Bipolar symptoms: What are the early signs of bipolar disorder?
Overview: What does bipolar disorder look like?
Bipolar disorder describes a group of mental health conditions characterized by episodes of extremely elevated mood episodes. These episodes typically cycle back to more normal moods and sometimes to periods of depression. Although bipolar disorder used to be called manic-depressive disorder, only highly elevated moods, called mania or hypomania, are necessary for a bipolar diagnosis.
What do manic behaviors look like? During a manic episode, a person engages in behaviors that are markedly different from their usual behaviors. They are energized and euphoric, focusing much of their energy on goal-oriented activities, sometimes excessively. They can have inflated notions of how great or important they are or how useless and unimportant other people are. Sleep patterns can change as well. Not only do they sometimes sleep less or not at all, but they may also say that they don’t need sleep. Their conversations change: they talk fast and without letup, jumping around between unrelated topics. Their thoughts race and they’re easily distracted. They may even have hallucinations or start talking about bizarre notions.
The greatest problem is that those with bipolar disorder can act impulsively and recklessly without any concern for the consequences. These impulsive behaviors can have ruinous outcomes. Most importantly, there’s no discernible reason for these behaviors, such as drug use or another illness.
Key takeaways:
Bipolar is an uncommon mood disorder that can affect anyone, regardless of age, sex, race, or ethnicity. Find updated bipolar statistics here.
Early signs of bipolar may include depression, but the defining symptoms are manic or hypomanic behaviors, such as inflated self-esteem, pressured speech, racing thoughts, distractibility, decreased need for sleep, increased goal-directed behaviors, reckless behaviors, impulsivity, irritability, and sometimes psychosis (hallucinations and delusions).
Serious symptoms of bipolar disorder, such as psychosis and risky or ruinous behaviors, may require immediate medical attention.
There are many factors involved with bipolar disorder, but its exact cause has not been determined. You may be at risk for developing bipolar symptoms if you have an immediate relative who has bipolar disorder.
Bipolar disorder requires a medical diagnosis.
Symptoms of bipolar disorder generally require treatment and may require hospitalization. They typically resolve with or without treatment, but immediate treatment will resolve symptoms quickly, and maintenance treatment is required to prevent future episodes.
Treatment of bipolar disorder may include medications, psychotherapy, and support. Read more about bipolar treatments here.
Untreated bipolar disorder could result in complications, such as decreased cognitive function, health problems, low quality of life, suicide, and early death.
Save on prescriptions for bipolar disorder with a SingleCare prescription discount card.
What are the early signs of bipolar disorder?
The defining sign of bipolar disorder is a manic or hypomanic episode. These episodes can come on very quickly. There are no early warning signs, though impulsive or reckless behaviors are often some of the earliest behaviors exhibited during a manic episode. Some people with bipolar disorder may experience depressive episodes as a teen or young adult before a manic episode. This may be an early sign of bipolar disorder, but it can be difficult to diagnose.
Other bipolar disorder symptoms
Both mania and hypomania are diagnosed from the same cluster of symptoms. Not every person will have all of the symptoms, but they have to have some symptoms every day over a certain time period. These symptoms are very noticeable and obvious to loved ones and acquaintances. Presenting with mania or hypomania is one of the requirements for a diagnosis of bipolar disorder.
The symptoms of a manic or hypomanic episode are:
An increased focus on goal-directed behaviors
Not wanting to sleep or not feeling that it’s necessary
Talking more than usual, talking fast, or talking nonstop (pressured speech)
Racing thoughts
Inflated sense of self-importance and grandiose ideas
Irritability or agitation
Impulsive and even reckless behaviors without regard for consequences
Psychotic symptoms, such as hallucinations or delusions (abnormal or bizarre ideas about the real world)
Sometimes, people with bipolar disorder will also have episodes of depression. The symptoms of major depressive disorder are:
Depressed mood (feeling sad or empty)
Feelings of worthlessness or guilt
Loss of interest and pleasure in normal daily activities or events
Sleeping too much or insomnia
Low energy levels
Restlessness or slowness
Indecisiveness
Trouble thinking
Thoughts of death or suicide
Some people will have episodes called mixed episodes that combine both manic and depressed behaviors.
Bipolar vs. BPD symptoms
Bipolar disorder can look much like other mental disorders, particularly borderline personality disorder (BPD). However, these two are significantly different mental health disorders. They look alike because they both involve extreme mood swings: highly euphoric or manic, alternating with a normal mood or depression. The distinguishing difference is that people with BPD are overreacting emotionally to situations, events, or other people when their mood changes. Bipolar disorder mood swings, on the other hand, are related to changes in brain chemistry rather than reactions. People with BPD can swing between extreme moods very rapidly in a short period of time based on the situation. People with bipolar disorder swing to extreme moods much more slowly. Some may have only one manic episode in their entire life. Most importantly, because bipolar disorder is related to brain chemistry, bipolar disorder can be controlled by psychiatric drugs. Psychotherapy is the standard treatment for BPD.
