8 Symptoms of Bipolar Disorder You Might Not Know
Updated: May 14, 2020Are your emotional highs and lows and changes in energy the result of a more serious mental illness? Here are common bipolar disorder symptoms you should know.
What is bipolar disorder?
There are two types of bipolar disorder, a mental illness characterized by changes in energy, concentration, and the ability to carry out day-to-day tasks. People with bipolar I have depression alternating with severely elevated mood, or what’s known as mania. Bipolar II is much more common, and is marked by less severe manic symptoms, called hypomania.
The symptoms of bipolar disorder exist along a spectrum ranging from relatively subtle to extreme, and good or bad moods can be a result of temporary events or circumstances rather than a mental illness, so diagnosis of bipolar disorder can be difficult. Only a mental health professional can diagnose an individual with a psychiatric condition, but here are some signs and symptoms of bipolar disorder. (Check out these signs you could have an anxiety disorder.)
You’re depressed
A bipolar person in a depressive state will have the same symptoms as someone who has depression alone. “They’ll have insomnia, tiredness, trouble concentrating, and decreased appetite,” says Mauricio Tohen, MD, professor and chairman in the department of psychiatry and behavioral sciences at University of New Mexico Health Sciences Center in Albuquerque. The period of mania, or elevated mood, that follows the depression is what differentiates a bipolar diagnosis. It’s important to discuss fluctuations in mood with your therapist or doctor because the treatment for depression will be different from bipolar disorder treatment, Dr. Tohen says.
“Prescribing an antidepressant alone in a patient with bipolar depression isn’t recommended because it might send the patient into mania,” says Dr. Tohen. “It’s not as common as once thought, but it does happen.” (Read more about the hidden warning signs of depression.)
You can’t sleep
It’s common to have periods of insomnia due to stress or anticipation of something exciting on the horizon. But someone in a manic phase of bipolar disorder will require significantly less sleep than usual (sometimes none at all) for days at a time—and still feel energized, says Dr. Tohen. “It’s not just the lack of sleep, but more importantly it’s the decreased need to sleep.” During a depressive phase, a person may sleep for longer than usual. Staying on a regular sleep schedule is especially important for people with bipolar disorder, Dr. Tohen says. (Here are 10 sleep aids that are actually hurting your sleep.)
You’re in a great mood—a really, really great mood
Who wouldn’t love to be in a great mood? And why would anyone see that as a sign of mental illness? “These phases of the disorder may actually be enjoyable to the individual because they allow for increased productivity and creativity that they normally might not experience,” says Smitha Murthy, MD, a psychiatrist and assistant professor in the department of psychiatry at The University of Texas at Austin Dell Medical School in Austin, Texas. But if the mood elevation is extreme, there is no apparent cause for it, it lasts for a week or longer, or it appears in combination with other symptoms, it may be mania, one of the symptoms of bipolar disorder. In fact, mania is dangerous; it can cause people to make important decisions—financially, sexually, and in their relationships—that they wouldn’t otherwise make. And it can sometimes lead to psychosis, a break from reality that can include delusions and hallucinations. Hypomania, characteristic of bipolar II, is more subtle and may be harder to differentiate from a generally good mood because the symptoms are milder. Look for a combination of elevated mood with other bipolar symptoms, especially in a repetitive cycle that alternates with depression. (Check out these easy ways to boost your mood.)
You get distracted easily
Trouble concentrating, a tendency to jump from task to task, or being generally unable to finish projects may be attributed to flightiness, stress, or other factors, like an attention deficit disorder. But if you’re so distracted that you’re unable to get anything done, and it’s interfering with your work or relationships, you might be showing symptoms of bipolar disorder, says Dr. Murthy. (Here are 12 silent signs of ADHD you might be ignoring.)
You’re unusually irritable
“This is one of the trickiest symptoms to recognize since it’s a natural reaction to frustration or unfairness,” says James Phelps, MD, director of the Mood Disorders Program at Samaritan Mental Health in Corvallis, Oregon, and co-author of Bipolar, Not So Much: Understanding Your Mood Swings and Depression. Getting upset that someone cut you off on the highway, for example, is pretty normal. “Anger out of proportion to the situation, rising too fast, getting out of control, lasting for hours, and shifting from one person to another, would differentiate the behavior as a possible bipolar symptom,” he says. (Don’t miss these medical reasons you always feel cranky.)
You talk—and think—fast
Many people talk rapidly and it is not abnormal, says Dr. Phelps. “But talking so fast that others can’t keep up or understand—especially in phases with other bipolar symptoms, may be hypomania,” he adds. Someone in a manic state may not even let another person get a word in. This type of rapid-fire talking—known as pressured speech—is especially concerning if a person doesn’t normally speak this way. Similarly, racing thoughts or ideas that come so quickly that others—and even you yourself—may not be able to keep up may be indicative of mania. (Check out these 6 annoying speaking habits.)
You’re extremely confident—but don’t make good decisions
Normally, high self-esteem is a good thing. In a person with bipolar disorder, excessive confidence could lead to poor decisions. Bipolar patients feel grandiose and don’t consider consequences when they’re in a manic state. This may lead to taking risks and engaging in erratic behavior you ordinarily wouldn’t attempt, like having an affair or spending thousands of dollars you can’t afford to spend. “That’s why it’s important for someone with bipolar disorder to appoint someone—their spouse or a parent, for example—to take care of their finances when they’re manic,” says Dr. Tohen. (Don’t miss these 9 signs of borderline personality disorder you shouldn’t ignore.)
Drug and alcohol use
“People with bipolar disorder have a higher than average rate of a co-occurring substance or alcohol use,” says Dr. Murthy. They may try to calm their symptoms of bipolar disorder with alcohol or drugs during a manic phase, or use them to cheer up during a depressive period. Both mood disorders and alcohol or drug use increase the risk of suicide, even more so together. (Make sure you know these 10 dangerous myths about mental health.)
- National Institute of Mental Health: "Bipolar Disorder"
- Mauricio Tohen, MD, professor and chairman in the department of psychiatry and behavioral sciences at University of New Mexico Health Sciences Center in Albuquerque, New Mexico
- Smitha Murthy, MD, a psychiatrist and assistant professor in the department of psychiatry at The University of Texas at Austin Dell Medical School in Austin, Texas
- American Psychiatric Association: "What Are Bipolar Disorders?"
- James Phelps, MD, director of the Mood Disorders Program at Samaritan Mental Health in Corvallis, Oregon, and co-author of Bipolar, Not So Much: Understanding Your Mood Swings and Depression
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