The many different faces of Bipolar disorder, March 30, 2015 World Bipolar Day

Bipolar disorder comprises a spectrum of mental health irregularities characterized by moods that swing between poles of mania and depression. These mood swings can range from mild to severe. All bipolar types experience manic, hypomanic and mixed bipolar symptoms to different degrees (Moadel, 2013). There are significant elements that make up what bipolar disorder can look like. Within the spectrum of bipolar disorder are two primary “types” — bipolar I and bipolar II. These types delineate varying degrees of mania and depression. The pattern, frequency, duration and intensity of the manic and depressive episodes will differ and not necessarily remain consistent in their patterns.

Kinds of bipolar disorder

Some related disorders and issues that all people with bipolar disorder will experience to greater or lesser degrees include:

1. Bipolar I is the most severe form of bipolar disorder and is usually what is being referred to when individuals discuss the disorder. It can begin suddenly and last from four to six months. Individuals with bipolar I are likely to have at least one manic or mixed episode lasting at least a week with hypomania or major depression. Bipolar I experiences include mixed episodes, manic highs and lows and a tendency to lose touch with reality to the point of psychosis. Rapid speech, delusional thoughts, extensive goal-setting/planning, restlessness and risky sexual behavior and spending habits are all very typical behaviors of a person with bipolar I. Manic tendencies are at higher frequency as compared to bipolar II in which mania tendencies are more hypomanic (less intense in severity)

2. Bipolar II is a lesser form of bipolar I. People who experience bipolar II have less severity in their hypomanic symptoms, but with a greater frequency of depression, hence the term “manic-depression.” Hypomania is still present with bipolar II and can often make the person with bipolar II seem like the life of the party. Rapid, loud speech that may seem delusional or seems to be coming from nowhere is common during the hypomania stages.

3. Rapid cycling is an interspersing of bipolar I and II. Short periods of mania as well as short periods of depression occur during rapid cycling with depressive tendencies being predominant. Rapid cycling is characterized by alternating episodes of mania and depression within a short period of time. This occurs more frequently in women than in men and occurs after the illness has already developed.

4. Mixed bipolar disorder is when the highs and lows of mania occur at the same time. This happens in either dysphoric mania or agitated depression. Dysphoric mania is a combination of simultaneous depressive and manic symptoms. Agitated depression is a depressive episode in which manic symptoms such as anger and irritability are more dominant.

5. Cyclothymic disorder is characterized by extreme highs and lows with mild depression. The individual with cyclothymic disorder may feel on top of the world one minute then extremely low the next. Dysthymic disorder is not as severe as major depression. Mild symptoms of depression along with hopelessness, low self-esteem and too much or too little sleep is characteristic of dysthymia. A person with dysthymia has an overall feeling of constant inadequacy and is typically overly critical and negative.

Symptoms of bipolar disorder

The symptoms for bipolar disorder can be categorized into four categories: hypomania, mania, depression and general bipolar symptoms. It is important to know what these symptoms are to know when a loved one may be struggling with bipolar disorder. Symptoms in their categories include:

● Hypomania

  • Hyperactivity and euphoria
  • Loss of interest of activities
  • Difficulty concentrating
  • Thoughts of suicide or death

● Mania

  • Sudden euphoria or rage
  • Aggressive behavior
  • Speech that is loud/rapid and/or angry
  • Inflated self-esteem
  • Racing thoughts
  • Decreased need for sleep
  • Preoccupation with irrelevant matters

● Depression

  • Sadness and fatigue
  • Loss of interest
  • Changes in sleeping and eating patterns
  • Difficulty concentrating
  • Feelings of hopelessness and worthlessness
  • Thoughts of death or suicide

● Overall symptoms of bipolar disorder

  • Euphoric mood
  • Psychomotor acceleration and hyper sexuality
  • Aggression and paranoia with low irritability
  • Very severe/classic mania
  • Prominent euphoria
  • Irritability
  • Sleeplessness or irregular sleeping patterns
  • Sexual drive
  • High levels of psychosis
  • Aggression
  • Delusional thoughts
  • Lack of insight
  • Delusional mania (delusional or psychotic mania has its own separate diagnosis called schizoaffective disorder, which is a cross between bipolar disorder and schizophrenia)
  • Suicidal ideation
  • Feelings of guilt
  • Paranoid thinking

Therapy and the right medication or combination of medications can be very effective in relieving the symptoms of bipolar disorder. Many times one medication doesn’t work and it’s necessary to take a combination of more than one. Sedatives are prescribed to bipolar patients that experience behavioral agitation or explosive rapid speech (Haggerty, 2015). Hostility and agitation as well as depressive mood swings are able to be managed with prescribed sedatives, antidepressants, therapy and support groups.

If you or a loved one are suffering from bipolar disorder, trained professionals are here to help. Contact the Mental Health Helpline today for more information on bipolar disorder and treatment options. To contact us you can call 855-653-8178.