Diagram showing the progression between high and low

Symptoms of Mania & Hypomania include:

  • Racing thoughts
  • Pressurised talk
  • Numerous plans and ideas
  • Elated or euphoric mood; alternatively high irritability
  • Increased activity and energy; talkativeness and familiarity
  • Restlessness and reduced need for sleep
  • Easily distracted
  • Paranoia
  • Rapid thoughts; changing from one thought to the next
  • Increased confidence, self esteem and feelings of self importance or power
  • Spending sprees
  • Provocative, inappropriate sexual or aggressive behaviour
  • Impaired judgement
  • Denial of change of behaviour

In mania there may be impairment of social, professional or personal functioning that may require hospitalisation.  There may also be associated psychotic symptoms, e.g. hallucinations, hearing voices, and delusions sometimes associated with religious thoughts.

There is a typically sudden onset of manic episodes, which vary in length from 2 weeks to 5 months (SIGN, 2005).

Symptoms of Depression:

  • Hopelessness and helplessness
  • Guilt and worthlessness
  • Loss of confidence and self esteem
  • Sad, empty or anxious mood
  • Loss of pleasure in activities previously enjoyed
  • Lethargy and loss of energy
  • Paranoia
  • Impaired concentration and decision making ability
  • Altered sleep (insomnia or oversleeping)
  • Altered appetite (under or over eating)
  • Feelings of physical illness with no physical abnormalities
  • Morbid or suicidal ideation

Depressive episodes are usually of longer duration and typically last for about 6 months (SIGN, 2005).

However, rapid cycling can occur which means episodes can be much shorter in duration but fluctuate much more rapidly.

When someone experiencing bipolar starts to get ‘high’ they will firstly go into the hypomanic phase of the mood spectrum. People experiencing hypomania tend to think much more quickly than usual, they tend to be much more confident and sometimes they can be full of great ideas, perhaps starting many projects, joining clubs, societies or starting off in new directions. They can be very productive and highly motivated. People are able to achieve things very quickly with little effort, and many who experience hypomania become very creative.

It is when the mood begins to change and the person becomes manic that the symptoms can become very disruptive. During mania and sometimes hypomania, some people’s spending habits can change and they spend much more than what would be typical for them. Some people also turn to gambling in this phase. As such, debt problems occur. Signs of mania are inflated self-esteem and rapid thoughts (much faster than hypomania, thoughts will be disjointed and change rapidly).

As a person gets higher they may begin to lose touch with reality, experience loss of judgement, and sometimes experience psychosis. Psychosis can manifest itself as hearing voices or hallucinations, and sometimes a person may believe they are in touch with God or have been chosen for a special purpose. Not everyone who experiences bipolar disorder will experience psychosis.

Included at the ‘high’ end of the scale will also be feelings of agitation, sometimes anxiety, sometimes anger, frustration and paranoia. When a person is getting low one of the first early warning signs may be an increased need for sleep. The person may become less talkative and they may begin to withdraw from social situations taking measures to avoid seeing people. They may talk of being stressed, feeling tired all the time and may start to get anxious, paranoid, agitated or angry. They may experience physical symptoms, aches and pains in their body.

When the period of depression worsens they may experience feelings of panic and find concentrating very difficult. Thinking will be slow, decisions will be difficult and memory will be poor. There may be loss of appetite or increased appetite. Lethargy is common and as such a person’s appearance and the way they normally present themselves may deteriorate.

Next, learn about depression.

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