Bipolar disorder, formerly called manic depression, is a mental and mood disorder that causes extreme mood swings. Symptoms include abnormally elevated emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. These are the 10 worst symptoms of bipolar disorder.
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Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy). Medications may include antidepressants, SSRIs, mood stabilizers, and antipsychotics. In extreme cases, electroshock therapy may be necessary to deal with symptoms.
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- Bipolar I disorder. You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II disorder. You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.
- Cyclothymic disorder. You’ve had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing’s disease, multiple sclerosis or stroke.
Worst Symptoms of Bipolar Disorder
1. Depression
Depression is a state of low mood and aversion to activity. Classified medically as a mental and behavioral disorder, the experience of depression affects a person’s quality of life. It also affects thoughts, behavior, motivation, feelings, and sense of well-being. The core symptom of depression is said to be anhedonia. This refers to loss of interest or a loss of feeling of pleasure in certain activities that usually bring joy to people. It’s a predominant symptom of bipolar disorder and accounts for half of the illness. Those experiencing a down during this disorder are displaying the same signs of major depressive disorder as others.
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Depressed mood is also a symptom of other mood disorders such as major depressive disorder and dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one. It is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. Someone may feature sadness, difficulty in thinking and concentration and a significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection, hopelessness and suicidal thoughts. It can either be short term or long term.
2. Mania
Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal affect, and energy level. It’s generally “a state of heightened overall activation with enhanced affective expression together with lability of affect.” During a manic episode, an individual will experience rapidly changing emotions and moods, highly influenced by surrounding stimuli. Although mania is often conceived as a “mirror image” to depression, the heightened mood can be either euphoric or dysphoric. As the mania intensifies, irritability can be more pronounced and result in anxiety or anger.
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The symptoms of mania include elevated mood (either euphoric or irritable), flight of ideas and pressure of speech, increased energy, decreased need and desire for sleep, and hyperactivity. They are most plainly evident in fully developed hypomanic states. However, in full-blown mania, they undergo progressively severe exacerbations and become more and more obscured by other signs and symptoms, such as delusions and fragmentation of behavior. This is one of the key features of bipolar disorder and requires mood stabilizers to help.
Worst Symptoms of Bipolar Disorder
3. Hypomania
Hypomania (literally means “less than mania”) is a mental and behavioral disorder, characterized essentially by an apparently non-contextual elevation of mood (euphoria) which contributes to persistently disinhibited behavior. It’s less severe than mania, but it exhibits many of the same features. Those experiencing hypomania during a manic episode of bipolar will be less affected. There are points in the manic episode where it can go back and forth or a hypomanic episode entirely replaces mania. It depends on a person’s episodic tendencies, as different combinations are certainly possible.
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The individual afflicted may suffer with irritability, not necessarily less severe than full mania; in fact, the presence of marked irritability is a documented feature of hypomanic and mixed episodes in Bipolar type II. According to DSM criteria, hypomania is distinct from mania in that there is no significant functional impairment. Mania, by DSM definition, does include significant functional impairment and may have psychotic features.
4. Psychosis
Psychosis is an abnormal condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes. Those dealing with bipolar can experience this as depressive episodes can exhibit psychotic depression symptoms.
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Delusions and hallucinations are very common among those with bipolar disorder. They typically show up during both manic and depressive episodes. During this time, paranoia and seclusion can accompany these symptoms, especially for those in a depressive episode. These features are especially true with those dealing with psychotic depressive episodes. The most common feature being delusions and outright skepticism. This is when something like antipsychotics might be considered as a viable option for help.
Worst Symptoms of Bipolar Disorder
5. Insomnia
Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. It may result in an increased risk of motor vehicle collisions, as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month. This is very common during bipolar disorder because of the anxiety and rush happening during manic episodes. Anxiety and remorse can also cause this during depressive episodes. The bad habits carry over to each episode and leaves the person more depressed and irritable for it.
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Insomnia can occur independently or as a result of another problem. Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol. Other risk factors include working night shifts and sleep apnea. Diagnosis is based on sleep habits and an examination to look for underlying causes. A sleep study may be done to look for underlying sleep disorders. Screening may be done with two questions: “do you experience difficulty sleeping?” and “do you have difficulty falling or staying asleep?”
6. Anxiety
Anxiety is an emotion characterized by an unpleasant state of inner turmoil. This entails subjectively unpleasant feelings of dread over anticipated events. It is often accompanied by nervous behavior such as pacing back and forth, somatic complaints, and rumination. A feeling of anxiety is often felt during bipolar disorder during the manic stages of the disorder. During an episode, a person can feel fine one second, and the next, they are induced into a panic. While anxiety is present throughout depressive episodes as well, the nature of mania makes it more common. Irritability and anger are also common during this stage, which further tend to exacerbate the anxiety. It does not help that during manic episodes, sufferers are more likely to engage in risky behavior.
