What is Bipolar Disorder

Understanding the Mood Swings of Bipolar Disorder

Bipolar Disorder, also known as manic depression, leads to mood fluctuations ranging from depressive lows to manic highs. During a depressive phase, the experience can be as severe or even more intense than a person without bipolar going through a major depressive episode. Conversely, when your mood swings to mania, you might feel euphoric, exhibit grandiosity, have abundant energy, and face high risks. Mixed episodes involve simultaneous experiences of depression and mania, while rapid cycling refers to swiftly changing moods. Both depression and bipolar disorder can frequently involve mood-related psychosis.

Some Signs and Symptoms of Bipolar Mania

• Increased energy, activity, restlessness, and euphoric or agitated mood: During a manic episode, individuals often experience a significant surge in energy levels that can lead to increased productivity and engagement in various activities. This heightened state may manifest as an overwhelming sense of excitement or elation, but it can also swing towards agitation, where the person feels irritable or easily frustrated. This duality in mood can lead to a chaotic state where the individual finds it challenging to focus on one task, often jumping from one activity to another without completing any of them.

• Racing thoughts and thoughts jumping: A hallmark characteristic of mania is the rapid flow of thoughts that can be difficult to control. Individuals may find their minds racing, with ideas and concepts flashing through their consciousness at a speed that makes it hard to articulate or organise them coherently. This rapid thought process can lead to a feeling of being overwhelmed, as the individual struggles to keep up with their own thinking, often resulting in fragmented conversations or an inability to stay on topic during discussions.

• Pressured Speech: This symptom is characterised by an urgent and rapid manner of speaking, where the individual may feel compelled to talk incessantly. Their speech can become loud and difficult to interrupt, as they may jump from one subject to another without pausing for others to contribute. This pressured speech often reflects the internal racing thoughts and can make it challenging for listeners to follow along, leading to misunderstandings or frustration in conversations.

• Grandiosity: A sense of inflated self-esteem or grandiosity is common in manic episodes. Individuals may have an exaggerated belief in their abilities, talents, or importance, often feeling invincible or exceptionally powerful. This can lead to unrealistic plans or ambitions, where the person may undertake projects or endeavors that are far beyond their actual capabilities. This grandiosity can also manifest in social situations, where individuals may believe they are more charming, intelligent, or attractive than they actually are, which can result in risky behaviors and poor decision-making.

• Behaviour with high risk for negative consequences: During manic phases, individuals may engage in impulsive and reckless behaviors without considering the potential consequences. This can include spending sprees, substance abuse, or engaging in risky sexual behaviors. The lack of foresight and the drive for immediate gratification can lead to significant personal and financial troubles, strained relationships, and legal issues. These high-risk behaviours often stem from the euphoric state associated with mania, where the individual feels that they are invulnerable and immune to negative outcomes.

Some Signs and Symptoms of Bipolar Depression

• Depressed mood, sadness, and crying spells: Individuals experiencing bipolar depression often find themselves engulfed in a pervasive sense of sadness that can be overwhelming. This depressed mood may manifest as a feeling of emptiness or despair, leading to frequent crying spells that seem to come out of nowhere. These emotional episodes can be triggered by various factors, including stress, changes in routine, or even without any identifiable cause. The intensity and duration of these feelings can vary significantly from person to person, making it essential to recognise them as potential indicators of bipolar disorder.

• Sleep and appetite problems: Another common symptom of bipolar depression is the disruption of normal sleep patterns. Many individuals may experience insomnia, finding it difficult to fall asleep or stay asleep throughout the night, while others may sleep excessively, feeling the need to rest for prolonged periods. Additionally, changes in appetite are prevalent; some may find themselves eating significantly less than usual, leading to weight loss, while others may engage in emotional eating, resulting in weight gain. These fluctuations in sleep and appetite can further exacerbate feelings of lethargy and disinterest in daily activities.

• Not able to concentrate or make decisions: Cognitive functions can be severely impacted during episodes of bipolar depression. Many individuals report difficulties in concentrating, leading to challenges in performing tasks that require mental effort. This inability to focus can extend to decision-making processes, where even simple choices may feel overwhelming or impossible. These cognitive impairments can hinder work performance, social interactions, and overall quality of life, often leaving individuals feeling frustrated and inadequate.

• Feelings of guilt, worthlessness, and/or hopelessness: A hallmark of bipolar depression is the pervasive sense of guilt or worthlessness that can envelop individuals. They may ruminate over past actions or perceived failures, leading to an internal dialogue filled with self-criticism. This can create a profound sense of hopelessness, where individuals feel trapped in their circumstances with no viable path to improvement. Such feelings can lead to a distorted self-image and contribute to the overall severity of the depressive episode, making recovery seem unattainable.

• Not able to enjoy things you once liked, not wanting to socialise: Anhedonia, or the inability to experience pleasure, is a significant symptom of bipolar depression. Activities that once brought joy or satisfaction, such as hobbies, social gatherings, or even spending time with loved ones, may no longer hold any appeal. This withdrawal from previously enjoyed activities can lead to increased isolation, as individuals may shy away from social interactions, feeling disconnected from friends and family. This isolation can further deepen feelings of loneliness and despair, creating a vicious cycle that is difficult to break.

