Bipolar Disorder Symptoms

In simple terms Bipolar Disorder is a mood disorder characterised by swings in mood from depression to mania. Most of the following information is taken from the fantastic book Take Charge of Bipolar Disorder by Julie A. Fast and John Preston, PsyD.  However I have added information based on my own experiences and a few other bits.  The lists that follow are extensive and if you prefer to read a standard, more basic version of the symptoms please click on the following links:

Bipolar Disorder Symptoms- NHS Choices

Understanding Bipolar Disorder (Manic Depression)- Mind

There are two main types of Bipolar Disorder: I and II. Bipolar I involves severe depression and full blown mania. Bipolar II involves severe depression and hypomania- the less severe form of mania. Both forms can experience mixed episodes.

Depression Symptoms

  • Sadness, unhappiness, feelings of despair and hopelessness.
  • Intense guilt. Don’t feel you belong in the world. Almost feel guilty for being alive.
  • Irritability, frustration, low tolerance, anger.
  • Low self-esteem, feeling worthless or inadequate, loss of self-confidence.
  • Negative, pessimistic thinking. A bleak view of yourself, current life circumstances and the future.
  • Lack of enthusiasm; apathy. Can’t be bothered.
  • Loss of sense of aliveness and diminished interest in life activities that once were a source of pleasure and interest.
  • Suicidal thoughts: these can range from suicidal ideas where you just think about what it would be like, or think you don’t deserve to live, up to planning how to do it. Get help if you experience any of these- it is vital.
  • Poor memory and concentration. At work I would literally talk out loud asking myself What am I doing? What do I need to do now? I’d forget all the time what I was in the middle of. Keeping my attention on something was difficult.
  • Sleep disturbances: insomnia, sleeping too much, restless sleep, waking up early and being unable to get back to sleep.
  • Appetite changes- increased or decreased.
  • Loss of sex drive.
  • Inability to work efficiently.
  • Extreme fatigue-slowness of movement, thinking and speech (Psychomotor Retardation).
  • Feeling that there is no purpose in life. Asking yourself, What’s the point?
  • Constant questioning and examining of life and your own behaviours.
  • Binge eating or starving yourself, and being unable to exercise.
  • Relationship problems and loss of relationships, eg. colleagues and friendships.
  • Feeling terrible all the time, mentally and physically.
  • Nagging unhappiness- the feeling that there’s never enough.
  • Agitation- very difficult to relax.
  • Negativity and meanness. Biting sarcasm with self and others.
  • Sense of numbness. Don’t feel love or joy or anything. Everything seems grey. No colour in life.
  • Hallucinations- hearing voices, for instance, or seeing yourself killed or hurt. Sometimes it felt like my own voice turned against me. It would bully me and be sarcastic and bitchy to me. I don’t know if this was hallucinations or not. Probably more along the lines of intrusive thoughts.
  • Neediness & clinging. My common scripts with my partner are: Do you love me.? Am I a good person? Are you sure you want to be with me?
  • Anxiety- for me this is usually intense social anxiety, scared to talk on phone, answer door, do anything that involves other people. Could be a different form of anxiety for others, eg. agoraphobia, OCD symptoms increase, panic attacks, generalized anxiety.
  • Being overly emotional; crying easily.
  • Distorted thoughts. (Difficult to identify these as they seem so real when you’re depressed. It’s only when you get better that you see how distorted your thinking was).
  • Paranoid ideas: People are talking about me, my colleagues are trying to get me sacked, I know they hate me really they’re just nice to my face.
  • Reduced immunity to illness.
  • Being overly concerned with the lives of others. This can take our minds off our own problems. But then we become too involved and realise we can’t cope anymore.
  • Making negative comparisons of yourself with others. (Stay away from Facebook-! Very easy to compare yourself with others whose lives often appear so great on Facebook. I’ve made myself miserable on countless occasions doing this.What we post is often only the good stuff though, so we get a distorted image of the lives of others. They may have an Audi or BMW, but what we don’t know is they also have a £30,ooo loan that they’re struggling to repay, etc. Or they may have an amazing career, but what we don’t know is that they’re complete workaholics and have poor relationships as a result.)
  • Feeling easily overwhelmed (by work, housework, kids, relationships in general, “keeping up with the Joneses”.) I can’t cope.
  • Difficulty meeting obligations.
  • Oversensitivity- easily offended, easily upset, cry easily at films/TV.
  • Overanalyzing everything. I totally do this and try to intellectualize myself out of depression. I think the more detective work I do into my psyche, the better I’ll feel. I believe I can think myself out of it. What you really need to do is accept it.
  • Brain racing and looping- thoughts keep going over and over in your mind. Constant worrying and rumination.
  • Inability to make a decision- and when you do it never feels right. Sometimes I couldn’t even decide what to do: read a book, watch a film, phone a friend, draw, listen to music. I’d start one, it wouldn’t feel right so start another, it wouldn’t feel right and on and on. No way to relax.