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Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing. It is often accompanied by muscular tension, restlessness, fatigue, inability to catch one’s breath, tightness in the abdominal region, and problems in concentration. Anxiety is closely related to fear, which is a response to a real or perceived immediate threat; anxiety involves the expectation of future threat including dread. People facing anxiety may withdraw from situations which have provoked anxiety in the past.
Worst Symptoms of Bipolar Disorder
7. Substance Abuse
Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder and is a symptom of bipolar disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur.
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These are particularly common during manic episodes, as a person will find drugs more appealing. A person during this time will become more impulsive and care little for the consequences. Depressive — to avoid depression — episodes can yield similar results, jeopardizing a person’s judgement. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
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Drugs most often associated with this term include: alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, hallucinogens, methaqualone, and opioids. The exact cause of substance abuse is not clear, but there are two predominant theories. It can be either a genetic disposition which is learned from others, or a habit which, if addiction develops, manifests itself as a chronic debilitating disease.
8. Suicidal Ideation
Suicidal ideation (suicidal thoughts) means having thoughts, ideas, or ruminations about the possibility of ending one’s life. It is not a diagnosis, but is a symptom of some mental disorders. It can also occur in response to adverse events without the presence of a mental disorder. This is very common among those with bipolar disorder, especially during the depressive episodes. On suicide risk scales, the range of suicidal ideation varies from fleeting thoughts to detailed planning. Passive suicidal ideation is thinking about not wanting to live or imagining being dead. Active suicidal ideation is thinking about different ways to die or forming a plan to die.
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Suicidal ideation is very common among those with bipolar disorder. The depressive episodes are the period where this is most prominent, but manic episodes can lead to it as well. The back and forth and episodic nature of the disease can lead to confusion and suicidal thoughts. This comes with the expectation of a mood swing they know they can do little to control. This is where mood stabilizers and talk therapy are very important for those with this disorder. If talk therapy does little to help, pragmatic habit changes and medication may be useful.
Worst Symptoms of Bipolar Disorder
9. Weight Fluctuation
Weight fluctuation is common among those with diabetes, bipolar disorder, and other disorders. There can be overeating or under eating during and between manic and depressive episodes. It’s very common for the fluctuation to happen more so within depressive episodes. This is because mania can reduce appetite, almost as if one is on a stimulant. As such, a person may lose weight when a manic episode occurs and causes the person to undereat.
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This kind of eating pattern can be destructive and unhealthy. The more a person does this, the more they are tiring their system out. This is especially true if their episodes are timed poorly to the point of rapid weight gain and loss. This can lead to poor eating habits for the rest of their life, as it creates unbreakable habits. This is where appetite enhancers can help a person to help them avoid losing weight during this time.
10. Lack of Focus
Finding it hard to focus and pay attention is a symptom of bipolar disorder. Those struggling to concentrate may have an attention deficit problem and is strongly associated with depression. The same can be said for the manic episodes, but it’s not experienced in the same ways. A person in a depressed state will simply be unable to think about anything but the negative. Those in a manic episode can focus, but they cannot stay focused on one thing for long. Their flight of ideas causes them to struggle staying on subject and figuring things out.
Worst Symptoms of Bipolar Disorder
11. Low Self-Esteem
Of course, low self-esteem is a key feature of the depressive episodes in bipolar disorder. Self-esteem problems are why so many people have suicidal thoughts and feelings. The low self-esteem is also experienced during manic episodes, but it’s easily overlooked. The display of behavior, in affect, is causing their poor self-esteem and judgement. This is usually the problem to begin with, as poor self-esteem will lead to bad decision making. The manic and depressive swings can cause this, but it’s usually something else causing it, too.
12. Extreme Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy. It may be sudden or gradual in onset. Feeling fatigued is extremely common during the depressive episodes of the disorder. It normally follows prolonged physical or mental activity, and resolves completely with rest. However, it may be a symptom of a medical condition if it is unresolved, severe, progressive, or occurs without provocation. During manic swings, it’s common to feel fatigue if the person has not gotten any sleep over periods of restlessness. This includes slow movement and behavioral changes among those with bipolar disorder.
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Physical fatigue is the transient inability of muscles to maintain optimal physical performance, and is made more severe by intense physical exercise. Mental fatigue is a transient decrease in maximal cognitive performance resulting from prolonged periods of cognitive activity. Mental fatigue can manifest as somnolence, lethargy, or directed attention fatigue. Fatigue can usually be alleviated by periods of rest, unlike weakness. Fatigue and “feelings of fatigue” are sometimes confused. Fatigability describes a susceptibility to fatigue.
Worst Symptoms of Bipolar Disorder
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