Bipolar disorder causes mood swings. You may feel very high or sad and without hope. Then you may feel high again. Often, there are times of steady moods in between these highs and lows. You may also have a change in energy and actions. The highs are called mania. The lows are called depression .

Depressive Episode

Low moods may cause:

  • Lasting sad, worried, or hollow mood
  • Lack of hope or negativity
  • Feelings of guilt, worthlessness, or helplessness
  • Not wanting to do things that you once liked
  • Low energy
  • Problems with focus, recall, or making choices
  • Restlessness or irritability
  • Sleeping too much or not being able to sleep
  • Change in hunger and weight loss or gain
  • Pain or other health symptoms that don't have a cause
  • Thoughts of death or self-harm, or trying to kill oneself

Manic Episode

High moods may cause:

  • Raised energy, activity, and restlessness
  • Very high, overly good mood
  • Irritability
  • Racing thoughts and talking quickly, jumping from one point to the next
  • Lack of focus
  • Little need for sleep
  • Odd beliefs in one's abilities and powers
  • Problems making choices
  • Spending sprees
  • Changes in how you are acting
  • A higher sex drive
  • Drug abuse , such as cocaine , alcohol , and sleeping pills
  • Aggressive actions
  • Denying that something is wrong

A mild to medium level of mania is called hypomania. It may feel good to the person who has it. You may be able to get more things done. It can become mania or can switch to depression if it isn't treated.

Other Symptoms

You may also have:

Psychosis

Sometimes, times of mania or depression turn into symptoms of psychosis, such as:

  • Hallucinations—hearing, seeing, or feeling that things are there that are not
  • Delusions—false, strongly held thoughts that are not based in reality
  • Disorders of thought—loose links between topics, flight of topics, or speech that others can't make sense of
  • Catatonia—strange motor actions or lack of reply (rare)

These symptoms are the extreme mood state at the time. A person with mania may believe that he or she is the President or has special powers or wealth. A person with depression may believe that he or she is ruined and penniless or has done a crime.

Suicidal Symptoms

Some people are in danger of self-harm. A person who is thinking about self-harm needs help right away. A person who talks about self-harm should get medical help right away. The risk of self-harm is higher early on. Finding bipolar disorder early and learning how best to treat it may lower the risk of death by self-harm.

Signs that you may have with thoughts of self-harm are:

  • Talking about feeling like killing oneself or wanting to die
  • Feeling hopeless, that nothing will ever change or get better
  • Feeling helpless, that nothing one does makes any change
  • Feeling like a weight to family and friends
  • Using alcohol or drugs
  • Putting affairs in order (organizing finances or giving away items to get ready for one's death)
  • Writing a note saying you are going to kill yourself
  • Putting oneself in harm's way or places where there is a danger of dying

Range of Symptoms

Problems can range from mild to severe. If you are feeling depressed, you may have a low mood, feel somewhat depressed, or have major depression. The symptoms of mania can also range from having more energy to being in a very high mood.

The disorder is complex because there is also a mixed state. You may feel like you have a lot of energy. At the same time you may also feel sad, wound up, and have thoughts of self-harm. In between these times, you could have times when your mood is steady.

Bipolar disorder is also broken down into four main types:

  • Type 1:
    • Having manic or mixed episodes that last for a week, or
    • Having severe manic symptoms that need care right away
  • Type 2:
    • Having episodes of depression and then hypomania
    • Not having severe mania or mixed episodes
  • Type 3:
    • Having symptoms that do not meet types 1 or 2
    • Having symptoms that are outside of the normal way that you act
  • Mild form (called cyclothymia):
    • Having times of hypomania and mild depression for at least two years
    • Not meeting the measures for types 1, 2, or 3

There is also a type called rapid cycling. This is more likely if you have severe bipolar disorder. It means that you have four or more times of major depression, mania, hypomania, or mixed state in one year.

This mental health problem is not easy to detect. Most people ask their doctors for help because they are depressed. They may not talk about their times of high mood. Doctors may not ask questions about mood changes.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2018 -