The symptoms of bipolar disorder depend on which type of the condition a person has, though all forms of bipolar disorder consist of periods of a level mood between episodes.
So, what constitutes a manic, hypomanic, or depressive episode?
Manic and Hypomanic Episodes: What Is the Difference?
- You're easily distracted
- You feel as though your thoughts are racing
- You experience an exaggerated level of self-confidence and self-importance
- Your need for sleep is reduced
- You're unusually or excessively talkative
- You engage in impulsive, reckless behavior with no consideration of the consequences (such as shopping sprees or unprotected, risky, or excessive sexual activity)
In manic episodes with both elevated and irritable moods, symptoms are present most of the day, every day.
For a behavior change to be considered a manic episode, it must meet the following criteria:
- Be a distinct and noticeable change in mood and functioning
- Include noticeable problems in your day-to-day activities or require hospitalization to prevent harm to yourself or others
- Not be the result of alcohol or drug use, a medication you're taking, or another medical condition
For a behavior change to be considered a hypomanic episode, it must meet these standards:
- Involve a distinct and noticeable change in mood and functioning
- Not be significant enough to disrupt daily activities or require hospitalization
- Not be the result of alcohol or drug use, a medication you're taking, or another medical condition
- Not have any associated psychotic symptoms (these would indicate a full-blown manic episode)
The Symptoms of Depressive Episodes
- Depressed mood
- Lack of interest in, or pleasure from, normal daily activities
- Significant weight loss or gain, or changes in appetite
- Insomnia or excessive need for sleep
- Restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of guilt or worthlessness
- Inability to think or concentrate
- Thoughts of death or suicide
Your symptoms must also cause disruption in your day-to-day activities, as well as social activities or relationships.
As with manic episodes, depressive episodes must not be the result of alcohol or drug use, a medication you’re taking, or another medical condition.
Other Symptoms and Patterns of Bipolar Disorder
- Anxiety
- A manic episode with some symptoms of a depressive episode, or a depressive episode with some symptoms of a manic or hypomanic episode
- Feeling empty or hopeless yet also highly energized
- Loss of pleasure in all or most activities
- Catatonia (a state of limited or abnormal movement)
- Psychosis (detachment from reality, often with hallucinations or delusions)
People with psychosis experience a severe episode of either mania or depression that causes them to become detached from reality.
Both bipolar 1 and bipolar 2 may occur after a woman becomes pregnant or within a month of giving birth (also known as peripartum onset).
The disorders may also follow a so-called seasonal pattern, in which episodes change with the seasons.
Diagnosis: Is There a Bipolar Disorder Test?
- A physical exam, including blood tests, to rule out other potential causes of your symptoms
- An MRI, PET scan, or CT scan to identify potential abnormalities or changes in your brain structure or chemistry that are linked to bipolar disorder, or to rule out other disease
- A psychological exam in which your doctor will ask you about your thoughts, feelings, and behaviors (family and friends may also be consulted, with your permission)
- Daily tracking of your moods and behaviors to confirm diagnosis
There are also multiple questionnaires that health professionals use to help make a diagnosis. These formal, researched, and clinically tested questionnaires are designed to identify and clarify your symptoms and assist in diagnosis. Your doctor may or may not use such a questionnaire.
Bipolar Disorder in Children and Teenagers
If your child shows signs of severe mood swings that appear different from previous or normal mood swings, talk to your doctor or pediatrician.
Additional reporting by Deborah Shapiro and Leona Vaughn.