Many of us experience mood changes in daily life, however some people’s moods fluctuate up and down more than others. Sometimes, these frequent mood fluctuations can be a sign of bipolar disorder.
Bipolar disorder, formerly known as manic depression, is characterized by episodes of feeling extremely high and euphoric followed by periods of feeling extremely low. These episodes can last from a few days to several weeks or more. When these mood changes begin to affect your behavior and how you function in everyday life, it’s important to seek support from a mental health professional.
If you’re wondering whether or not you have bipolar disorder, this article can help. We’ll explore what bipolar disorder is, the different types of bipolar disorder, common symptoms and causes, and how to know if you have bipolar disorder. We’ll also examine the difference between bipolar disorder and depression and point you towards where you can find support.
What is bipolar disorder?
Bipolar is a mood disorder that’s defined by fluctuating episodes of what’s known as mania and depression. Mania is characterized by ‘high’, elevated emotions of euphoria, energy, and impulsiveness, while depression is a period of extremely ‘low’ or depressed mood.
If you have bipolar disorder, you might find yourself feeling or behaving differently than usual during these episodes. Mood changes can last days, weeks, or months, and you may find yourself feeling well in between. Bipolar symptoms can be severe and affect different areas of life, including relationships, work, and school.
If you think you may have bipolar disorder, know that you are not alone. According to the National Institute of Mental Health, more than 2.8% of the population, or around 5 million people, are diagnosed with bipolar disorder in the United States. Most people begin to experience symptoms before the age of 20, however it can also develop later on in life.
Types of bipolar disorder
There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia. Let’s look at each of these in more detail.
Bipolar I
Bipolar I disorder is characterized by at least one full manic episode, which involves a period of extremely elevated or irritable mood with high energy levels, for at least a week. Sometimes, manic episodes in bipolar I can be severe, require hospitalization, and lead to significant impairment or psychosis. People with bipolar I may also experience depressive episodes or periods of hypomania, however they are not needed for diagnosis. This type of bipolar disorder is experienced by all sexes equally.
Bipolar II
Bipolar II disorder involves at least one episode of hypomania, which is a less intense form of mania that lasts at least four days, and at least one major depressive episode that lasts at least two weeks. Unlike bipolar I, bipolar II doesn’t involve full manic episodes. While mood swings in bipolar II are usually less extreme, depressive episodes can be more severe and frequent. This type of bipolar disorder is experienced more often in females.
Similar Reading: What is Low-Grade Depression? Symptoms, Diagnosis & Treatment
Cyclothymia
Cyclothymic disorder is characterized by chronic, fluctuating mood swings that include periods of hypomania symptoms and periods of depressive symptoms, neither of which meet the criteria for full hypomanic or major depressive episodes. While less severe than bipolar I or bipolar II, these mood swings last for at least two years (one year for children and adolescents) and cause notable disruption in daily life.
What type of bipolar disorder do I have?
If you’re unsure where you fit in with these types of bipolar disorder, speaking to a mental health professional can help you get an accurate diagnosis. Sometimes, people experience mood fluctuations that don’t quite fit within these three categories. These mood disorders are usually diagnosed as:
- Other specified bipolar and related disorders
- Unspecified bipolar and related disorders.
Symptoms of bipolar disorder
The three main symptoms of bipolar disorder are mania, hypomania, and depression. Different types of bipolar disorder involve different combinations of these three core symptoms. To be diagnosed with bipolar disorder, however, you must experience at least one period of either mania or hypomania.
Both mania and hypomania are characterized by high energy, impulsiveness, and euphoria, but hypomania involves less severe symptoms than mania. Some people with bipolar disorder also experience periods of major depressive symptoms, which can also be distressing and disruptive to everyday life.
Let’s take a look at the symptoms of mania, hypomania, and major depression in bipolar disorder.
Mania symptoms
Manic episodes are usually characterized by elevated emotions of euphoria, excitement, impulsiveness, and high energy. Some people also experience hallucinations or other symptoms of psychosis.
