Bipolar Disorder Signs & Symptoms

Learn about bipolar disorder

Bipolar and related disorders are a category of mental illnesses that can cause monumental turmoil in the lives of those afflicted by them. Of these disorders, the most commonly recognized are bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Descriptions of these three disorders, based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are explained briefly in the following:

Bipolar I disorder is recognized as being the most severe type of bipolar disorder, as the mood disturbances that are characteristic of it will cause significant impairment in an individual’s ability to function. In order to be diagnosed with bipolar I, an individual must have experienced at least one manic episode, which may be followed by or preceded by major depressive or hypomanic episodes. (The differences between these episodes are discussed later in this page.) Mood fluctuations in those with bipolar I can be drastic, shifting rapidly from euphoria to anger to depression.

Bipolar II disorder is classified as a disorder of mood that includes at least one major depressive episode and at least one hypomanic episode. While individuals with bipolar II will experience disturbances in some areas of functioning, they do not experience the same level of impairment as do those suffering from bipolar I.

Cyclothymic disorder is diagnosed when an individual experiences symptoms of both hypomania and depression, yet those symptoms are not severe enough to meet criteria for a true episode of hypomania, depression, or mania. According to the American Psychiatric Association (APA), the cornerstone feature of cyclothymic disorder (also known as cyclothymia) is a chronically fluctuating mood that encompasses the symptoms of depression and hypomania.

While the presence of any type of bipolar disorder can lead to significant upheaval in the lives of those suffering from it, the challenges that individuals with bipolar disorders face can be magnified if they are simultaneously battling an addiction to drugs and/or alcohol. The presence of a co-occurring substance use disorder can not only exacerbate the symptoms that people already struggle with, but they can also elicit the onset of new symptoms as well. The physical health of these individuals can also be placed at risk as well. Fortunately, there are treatment options available that are specifically designed to help individuals battling a dual diagnosis of bipolar disorder and learn how to manage their symptoms while also overcoming their addictions. By taking part in such treatment, happy, healthy, and well-adjusted lives can be obtained.

Bipolar disorder statistics

In the United States, the American Psychiatric Association (APA) reports that approximately 0.6% of the population suffers from bipolar I disorder. Bipolar II disorder is said to affect 0.8% of the population, and the lifetime prevalence of cyclothymic disorder is estimated to be between 0.4% and 1%.

Causes and risk factors for bipolar disorder

The causes and risk factors for bipolar disorders are described briefly in the following:

Genetic: An individual’s genetic background is cited as being one of the most prominent and consistent causes for the onset of bipolar disorders. If a person has a family history of bipolar disorders, he or she is at a heightened risk for experiencing the onset of symptoms him or herself. In regards to cyclothymic disorder, having a family history of major depressive disorder can also increase one’s chances of suffering from the disorder. Additionally, the APA notes that genetic factors can also play a role in determining the age at which an individual experiences the onset of symptoms.

Environmental: One’s environment can impact the onset of bipolar I disorder when a genetic predisposition for the disorder is present. The APA notes that bipolar I disorder is more common in high-income countries than it is in low-income countries. Additionally, the APA states that people who are divorced, widowed, or separated have a higher rate of bipolar I disorder than do individuals who are either married or who have never been married. However, the correlation between the two has yet to be defined.

Risk Factors:

• Having a family history of bipolar I, bipolar II, cyclothymic disorder, or major depressive disorder
• Living in a more developed country
• Being widowed, divorced, or separated
• Abusing drugs and/or alcohol can cause the onset of symptoms when one possesses a genetic predisposition for the disorder.

