Bipolar Disorder

Common Symptoms

The most severe form of the disorder, bipolar I disorder, is characterized by one or more manic or mixed (simultaneously manic and depressed) episodes of sufficient severity to cause marked impairment in social and occupational functioning, often resulting in a psychiatric hospitalization. Typically, people with bipolar I disorder experience extreme fluctuations in mood ranging from severe depression to mania. During manic episodes people experience euphoric, elevated, or irritable moods in which they may become highly energized, have an inflated sense of self-esteem, experience a reduced need for sleep, become very talkative, have racing thoughts, take on multiple projects at once, and become easily distracted.

People in a more severe state of mania may lose their normal sense of judgment and may undertake risky behaviors with the potential for painful negative consequences. In the most severe stages of acute mania individuals will become disorganized in their behavior and thought processes. These individuals may appear bizarre to others, and they may experience strange or unusual ideas.

Bipolar II disorder is distinguished from bipolar I disorder by the presence of a milder form of mania called hypomania. Hypomanic episodes are characterized by a shorter duration (4 days versus 7 days) than manic episodes and less severe impairment in social and occupational functioning. Hypomanic episodes do not terminate in grossly disorganized behavior or psychotic features that typically require hospitalization. While bipolar II disorder is often thought of as a “milder form” of the disorder, individuals with this disorder have a high risk of suicide and a severe depressive course just as devastating as that experienced in bipolar I disorder. Individuals with bipolar II disorder may have significant interpersonal and occupational problems due to ongoing fluctuations in mood.

Individuals with bipolar I and bipolar II disorders also experience significant periods of depression. These periods are characterized by a depressed mood and loss of interest or pleasure as well as the following symptoms: significant weight loss or decrease or increase in appetite; sleeping too much or too little; and being agitated, slowed down, or feeling fatigued. During depressed periods, individuals often report feelings of worthlessness, excessive or inappropriate guilt, diminished ability to think or concentrate, inde-cisiveness, or suicidal thoughts or plans. A significantly elevated risk of suicide occurs during the depressed phase of bipolar and bipolar II.

The mildest form of bipolar disorder is cyclothymic disorder, a chronic fluctuating mood disorder characterized by numerous periods of hypomanic and depressive symptoms over at least 2 years. Individuals with cyclothymic disorder are at increased risk to develop bipolar I or bipolar II disorder.

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