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| Bipolar
disorder causes dramatic mood swings-from overly "high"
and/or irritable to sad and hopeless, and then back again, often
with periods of normal mood in between. Severe changes in energy
and behavior go along with these changes in mood. The periods
of highs and lows are called episodes of mania and depression.
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| Mania
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Mania can include
any of the following symptoms: increased energy, activity, and
restlessness, excessively "high," overly good, and
euphoric moods. The individual may become extremely irritable,
have racing thoughts and begin talking very fast. The individual
may not being able to concentrate, little sleep needed, unrealistic
beliefs about one's abilities and powers, poor judgment, going
on spending sprees, an increased sexual drive, aggressive behavior,
denial that anything is wrong. Possible drug abuse, in particularly
cocaine, alcohol and/or sleeping medications may be utilized.
A manic episode is diagnosed if elevated mood occurs with three
or more of the other symptoms most of the day, nearly every
day, for 1 week or longer. If the mood is irritable, four additional
symptoms must be present. (More symptoms are listed in the section
about depression)
A mild to moderate level of mania is referred to as hypomania.
Hypomania may feel good to the person who experiences it and
may even be associated with good functioning and enhanced productivity.
Thus even when family and friends learn to recognize the mood
swings as possible bipolar disorder, the person may deny that
anything is wrong. Without proper treatment, however, hypomania
can become severe mania in some people or can switch into depression.
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| Depression |
Depression can
include any of the following symptoms: lasting sadness, anxious,
or empty mood, feelings of hopelessness or pessimism, feelings
of guilt, worthlessness, or helplessness, loss of interest or
pleasure in activities once enjoyed, including sex, decreased
energy, a feeling of fatigue or of being "slowed down",
difficulty concentrating, remembering, making decisions, restlessness
or irritability, sleeping too much, or can't sleep, change in
appetite and/or unintended weight loss or gain, chronic pain
or other persistent bodily symptoms that are not caused by physical
illness or injury, thoughts of death or suicide, or suicide
attempts, a depressive episode is diagnosed if five or more
of these symptoms last most of the day, nearly every day, for
a period of 2 weeks or longer.
Sometimes, severe episodes of mania or depression include symptoms
of psychosis (or psychotic symptoms).
Common psychotic symptoms are hallucinations (hearing, seeing,
or otherwise sensing the presence of things not actually there)
and delusions (false, strongly held beliefs not influenced by
logical reasoning or explained by a person's usual cultural
concepts). Psychotic symptoms in bipolar disorder tend to reflect
the extreme mood state at the time and can also mimic schizophrenia,
since many of the psychotic symptoms are similar. Grandiosity,
such as believing one is the President or has special powers
or wealth, can occur during mania; delusions of guilt or worthlessness,
such as believing that one is ruined and penniless or has committed
some terrible crime, may appear during depression.
Bipolar disorder may appear to be a problem other than mental
illness-for instance, alcohol or drug abuse, poor school or
work performance, or strained interpersonal relationships. Such
problems in fact may be signs of an underlying mood disorder.
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