns. In some instances sufferers can become aggressive (mania translating literally as extreme rage) and selfish and lack judgement. Observable bipolar symptoms during the manic phases can include rapid thinking, insomnia, delusions of grandeur (believing you have special powers or abilities) and addiction (particularly to sleeping tablets and occasionally cocaine). Other unusual behaviour may include dangerous driving, spontaneity, spending too much money and gambling, unsafe sex and general reckless behaviour. In extreme cases the patient can prove so ‘out of control’ as to need to be hospitalised to prevent them doing harm to themselves or others.

These latter ‘out of control’ symptoms are the more severe bipolar symptoms however, and it is possible to experience much milder mania called ‘hypomania’. These milder symptoms would consist of just the rapid speech and restlessness. This will still seem like a highly noticeable change however, particularly when compared to the bouts of major depression. It is also possible to experience mania on its own, which is highly tiring though perhaps preferable to depression (and highly rare). Some sufferers of mania maintain that the effects are more favourable than unpleasant, citing the creative thinking and energy as blessings rather than curses. Andy Behrman, director and author of ‘Electroboy’, is among these individuals.

Mania tends to last for between two weeks to five months, hypomania will tend to be shorter but will last at least four days. After a bout of mania it is common for patients to feel ‘warn down’ following periods of exertion and possibly neglect for their health.

The other side of bipolar symptoms however is the symptoms associated with major depression. These symptoms are similar to unipolar depression (depression without mania) and tend to last for around six months. Here it is usual to feel sad, anxious, empty, hopeless, pessimistic, guilty, worthless, tired, uninterested and restless. Patients will often put on or lose weight, lack sex drive, sleep either a lot or not at all, struggle to remember things, cry a lot and think about suicide and death. Again these symptoms can vary in severity, and depression is one of the most over-diagnosed conditions. However the symptoms again should be particularly noticeable and pronounced when following bouts of mania.

There exist other bipolar symptoms and patterns. For example some patients will suffer from hallucinations, usually associated with the manic phases. Sometimes patients may experience ‘cyclothymia’, characterised by rapid cycling between the milder forms of depression and mania. It is also possible to experience ‘mixed episodes’, also known as ‘mixed affective states’, where a combination of features from mania and depression are experienced such as extreme sadness but with racing thoughts and high energy levels.

Mack LeMouse

Copyrighted material; do not reprint without permission.

 

View all articles by Mack LeMouse