• Recurring thoughts of death or suicide: One of the most concerning symptoms associated with bipolar depression is the presence of recurring thoughts about death or suicide. Individuals may find themselves preoccupied with thoughts of ending their life or feeling that life is not worth living. These thoughts can range from passive ideation, such as wishing they were dead, to active planning of suicide. It is crucial for individuals experiencing these thoughts to seek immediate help, as they indicate a severe level of distress and a need for professional intervention. Mental health support is essential in addressing these feelings and finding healthier coping mechanisms.

Other Mood Disorders

• Cyclothymia: Cyclothymic disorder, often referred to simply as cyclothymia, is characterised by a chronic pattern of mood fluctuations that are less severe than those seen in bipolar disorder. Individuals with cyclothymia experience periods of hypomanic symptoms—elevated or irritable moods—and periods of depressive symptoms that do not meet the full criteria for a major depressive episode. These mood changes can last for years, and while they may not be as intense as those found in bipolar disorder, they can still significantly impact an individual's daily functioning and quality of life. The persistent nature of these mood swings can lead to challenges in relationships, work, and overall emotional stability.

• Depression: Major depressive disorder (MDD) is a common yet serious mood disorder characterised by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities once enjoyed. Symptoms may also include changes in appetite or weight, sleep disturbances, fatigue, difficulty concentrating, and thoughts of death or suicide. The impact of depression can be profound, affecting not only the individual but also their relationships and social interactions. Treatment options typically include psychotherapy, medication, or a combination of both, aimed at alleviating symptoms and improving overall functioning.

• Premenstrual Dysphoric Disorder: This severe form of premenstrual syndrome (PMS) affects a small percentage of women, manifesting with significant emotional and physical symptoms during the luteal phase of the menstrual cycle. Symptoms may include severe mood swings, irritability, depression, anxiety, and physical symptoms such as bloating and breast tenderness. The emotional symptoms can be debilitating, leading to significant impairment in daily activities and relationships. Treatment often involves lifestyle modifications, dietary changes, and in some cases, antidepressants or hormonal therapies to manage symptoms effectively.

• Mood Disorder, NOS: Mood Disorder Not Otherwise Specified (NOS) is a classification used when an individual exhibits symptoms of a mood disorder that do not fully meet the criteria for any specific mood disorder diagnosis. This can include atypical presentations of mood disturbances that are clinically significant but are difficult to categorise. Treatment approaches for NOS may vary widely, focusing on the specific symptoms presented and the individual’s unique circumstances, often incorporating psychotherapy and medication as needed.

• Schizoaffective Disorder: This complex mental health condition features symptoms of both schizophrenia and mood disorders, such as depression or bipolar disorder. Individuals with schizoaffective disorder may experience hallucinations, delusions, and disorganised thinking, alongside significant mood disturbances. This dual presentation can complicate diagnosis and treatment, as both the psychotic symptoms and mood symptoms need to be addressed. Treatment typically involves antipsychotic medications, mood stabilisers, and psychotherapy, aiming to stabilise mood and manage psychotic symptoms effectively.

• Dysthymia: Also known as persistent depressive disorder, dysthymia is a chronic form of depression that lasts for at least two years in adults (one year in children and adolescents). Individuals with dysthymia often experience a low mood, feelings of hopelessness, and a lack of energy or motivation. While the symptoms may not be as severe as those of major depression, their persistent nature can lead to significant impairment in social, occupational, and other important areas of functioning. Treatment may include psychotherapy, medication, or a combination of both, focusing on improving mood and coping strategies.

• Bereavement: The process of grieving after the loss of a loved one can lead to significant emotional distress and may be classified as a mood disorder when it severely impacts daily functioning. While grief is a natural response, some individuals may develop complicated grief or prolonged grief disorder, characterised by intense sorrow, longing, and difficulty moving forward after the loss. Supportive therapy, grief counselling, and, in some cases, medication may be beneficial in helping individuals navigate their grief and find a path toward healing.

• Anxious Depression: This condition refers to the co-occurrence of anxiety and depressive symptoms, creating a complex clinical picture. Individuals may experience persistent worry, restlessness, and physical symptoms of anxiety alongside feelings of sadness, hopelessness, and a lack of interest in activities. This overlap can complicate treatment, as both anxiety and depression need to be addressed simultaneously. Effective management often involves a combination of psychotherapy, medication, and lifestyle changes aimed at reducing both anxiety and depressive symptoms to improve overall well-being.

• Substance-induced disorders: These mood disorders arise as a direct result of substance use, including alcohol, drugs, or medications. Symptoms can mimic those of major depressive disorder or bipolar disorder, depending on the substance involved and the individual's response. It is crucial to differentiate between primary mood disorders and those induced by substances, as treatment strategies may differ significantly. Addressing the underlying substance use through detoxification, rehabilitation, and ongoing support is essential for recovery and the management of mood symptoms.

If you're experiencing difficulties with any of these issues, please contact a medical professional, talk to your family and friends, and reach out. There is a hand out there to help you pull through the hard times.