Common symptoms of mania include:
- Feeling unusually elated or euphoric, even when you’re in a tough situation
- Having lots of new and exciting ideas
- Jumping rapidly from one idea to the next
- Racing thoughts
- Talking at an unusually fast pace
- Hearing voices that others can’t hear
- Feeling more irritable than usual
- Having an inflated sense of self-confidence
- Being easily distracted and struggling to concentrate
- Not wanting to sleep or being unable to sleep
- Believing you can do much more than is realistically possible
- Making spontaneous or big decisions without thinking them through.
Many people who experience mania will feel invincible, causing them to behave more impulsively than usual. This might include doing things like:
- Spending excessive amounts of money
- Quitting your job suddenly
- Having casual sex with lots of different people
- Driving well above the speed limit
- Misusing alcohol and drugs
- Making a big investment on an impulse
- Going on a trip without telling anyone.
Of course, there are many reasons why people might engage in these behaviors without having bipolar disorder. People with mania, however, wouldn’t normally partake in these activities when their mood is stable.
Manic symptoms in children
For children, symptoms of mania can look a little different. Manic symptoms in children might include:
- Acting excessively silly
- Feeling overly happy, more than usual
- Difficulty maintaining focus or concentrating
- Engaging in risky behaviors that can be harmful
- Having a short temper that can quickly escalate to angry outbursts
- Difficulty sleeping and not feeling tired despite lack of sleep.
Manic symptoms in teenagers
Like children, teenagers can experience mania differently to adults. Manic symptoms in teenagers might include:
- Feeling overly happy
- Engaging in rebellious or disruptive behavior
- Partaking in risky behaviors that can be harmful, such as substance use
- Thinking about sex more often than usual
- Displaying overly sexual behavior
- Difficulty sleeping and not feeling tired or fatigued despite lack of sleep
- Being quick to anger
- Difficulty staying focused or getting easily distracted.
Hypomania symptoms
Symptoms of hypomania are similar to those of mania but at a much lesser degree. Unlike mania, which can be extremely disruptive to a person’s home, social, school, and work life, hypomania tends to have less impact on a person’s life. It also doesn’t involve symptoms of psychosis, such as hearing voices that others can’t hear. Usually, hypomania symptoms don’t last as long as manic symptoms and in most cases won’t require inpatient care.
If you’re experiencing hypomania, you might feel overly productive and energized but not notice any other mood changes. People who know you well, such as friends and family, may be more likely to notice changes to your mood and energy levels.
Depression symptoms
Depression experienced by people with bipolar disorder is often referred to as bipolar depression. It’s mostly characterized by a low mood, lack of motivation, and feelings of lethargy and fatigue.
Bipolar-related depressive symptoms can include:
- Persistent low mood
- Lack of energy
- Feeling slower or more restless than usual
- Feelings of hopelessness, worthlessness, or emptiness
- Feelings of guilt
- Lack of interest in activities you normally enjoy
- Oversleeping or experiencing insomnia
- Difficulty concentrating or making decisions
- Changes in appetite
- Gaining or losing weight without meaning to
- Thoughts of death, dying, or suicide.
While not everyone with bipolar disorder experiences depression, it is extremely common. In most cases, you’ll need to experience five of the above symptoms for your depression to be defined as a major depressive episode.
Keep Reading: How Depression Affects Relationships and What You Can Do
Bipolar depression symptoms in children
Symptoms of bipolar depression in children can include:
- Acting withdrawn, sad, or crying often
- Sleeping excessively or struggling to sleep
- Lacking energy for normal activities or showing no interest in anything
- Frequent complaints of physical discomfort, such as headaches or stomachaches
- Feelings of guilt or worthlessness
- Eating significantly more or less than usual
- Thoughts of death or suicide.
Bipolar depression symptoms in teenagers
Symptoms of bipolar depression in teenagers can include:
- Excessive sleeping or struggling to sleep
- Eating significantly more or less than usual
- Feeling sad and losing interest in everything
- Withdrawing from friends and activities
- Thinking or talking about death or suicide.
Remember, many of these signs are common behaviors for adolescents and teenagers. However, when they appear as part of a larger pattern of changing moods or begin to affect their daily life, it may be a sign of bipolar disorder or another mental illness.