Mania and Hypomania Symptoms

  • Feeling great no matter what happens.
  • A profound feeling of physical well-being. Feeling ALIVE! Energy coursing through body. Feel you have endless reserves of energy.
  • Increased self-esteem or grandiosity; an unrealistically inflated sense of self-esteem.eg. looking in the mirror and thinking how amazingly good-looking you are, feeling like the smartest, most talented person in the world.
  • Decreased need for sleep. You may feel fully rested after only four or five hours of sleep at night.
  • Increased involvement in goal-directed activities.
  • Having thoughts such as, The world is just so beautiful and full of possibilities, I can do anything I want to do! Life is so amazing!
  • Talkativeness and rapid speech; others have a difficult time getting a word into the conversation. Feel intense inner pressure to keep talking, talk loudly, talk over everybody, talk even louder, repeat sounds, rhyme, keep talking- don’t stop talking! I always feel like I have to get every word out of my mouth that I think of. Get really silly.
  • Racing thoughts.
  • Gregariousness: seeking and enjoying the company of others, much more sociable than usual. Want to be involved in everything.
  • Starting new projects you’re confident will change the world.
  • Highly distractible- unable to focus on one project. Get excited by something else so abandon first project for something else.
  • Hyperactivity, restlessness, or agitation.
  • Talkativeness with strangers. Feel familiar with everybody.
  • Excessive spending- maxing out credit cards, gambling, buying loads. For me I’ll end up buying loads of DVDs, books, collectables, small things I don’t need. I’ll go shopping as often as possible. The shops feel really exciting and everything looks so good. Really impulsive spending.
  • Often inability to distinguish between safe and unsafe behaviours.
  • Increased use of alcohol, caffeine or stimulant drugs. I drink tonnes more Diet Coke.
  • Psychotic symptoms (more severe psychotic symptoms are only seen in full-blown mania).
  • Increased sexual desire- this can be extremely destructive. Can lead to one-night stands, affairs, cheating on partner. Increased interest in porn etc. Often not talked about. Bit of a taboo, but can actually be a really prominent symptom.
  • Lack of concern for how family members and friends feel about your behaviour. Feel way more important than anyone else.
  • Poor judgement and engaging in high-risk behaviours: reckless driving, sexual promiscuity. Feel invincible so have no fear.
  • Loss of all contact with reality.
  • The inability to see you’re sick even though it’s obvious to others- I think this may just be with severe mania, as I usually have an awareness that I am hypomanic, but am enjoying it so much I don’t want to do anything about it. Resisting treatment.
  • With full-blown mania the person eventually can’t function on his or her own and must go to hospital.

Hypomania is basically a milder version of mania- but this can still feel anything but mild. In mania psychotic symptoms take over and behaviour becomes completely erratic. Hypomania is much less likely to require hospitalization.

Mixed Episode Symptoms.

Hypomania and mania can also feel more negative, where the seemingly more positive symptoms make a 180 degree turn to intense negativity. This results in a MIXED EPISODE- called mix due to the prevalence of symptoms of depression AND mania.

