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:
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.
- 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.
- 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.