WHAT IS BIPOLAR DISORDER?
It can be tough to figure out if you’re just moody, or if your emotional highs and lows are the result of a more serious mental illness. Here’s how to tell if you might have bipolar disorder.
There are two commonly diagnosed types of bipolar disorder, a mental illness characterized by mood swings from emotional highs to lows. People with bipolar I have depression alternating with severely elevated mood, or mania. Bipolar II is much more common, and is marked by less severe manic symptoms, called hypomania. Since the characteristics of bipolar disorder exist along a spectrum ranging from non-existent to extreme, and because good or bad moods can be a result of temporary events or circumstances rather than a mental illness, diagnosis of bipolar disorder can be difficult.
1. YOU’RE DOWNRIGHT DEPRESSED
A bipolar person in a depressive state will have the same symptoms as someone who has only depression. ‘They have the same problems with energy, appetite, sleep, and focus as others who have ‘plain old depression,” Don Malone, MD, chair of the department of psychiatry at Cleveland Clinic, in Ohio, tells Health. 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 because the treatment for depression will be different from bipolar disorder treatment. ‘Antidepressants can be downright dangerous in people with bipolar because they can send them into mania,’ says Dr. Malone. Signs of depression include: feeling sad or hopeless for long periods of time, withdrawal from family or friends, lack of interest in activities you used to enjoy, significant changes in appetite, lack of energy, slow speech, problems concentrating, and preoccupation with death.
2. 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. During a depressive phase, a person may sleep for longer than usual. Carrie Bearden, PhD, professor of psychiatry and behavioral sciences and psychology at UCLA, tells Health that staying on a regular sleep schedule is one of the first things she recommends for bipolar patients.
3. 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, psychiatrist at the Seton Mind Institute 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 indicative of bipolar disorder. Hypomania, characteristic of bipolar II, may be even 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 repetitive cycle that alternates with depression.
4. 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. But if you’re so distracted that you’re unable to get anything done, and it’s interfering with your work or relationships, it could be a sign of bipolar disorder, says Dr. Murthy.
5. 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 coauthor of the upcoming book, 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.
6. YOU TALK—AND THINK—FAST
A ‘chatty Cathy’ 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 speech is especially concerning if a person doesn’t speak this way typically. 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.
7. 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. ‘They feel grandiose and don’t consider consequences; everything sounds good to them,’ Dr. Malone told Health. 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.
8. 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 themselves with alcohol or drugs during a manic phase, or use them to cheer up during a depression.