Signs and symptoms of bipolar disorder

The signs and symptoms that are displayed by individuals who are suffering from bipolar disorders will vary depending upon whether they are suffering from bipolar I, bipolar II, or cyclothymic disorder, as well as whether they are experiencing an episode of depression, mania, or hypomania. Manic episodes only occur in individuals with bipolar I disorder, so if the symptoms of such are present, this diagnosis would be most appropriate. Examples of signs and symptoms that could be present during the different types of episodes are listed in the following:

Manic episode: According to the DSM-5, manic episodes occur when individuals experience a defined period of determinedly elevated, expansive, or irritable mood that would be considered abnormal in nature. This mood lasts for at least one full week, with symptoms presenting for most of the day, nearly every day. Manic episodes cause a disturbance of mood that is so severe that it results in significant impairment in an individual’s ability to function. Signs of a manic episode can include:

• Euphoric or excessively cheerful mood
• Decreased need for sleep
• Experiencing a flight of ideas
• Racing thoughts
• Excessively talkative
• High level of distractibility
• Inflated self-esteem or sense of grandiosity
• Psychomotor agitation
• Spending an increased amount of time in goal-directed activity
• Participating in activities that have the potential to elicit detrimental consequences, such as going on major spending sprees or engaging in risky sexual behavior

Hypomanic episode: Hypomanic episodes are similar to manic episodes, yet they are less intensive and last for shorter periods of time. The symptoms must be present for at least four consecutive days and exist for most of the day. While the symptoms of hypomanic episodes are noticeable to others, unlike manic episodes, they do not cause impairment in an individual’s ability to function. Signs of a hypomanic episode can include:

• Heightened self-esteem or false sense of grandiosity
• Becoming easily distracted
• Lacking a need for sleep
• Talking excessively
• Experiencing a flight of ideas and/or racing thoughts
• Participating in high-risk behaviors

Major depressive episode: When individuals are suffering from a major depressive episode, they will experience at least five symptoms during a two-week period and will demonstrate a change in their normal pattern of functioning. The symptoms of a major depressive episode also lead to functional impairment and distress that is clinically significant and negatively impacts the individuals’ lives. According to the APA, signs of a major depressive can include:

• Suffering from a depressed mood most of the day, nearly every day
• Feelings of worthlessness
• Experiencing excessive and/or inappropriate guilt
• No longer demonstrating an interest in things that were once found pleasurable
• No longer engaging in activities that one once enjoyed
• Struggling with insomnia or hypersomnia nearly every day
• Noticeable change in appetite and subsequent weight loss or weight gain
• Psychomotor agitation or retardation
• Fatigue or extreme loss of energy
• Diminished ability to concentrate
• Struggling to make decisions
• Experiencing recurrent thoughts of death

Effects of bipolar disorder

When individuals suffer from bipolar disorders and do not receive appropriate treatments, they are susceptible to experiencing a number of detrimental effects. Examples of such effects are discussed in the following:

• Occupational struggles, which can lead to job loss and subsequent financial struggles
• Financial turmoil as a result of spending excessive amounts of money during manic or hypomanic episodes
• Disturbances within interpersonal relationships
• Familial strife
• Marital discord
• Cognitive impairments
• Worsening of symptoms
• Beginning to abuse drugs and/or alcohol
• Engaging in self-harming behaviors
• Suffering from suicidal thoughts or engaging in suicidal behaviors

Bipolar disorder and co-occurring disorders

According to the American Psychiatric Association, co-occurring mental disorders are common among individuals who are suffering from bipolar disorders. Co-occurring substance use disorders, in particular, are cited as being especially prominent in those battling this type of mental illness. Specific examples of various co-occurring conditions are separated by the three types of bipolar disorders and are listed in the following:

Bipolar I disorder: Anxiety disorders, including social anxiety disorder, panic disorder, and specific phobia reportedly occur in nearly three-fourths of people suffering from bipolar I disorder. Other disorders cited as co-occurring with bipolar I include:

• Intermittent explosive disorder (IED)
• Oppositional defiant disorder (ODD)
• Conduct disorder
• Attention-deficit/hyperactivity disorder (ADHD)
• Alcohol use disorder
• Other substance use disorders

Bipolar II disorder: Research has shown that people with bipolar II disorder more often than not suffer from one or more co-occurring mental health condition. In fact, the American Psychiatric Association states that 60% of people with bipolar II disorder suffering from three or more co-occurring disorders. Examples of such disorders include:

• Anxiety disorders
• Substance use disorders

Cyclothymic disorder: For people with cyclothymic disorder, the most common co-occurring disorders include:

• Sleep disorders
• Substance use disorders
• Attention-deficit/hyperactivity disorder (ADHD)