Two names for this disorder are in common usage: bipolar disorder and manic depression. The former term is now the more common and less stigmatizing. The disorder is one of severe mood changes from depression, excessively low mood to mania, excessively high mood. It cannot be compared to normal changes in mood experienced by most people. It can be very destructive, causing disruption in relationships, loss of work, financial difficulties (it is often associated by excessive spending). However, like depression alone, it can be treated so that people can lead relatively normal productive lives. For the symptoms of depression, see Depression. Below we give the symptoms of mania (excessively high mood).
Characteristic Symptoms of Mania
- Inappropriate elation
- Inappropriate irritability
- Severe insomnia
- Grandiose notions
- Increased talking
- Disconnected and racing thoughts
- Increased sexual desire
- Markedly increased energy
- Poor judgment
- Distractibility, can't concentrate well
- Spending sprees
- Inappropriate social behaviour
- Euphoric mood
- Provocative, intrusive or aggressive behaviour
- Lack of insight into the condition
Hypomania is a mild to moderate level of mania that may feel very good to the person. This may, however, become severe mania or can switch to depression.
In some cases manic or depressive symptoms can be accompanied by psychotic symptoms. Psychosis means being out of touch with reality for at least some of the time. Psychotic symptoms are false perceptions such as visual, auditory or other sensory hallucinations, and delusions: false beliefs which are impervious to reasoned thought. Such delusions tend to reflect the elated or depressed mood state. You may read about psychotic symptoms under Schizophrenia.
Who is at Risk?
Anyone may be at risk.
Cause or Causes
The causes of these disorders are as yet unknown, although a great deal of research is now taking place with the new tools and technology available to researchers.
As yet there is no blood test of brain scan that can help the doctor to diagnose the condition. We must rely on anecdotal information given by the patient and his/her family. A thorough physical and mental examination should be given and a full history taken by the medical professional. In some cases the diagnosis may be blurred by features present in several other mental illnesses, so that it may be that a diagnosis takes longer than one might expect.
The website of the NIMH (National Institute of Mental Health US) offers the following comments by people with bipolar disorder that give valuable insights into the various mood states associated with the illness:
Depression: I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless... [I am] haunt[ed]... with the total, the desperate hopelessness of it all... Others say, "It's only temporary, it will pass, you will get over it," but of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think or care, then what on earth is the point?
Hypomania: At first when I'm high, it's tremendous... ideas are fast... like shooting stars you follow until brighter ones appear... All shyness disappears, the right words and gestures are suddenly there... uninteresting people, things become intensely interesting. Sensuality is pervasive; the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria... you can do anything... but, somewhere this changes.
Mania: The fast ideas become too fast and there are far too many... overwhelming confusion replaces clarity... you stop keeping up with it memory goes. Infectious humour ceases to amuse. Your friends become frightened... everything is now against the grain... you are irritable, angry, frightened, uncontrollable, and trapped.
How often do the moods change?
People may experience moods for many weeks or months before they change. In other cases, called rapid cycling, moods swing daily and are very difficult to deal with.
Risk of Suicide
Families must always be aware that there is a risk for suicide in people with bipolar disorder. We direct you to our booklet 2 in the publications section of the site, where some of the risk factors are described.