Balancing Bipolar

The following is an Editorial Resource from YourTotalHealth.

Reviewed by:  Steven A. King, M.D.

Many people who are ultimately diagnosed with bipolar disorder are initially misdiagnosed with major depressive disorder because they have the symptoms of depression before ever having a full-blown manic episode. If you are diagnosed with depression and given an antidepressant, however, this medication could make your bipolar symptoms worse. That’s why it’s important to be very specific about your symptoms. Even if you think you are feeling well, pay attention if others express concern about the fact that you seem "hyper" or are talking really fast, or if people mention that you seem on edge or stressed out—all symptoms of mania that can indicate bipolar disorder.

Symptoms of Mania

According to the National Institute of Mental Health (NIMH), a manic episode is diagnosed if an elevated mood occurs with three or more of the following symptoms and lasts most of the day, nearly every day, for one week or longer. If the mood is irritable, four additional symptoms must be present. A mild to moderate level of mania is called hypomania. Symptoms may include: 

• Increased energy, activity, restlessness 
• Excessively "high" euphoric mood
• Extreme irritability 
• Racing thoughts, talking fast, jumping from one idea to another 
• Distractibility or inability to concentrate well 
• Little sleep needed 
• Unrealistic beliefs in your abilities and powers
• Poor judgment 
• Spending sprees 
• Increased sexual drive
• Abuse of alcohol or other drugs 
• Provocative, intrusive or aggressive behavior 
• Denial that anything is wrong

Symptoms of Depression

According to NIMH, a depressive episode is diagnosed if five or more of the following symptoms last most of the day, nearly every day, for a period of two weeks or longer:

• Chronic sad, anxious or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness or helplessness
• Loss of interest or pleasure in activities you once enjoyed
• Decreased energy, fatigue
• Difficulty concentrating, remembering or making decisions
• Restlessness or irritability
• Sleeping too much or too little
• Change in appetite or unintended weight gain or loss
• Chronic pain not due to physical illness or injury
• Thoughts of death or suicide, or suicide attempts

Symptoms of Psychosis

These can occur during severe episodes of mania or depression and may include:

• Hallucinations (hearing, seeing or sensing the presence of things not actually there)
  
  
• Delusions (strongly held illogical beliefs)

Many people do not tell their doctors if they’re having these symptoms because they may not recognize them as problematic. But symptoms of "hypomania" can lead to more severe symptoms of mania or even to episodes of depression. The earlier you can detect your symptoms and get help for them, the more likely it is that you will ward off or minimize a manic or a depressive episode.

What's Next: Be Aware of Triggers for Manic or Depressive Episodes

• Does Bipolar Put You at Increased Risk for Other Conditions?
  
• Prevent Future Episodes of Mania or Depression
  
• Get the Right Diagnosis

Review Date: May 01, 2009