  • Full of energy, but it’s more destructive- agitation, irritability, easily angered, rage attacks, aggression.
  • Sleeping in fits and starts, or not at all.
  • Intense anxiety.
  • Swinging between euphoric and irritable.
  • Arguments are very likely. Be extremely careful at work, or don’t go in if you’re at all in doubt of your ability to deal with your anger. I’ve lost a job this way and raged at a total stranger leading to police involvement. This was extremely out of character for me and has caused me a great deal of pain. It took me a long time to get over both incidents and triggered severe depressive episodes.
  • Rapid thoughts of a negative quality.
  • Paranoia.
  • Thoughts of suicide and self harm- these feel much more impulsive in tone than those of depression. Feel like intense urges that must be acted upon immediately.
  • Rage with the self. Self-hatred.
  • Psychotic symptoms.

Duration and Frequency of Occurrence

Depression can last any length of time over two weeks. My longest episode lasted about 18 months, before I had found adequate medication. Finding effective can be very trial and error to start with, as everybody reacts differently to different drugs, dosages and combinations.

Mania, hypomania and mixed episodes have generally been shorter with me- between a few days and a month.

I generally have 1-2 episodes each of hypomania and depression per year.

Rapid-cycling is a term used to describe Bipolar Disorder that manifests in very frequent episodes- four or more severe episodes in a one-year period. Ultra or Ultradian rapid- cycling may involve a dozen or more shifts in a one year period.

One of the best websites out there for Bipolar and Depression information is by John McManamy called McMan’s Depression and Bipolar Web. It really is an outstanding resource with many articles about all the ins and outs of Bipolar, and worth spending a good deal of time on. I’ve linked to a few articles relating to Bipolar Symptoms below.

Resources

Take Charge of Bipolar Disorder- By Julie A. Fast and John Preston, PsyD

Bipolar Disorder Symptoms- NHS Choices

Understanding Bipolar Disorder (Manic Depression)- Mind

Bipolar I and Mania- McMan’s Depression and Bipolar Web

Bipolar II and Hypomania- McMan’s Depression and Bipolar Web

Bipolar Depression- McMan’s Depression and Bipolar Web

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21 thoughts on “Bipolar Disorder Symptoms

  1. bipolarmoms

    This is such an informative post. I’m going to refer a friend to it who suspects that she has Bipolar II.

    Reply
  2. Liz

    Hi Rachel; I’m so pleased I found this Blog. I was diagnosed with Bipolar type II a few months ago, I’ve been having episodes since I was 17 but was mis-diagnosed (or maybe just no one noticed!) and it’s basically ruined my life. My relationships, careers, college courses, finances etc all in tatters; I wish I’d known about Bipolar earlier! Your list of symptoms is better than anything I’ve found on an nhs website or in a book and help a lot; I’ll perhaps be able to explain my behaviour better in future, it’s not easy to verbalise it when you’re in the middle of it. I just filled in a form for the DWP and I’m sure I didn’t really explain how it affects me properly. Thank you for this.

    Reply
    1. rachelmiller1511 Post author

      Hi Liz, so great to hear from you! Thank you for what you’ve said about the symptom list- I’m so glad it was helpful to you.

      So sorry to hear that you’ve been through all the bipolar troubles though- I really hope things get better and better for you.

      Once I was put on Lamotrigine (mood stabiliser) things started to improve for me. It also helped greatly when I
      stopped trying to work in a regular job (took me a good 12 years to figure this one out :)).

      Really appreciate you stopping by and commenting. Wish you the best of luck with treatment xxx

      Reply
  3. Sara

    Really want to say thanks for this blog. I have just been referred by my GP to a psychiatrist as he suspects bipolar and reading the symptoms list above and my own research I too think this – infact I have thought this for some time. I am scared of the diagnosis because I dont want to spend my life on medication but I dont want to spend my life like this – I dont who who I am anymore – I dont trust any decisions I make as I dont know if its the pills the bipolar or my own mind makinig me think the way I do and behave the way I do – im so conflicted all of the time – I feel like my mind and thoughts are no my own anymore – I actually like the mania I like myself when Im happy upbeat and everyone else likes that side of me too I am sociable funny confident and feel like I can achieve anything – it just spiralls into somethng else – I have run up thousands in debt I have cheated on my partner I have gone into rages I have lost touch with family members because of my behaviour and its that part when I am coming down form the mania that it dawns on me how I have behaved and how it has affected others – my life is in tatters financially I am broken I have pushed away my familiy I am divoriced from my husband and I am unable to maintain a relationship with anyone. I then go into the deepest of depressions where I am unable to get out of bed wash or dress or feed myself. I plan my suicide write letters to my children and plan my funeral – I am calm and methodical but consumed with the need to kill myself to stop the pain the hurt and the despair. I just need to know that I am not alone in these thoughts and life will get better for me and I will find who I am again.

