Symptoms of bipolar disorder

This fact sheet can be on the “Black Dog Institute” website.

The information in this fact sheet is not intended as a substitute for professional medical advice, diagnosis or treatment.

What this fact sheet covers:
• What is bipolar disorder?
• Distinguishing between bipolar I and bipolar II disorder
• The symptoms of bipolar disorder
• Key features of mania and hypomania
• When to seek help for bipolar disorder
• Key points to remember

What is bipolar disorder?
Bipolar disorder is the name used to describe a set of ‘mood swing’ conditions, the
most severe form of which used to be called ‘manic depression’. The term describes
the exaggerated swings of mood from one extreme to the other that are characteristic
of the illness.

People with this illness suffer recurrent episodes of high, or elevated, mood (mania or
hypomania) and of depression. A very small percentage of sufferers of bipolar
disorder only experience the ‘highs’. Most experience both the highs and the lows.
Occasionally people can experience a mixture of both highs and lows at the same
time, or switch during the day, giving a mixed picture. People with bipolar disorder
experience normal moods in between their swings.

The mood swings pattern for each individual is generally quite distinct, with some
people only having episodes of mania once a decade, while others may have daily
mood swings.

Bipolar disorder can commence in childhood, but onset is more common in the teens
or early 20s. Some people develop their first episode in mid‐to‐late adulthood.
It is important to note that everyone has mood swings from time to time. It is only
when these moods become extreme and interfere with personal and professional life
that bipolar disorder may be present and medical assessment may be warranted.

Distinguishing between bipolar I and bipolar II
Bipolar I disorder is the more severe disorder − with individuals being more likely to
experience mania, have longer ‘highs’, and to have psychotic experiences and be more
likely to be hospitalised.

Bipolar II disorder is defined as being less severe, with no psychotic experiences and
with episodes tending to last only hours to a few days; a person experiences episodes
of both hypomania and depression but no manic episodes, and the severity of the
highs does not lead to hospitalisation.

Women and men develop bipolar I disorder at equal rates, while the rate of bipolar II
disorder is somewhat higher in females.

Symptoms of bipolar disorder
Diagnosing bipolar disorder is often not a straightforward matter. Many people go 10
years or more before their illness is accurately diagnosed as bipolar disorder.

There are two starting points for considering whether you might have bipolar
disorder. Firstly, you must have had episodes of clinical depression. Secondly, you
must have had ‘highs’, where your mood is more ‘up’ than usual, or where you feel
more ‘wired’ and ‘hyper’.

If both depression and ‘highs’ have been experienced, then the next thing to consider
is whether you also experience any of the six key features of mania and hypomania.
These are described below.

The Black Dog Institute has developed a self‐test for bipolar disorder which can help
to give you an initial indication of whether you might have this condition. The test is
available on HERE

Some people with bipolar disorder can become suicidal. It is very important that talk
of suicide be taken seriously and for such people to be treated immediately by a
mental health professional or other appropriate person.

Key features of mania & hypomania
What is it that separates normal ‘happiness’ from the euphoria or elevation that is
seen in mania and hypomania? Researchers at the Black Dog Institute have identified
six key distinguishing features:
• High energy levels
• Positive mood
• Irritability
• Inappropriate behaviour
• Heightened creativity
• Mystical experiences.

More extreme expressions of mania (but not hypomania) may have the added
features of delusions and hallucinations.

High energy levels – the individual feels ‘wired’ and ‘hyper’, extremely energetic, talks
more and talks over people, makes decisions in a flash, is constantly on the go, and
feeling less need for sleep.

Positive mood – the individual feels confident and capable, optimistic, that they can
succeed in everything. They are more creative, happier and perhaps feel ‘high as a
kite’.

Irritability – this is reflected in irritable, impatient and angry behaviours.
Inappropriate behaviour – the individual becomes over involved in other people’s
activities, engages in increased risk taking (i.e: by over indulging in alcohol and drugs
and gambling excessively), says and does outrageous things, spends more money,
haves increased libido; dresses more colourfully and with disinhibition.

Heightened creativity – this is experienced as ‘seeing things in a new light’, seeing
things vividly and with crystal clarity, finding one’s senses are heightened and feeling
quite capable of writing the ‘great Australian novel’.

Mystical experiences – these can be experienced by believing that there are special
connections between events, that there is a higher rate of coincidence between things
happening, feeling at one with nature and appreciating the beauty and the world
around, and believing that things have special significance.

A number of symptoms can indicate whether bipolar disorder is likely, particularly for
those under the age of forty. These include:
• racing thoughts (for example, feeling like you are watching a number of
different TV channels at the same time, but not being able to focus on any)
• sleeping a lot more than usual
• Feeling agitated, restless and/or incredibly frustrated.

When to seek help for bipolar disorder
If you have experienced an episode of mania or hypomania, it’s best to seek
professional help as soon as possible. It may indicate that you have bipolar disorder,
which, if left untreated, will likely involve further episodes of mania or hypomania.
bipolar disorder is not an illness which goes away of its own accord, but one which
often needs long‐term treatment. Accurately diagnosing bipolar disorder is a task for
a professional. A first step is to see your local general practitioner, who will likely refer
you to a psychiatrist for assessment and treatment.

Key points to remember
• Bipolar disorder is an illness involving exaggerated mood swings from one
extreme to the other, involving, usually, alternating periods of depression and
mania or hypomania.

• The pattern of mood swings for each individual is quite distinct.
• The six key features of mania and hypomania are
      o High energy levels
      o Positive mood
      o Irritability
      o Inappropriate behaviour
      o Heightened creativity
      o Mystical experiences.
• Accurately diagnosing bipolar disorder is a task for a skilled mental health
practitioner.
• If symptoms of bipolar disorder are suspected it’s best to first see your general
practitioner who will likely refer you to a psychiatrist.
• People with bipolar disorder can become suicidal. Talk of suicide should be
taken seriously and immediate help should be sought from a GP or other mental
health professional.
• For people under the age of forty, some symptoms of bipolar disorder may
include− sleeping a lot more than usual; feeling agitated, restless and/or
incredibly frustrated.

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