Bipolar Disorder symptoms
Bipolar disorder is typically characterized by alternating periods of mania and depression, although some people will experience mostly depressive episodes during their lifetime (Bipolar type II), others mainly manic ones (Bipolar I), there could be also mixed episodes with both symptoms of mania and depression, and yet other people will alternate between slighter mood swings (cyclothymia). The period of time between episodes (euthymia) a person remains asymptomatic, although some mild cognitive deficits are generally present.
Symptoms of a manic episode
Several or all of these may be present during at least a few days, if unmedicated they may persist for up to four or five months:
- Restlessness, little or no need for sleep without feeling tired
- High levels of self confidence
- Feelings of elation or extreme happinness
- More talkative than usual, excessive verbiage
- Very fast thinking, flight of ideas or racing thoughts
- Increase in goal oriented activity
- Distractability, unable to focus on tasks
- Irritable mood
- Lack of sexual inhibition
- Engages in risk taking behavior
- Uncontrollable spending sprees
Oftentimes, mania is also accompanied by psychotic features. These symptoms may include bizarre thoughts or delusions, where the patient holds beliefs that are regarded to be out of touch with reality, normally of a grandiose nature. Hallucinations (hearing voices or seeing things that do not exist) may also appear in up to 30% of these cases. If this is a first episode, ruling out the possibility of schizophrenia is needed. You can have a look at the typical symptoms of schizophrenia by filling out the following test. If a patient is psychotic she will need to be urgently hospitalized because this state can permanently damage personal or career related relationships.
Symptoms of hypomania
Hypomania is a a less severe form of mania without deliria or hallucinations, where the patient is particularly productive and well adjusted at a personal level and therefore is less likely to seek treatment. However, it may evolve into a full manic episode or the patient may slip into depression.
Symptoms of a depressive episode
Depression is the other pole of the mood scale. At least five of the following symptoms must be present during a two week period:
- Feelings of sadness or emptiness nearly all day every single day
- Evident lack of interest in normal day to day activities
- Weight loss or weight gain of around five percent of body mass
- Imnsomia, decreased need of sleep
- Diminished thinking ability
- Fatigue and lack of energy
- Thinking about death and suicide, possibly even attempting to commit suicide
- Low self esteem
As in the case of mania, psychotic features may also be present during a depressive episode as well. Just as manic psychoses are characterized by grandiose delusions, a depressed patient may feel that she is bankrupt or has commited a crime. Psychosis warrants immediate hospitalization.
Bipolar patients suffering from depression may be inadvertently prescribed regular antidepressants used to treat other forms of depression, and this may provoke drug induced mania.
How severe is the illness?
The average bipolar female at 25 years of age will lose, on average, 9 years of life expectancy if untreated (Goldberg, Harrow - 1999), as there is a high risk of suicide in this scenario. About 15% of bipolar sufferers will commit suicide and tragically end their lives. Treatment is therefore essential. It is important that the patient understands the situation and follows the medication regime as there is a high degree of non compliance among bipolar patients when it comes down to keeping up with meds.