    Reply
    1. rachelmiller1511 Post author

      You are definitely not alone! Unfortunately there are many of us who go through this. You say you are so conflicted all the time- this for me, is the essence of Bipolar- I always feel I am doing battle with myself and even that I have different personalities. To me it sounds like your GP has got your diagnosis correct, from your description this sounds 100% bipolar. It was my GP who first suspected Bipolar in me.

      The diagnosis can be scary at first, but I must say for me it came as a relief- I just needed to know what was going on with me and that I could be helped.

      Please know that you are not alone and that you are extremely strong to get through this.

      The help you can get through the psychiatrist can also be supplemented with various complementary therapies which I would thoroughly recommend. I myself have had great results with Bach Flower Remedies and Reiki.

      Thanks so much for getting in touch and I wish you the best of luck in managing bipolar.

      Reply
  4. Nat

    Hi Rachel,

    Very grateful for your blog.

    You have a comment above where you say “It also helped greatly when I
    stopped trying to work in a regular job (took me a good 12 years to figure this one out.”

    I was just wondering if you wouldn’t mind expanding on that comment? What types of jobs had you worked? (regular, meaning office job?) and what seems to be more helpful to you now?

    I’d really appreciate it!

    Thank you

    -NR

    Reply
    1. rachelmiller1511 Post author

      Hi there,

      Thanks for your question.

      I’ve worked in jobs such as retail and for longer periods of time in administration. I’ve realised I need to be more creative and use my spiritual gifts more- healing, writing, art, etc. This feels much more ‘me’. I am currently working part time in retail, but find I can cope with this at the moment, as long as I am working on my passions too. My denial of these had been my downfall I think!

      Does that help?

      Rachel

      Reply
  5. Nat

    I would also like to say that those dealing with this illness should look into DBT therapy. (Dialectical Behavioral Therapy). It teaches Mindfulness based strategies for coping with the enormous, seemingly unmanageable thoughts, feelings and emotions that go along with bipolar disorder, and you also learn distress tolerance skills – and all types of things that help you to live a productive, more emotionally balanced life.

    Reply
  6. Lyndsay Lane

    My boyfriend is bipolar and has had two severe hyper-manic episodes. He is incredibly cruel and vulgar to me during these and I was wondering the best way for those around the person experiencing the episode to handle it and help.

    Reply
    1. rachelmiller1511 Post author

      Hi- I’m really sorry to hear this. Bipolar is never an excuse for such behaviour, and whilst it does make somebody liable to becoming out of control in some ways, it is still the responsibility of the bipolar sufferer to moderate these symptoms as best they can and to make sure they protect loved ones. It sounds really harsh, but I think I would leave him- you deserve way better than to put up with cruelty- it is abusive, no matter what the diagnosis he has. Please understand you are being emotionally abused and your first priority should be your health, safety and wellbeing. I know it may seem easy for me to say, and many more issues than this are probably involved, but you owe it to yourself to be with someone who treats you with love and respect. Yes, somebody with bipolar can still act with love and respect.

      Reply
  7. Sam K

    Very informative I think I have this. I have only ever described the depression to my psychiatrist and have tried so many different antidepressants..they don’t work for me.
    I spend hours and sometimes a whole day just talking out loud to myself…I wondered if you do this and whether it may be a symptom of hypomania.
    I have been doing since the age of 16, I am 38 now.

    Reply
    1. rachelmiller1511 Post author

      Hi Sam- thanks for your comment. Yes, I do the talking to myself thing! Yes, it’s usually when I’m getting hypomanic. It sometimes feels like a pressure to keep talking, at other times it feels more like I don’t really know what I’m doing and I connect with my mind better when I talk out loud, telling myself what I need to do, or how I need to do something. I’ve only ever experienced it in episodes though- so maybe 20 minutes at a time, not constantly. I don’t know if that’s helpful to you to know- I hope so! Thanks again!

      Reply

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