Symptoms of Bipolar Disorder

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Bipolar disorder is an illness that is presented in the form of episodes or phases. There are two types: the depressive phases, in which the person feels sad or gloomy and shows little interest, and the manic phases, which, depending on their severity, can be classified as hypomania (if they are milder) and are usually manifested by great euphoria, excess of energy, or irritability.

Some patients appear emotionally stable (euthymia) between episodes, that is to say, they do not have any type of psychiatric symptom if they are not in an acute phase. However, between episodes it is common for minor symptoms to appear in the form of anxiety, tiredness, difficulties in concentration, and irritability, among others.

Symptoms of Mania

Smiling person with episodes of hyperactivity or mania due to bipolar disorder

Mania is a pathological elevation in mood and/or energy. The individual that is in a manic phase usually has some of these symptoms (it is not necessary that they have all of them):

  • Irritability
  • Hyperactivity
  • Decrease in the need to sleep
  • Talkative
  • Increase in sociability
  • Increase in energy
  • Euphoria
  • Cheerfulnes
  • Increase in financial spending, generally on unnecessary objects or activities
  • Increase in sexual impulse
  • Increase in speed of thought
  • Occasional neglect their physical appearance or dress extravagantly or flamboyantly
  • Incapable of staying still
  • Usually imagine new projects—generally grandiose and absurd—and, in the more severe cases, can have psychotic symptoms (delusions and/or hallucinations).

Symptoms of Depression

Person with a cloud and rain over his head as a sign of depression

Depression is not only to be very sad, but it also includes other common symptoms, such as:

  • Apathy
  • Loss of hope/dreams for things
  • Physical discomforts
  • Tiredness
  • Increase in hours of sleep—although there may also be insomnia
  • Anxiety
  • Loss or excess of appetite
  • Low self-esteem
  • Pessimism
  • Ideas of death

Mixed Symptoms

Reflected and unfolded person in the mirror

They are called mixed symptoms when manic symptoms appear in a depressive phase, or depressive symptoms, in a manic phase. They are particularly complex periods to diagnose in those that have them, as they involve much suffering. It is common in these phases for there to be hyperactivity and acceleration of thoughts, at the same time as negative ideas and depressive thoughts. Some symptoms are:

  • Bad mood
  • Speed of thought
  • Restless
  • Hostility
  • Lack of enthusiasm
  • Rapid mood changes
  • Insomnia
  • Uncontrolled behaviour
  • Delusional ideas
  • Negative ideas
  • Hallucinations

Psychotic Symptoms

Person with psychotic symptoms, delusions and hallucinations

There are two types of psychotic symptoms: delusions and hallucinations.

The delusions are ideas with no real basis, often based on an erroneous interpretation of the information. For example, the patients believe that there is a conspiracy against them because the cars on the motorway are following them.

Hallucinations are perceptions with no object: to hear voices or noises that do not exist (auditory hallucinations), see faces or appearances (visual hallucinations), perceive smells, etc.

The delusions are much more frequent than the hallucinations. The psychotic symptoms may appear in the depression as well as in the mania and generally, their content tends to be in keeping with the mood state. It is likely, for example, that a patient in the manic phase thinks that he/she has superpowers and, in the depressive phase, may have the delusional conviction the he/she and his/her family suffer from a deadly disease.

Substantiated information by:

Ana Isabel Martínez Arán
Diego Alberto Hidalgo Mazzei
Eduard Vieta Pascual
Mercè Comes Forastero

Published: 20 March 2018
Updated: 20 March 2018

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