Psychosis symptoms
Some people with bipolar disorder will experience symptoms of psychosis during severe episodes of mania or depression. This might include:
- Hallucinations: Seeing, hearing or feeling things that aren’t there
- Delusions: Believing things that others may find unusual or untrue.
Psychotic symptoms in bipolar disorder may differ depending on whether you’re experiencing a manic or depressive episode. During a manic episode, for example, you may believe you have special powers or are being watched by the government. During a depressive episode, on the other hand, you may feel extreme guilt over something you think you have done.
How do I know if I have bipolar?
If you’re experiencing some of the above symptoms and believe you might have bipolar, it’s extremely important to seek support from a mental health professional. They will be able to assess your symptoms and give you an accurate diagnosis.
To help you better understand how bipolar disorder is diagnosed, we’ll look at the diagnosis for each type of bipolar disorder below. These diagnoses come from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and it’s likely what your doctor or mental health provider will be examining when consulting with you.
How to know if you have bipolar I
The criteria for diagnosing bipolar I disorder are:
- At least one manic episode that lasts at least a week
- At least three or more of the following symptoms during the manic episode:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual
- Lots of new ideas or racing thoughts
- Easily distracted Increase in goal-oriented activity
- Excessive involvement in risky activities
- Symptoms severe enough to affect daily function or necessitate hospitalization
- Symptoms are unrelated to other mental health conditions, medical issues, or substance use.
Although many people with bipolar I experience depressive episodes, they are not required for diagnosis.
How to know if you have bipolar II
The criteria for diagnosing bipolar II include:
- At least one hypomanic episode that lasts at least four days or longer
- At least three or more of the following symptoms during the hypomania episode:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual
- Flight of ideas or racing thoughts
- Easily distracted
- Increase in goal-directed activity
- Engaging in activities with high potential for harmful consequences.
- At least one episode of major depression that lasts two weeks or longer, and involves five or more key symptoms of depression
- No history of a full manic episode
- Significant distress or impairment in daily function due to hypomania and depression symptoms
- Symptoms are unrelated to another medical or mental health condition or substance use
- Hypomanic episodes aren’t severe enough to necessitate hospitalization or cause marked impairment in social or work function.
People with bipolar II don’t experience mania. If you’re experiencing manic symptoms then you’ll more likely receive a bipolar I diagnosis.
How to know if you have cyclothymia
The criteria for diagnosing cyclothymic disorder include:
- Chronic periods of hypomania and depression for at least two years (or one year for children and adolescents) that never meet the full criteria for a full hypomanic episode or full depressive episode
- Symptoms of hypomania and depression are present for at least half of the two years, with never more than two months without symptoms
- Mood swings cause clinically significant distress or impairment in daily function
- Symptoms are unrelated to another medical or mental health condition or substance use.
Do I have bipolar or depression?
Some people may be unsure if they are experiencing bipolar disorder or depression. While bipolar disorder can involve periods of major depression, it’s characterized by fluctuating moods. Depression, on the other hand, involves a persistently low mood.
Sometimes, it can even be difficult for doctors to distinguish between bipolar disorder and depression, leading to misdiagnosis. This is usually because people with bipolar disorder are more likely to seek support during depressive episodes as they tend to have a more negative impact on their mental wellbeing.
Some factors that contribute to misdiagnosis can include:
- Having depression as the more dominant mood
- The first episode being a depressive episode
- Not realizing your manic or hypomanic symptoms were significant.
Starting with an accurate diagnosis is essential to receiving tailored treatment and guidance.
Similar Reading: Depression vs. Anxiety: Which One Do I Have? Symptoms & Treatment
How to know if you have bipolar disorder
If you believe you or a loved one may be experiencing symptoms of bipolar disorder, we are here to help. While bipolar disorder has no known cure, there are several treatments available that can help reduce symptoms or create a more balanced state. Our experienced mental health providers can accurately assess your symptoms and provide tailored treatment, including medication management and telemedicine appointments.
If you’re in Colorado, you can schedule an in-person appointment with our mental health providers at one of our many locations. We also have several in-person clinics located in Oregon. For any other questions, or to book an online appointment, contact us today and one of our friendly team members will be in touch.