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RELATED: Borderline personality disorder vs. bipolar disorder: what’s the difference? Can you have both?
Types of bipolar disorder: How can I tell which one I have?
Types of bipolar disorder are diagnosed based on the severity, number, and duration of manic symptoms. Symptoms of depression are not required for a diagnosis.
People with bipolar I disorder have experienced one or more week-long manic or mixed episodes. These episodes severely impair their ability to function.
People with bipolar II disorder have had one or more hypomanic episodes that lasted at least four days. Hypomania has all the symptoms of mania but without severe impairment.
People diagnosed with cyclothymia have either elevated or depressive episodes that aren’t severe enough to be considered mania, hypomania, or a major depressive episode.
Unspecified bipolar disorder is a catch-all term for people who do not meet any of the criteria for bipolar I or II disorders, but have had symptoms of a manic episode at least once.
Secondary mania is a catch-all term for a manic or hypomanic episode caused by illicit drugs, prescription drugs, or a medical condition.
In addition, mental healthcare professionals will also specify certain characteristics that can affect treatment, such as:
Rapid-cycling: four or more episodes of mania in a year
Mania with psychotic features
Mania with symptoms of depression
Depression with atypical features
Manic episodes with anxious distress
Episodes of mania during or shortly after pregnancy
Seasonal patterns of manic and depressive episodes
When to see a doctor for bipolar symptoms
Medical treatment is required for any symptoms of mania, hypomania, or major depression. Most people experiencing mania will not feel that medical treatment is needed. It may be up to loved ones or others to get the person the medical care that they need.
A bipolar diagnosis is made with great care and thoroughness. Often, the diagnosis is made when a person is actively manic. First and foremost, the diagnosis requires a detailed and thorough medical history and family history. In addition, a healthcare provider will usually perform a physical examination and use blood tests and urine tests to rule out possible causes, such as drugs or another medical condition. Blood tests are also needed to establish baseline values of the body’s health because of possible side effects of drugs like mood stabilizers or antipsychotics. Finally, anyone who is actively psychotic may get an MRI or EEG to rule out other neurological issues.
RELATED: Finding the right medication for your mental health starts with finding the right doctor
Complications of bipolar disoder
Untreated bipolar disorder can lead to unwanted physical, social, and psychological complications, including:
Suicide
Lifestyle habits that compromise physical health
Substance use
Decreases in cognitive function
Early death
Low quality of life
Functional disability
How to treat bipolar symptoms
Bipolar disorder requires treatment. Without treatment, the risk of future manic or hypomanic episodes is significantly increased.
During an acute manic, hypomanic, or depressive episode, treatment primarily consists of mood stabilizers, such as lithium or valproate. Psychotic symptoms will require antipsychotic medication. Benzodiazepines could be used to get a person to sleep. An antidepressant, such as Wellbutrin (bupropion), might be needed during a depressive episode. In some cases, electroconvulsive therapy (ECT) may be used.
When the mood returns to normal, the standard treatment is a combination of mood stabilizers or a mood stabilizer and an antipsychotic. Additional effective treatment options, such as careful monitoring, psychotherapy, functional therapy, group therapy, and family-focused therapy, are important in helping people live with bipolar disorder and prevent future episodes.
RELATED: Taking medications is self-care
Living with bipolar disorder
Bipolar disorder is a lifetime diagnosis. With treatment, some people may never have another episode. Some may have future episodes, but the risk is much lower. The goal of living with bipolar disorder is to be functional, maintain wellness, and reduce the risk of mood episodes. This can be realized by:
Following the treatment plan by taking prescribed medications and keeping all healthcare appointments
Educating yourself and loved ones about bipolar disorder and the signs of a relapse
Day-to-day monitoring of mood and behaviors
Joining a support group
Constructing a safety plan for relapses
Making financial arrangements to prevent reckless spending during a manic episode
Minimizing stress
Taking normal preventive measures to preserve health and wellness
Removing guns and alcohol from the house
Staying away from recreational or illicit drugs
Most importantly, see a doctor and take the medications
Bipolar disorder can only be diagnosed and treated by a doctor. A manic episode can be very harmful and lead to financial ruin, divorce, arrest, and even death because of reckless or impulsive behaviors. There is also a risk of suicide. Immediate medical care is needed. Once diagnosed, take the medications as prescribed without fail.
FAQs about bipolar symptoms
How do you know if you have bipolar disorder?
Bipolar disorder is diagnosed when someone has a manic or hypomanic episode without any identifiable cause. Most people experiencing mania will not think it’s a problem because they feel powerful, productive, and elated. For family and friends, however, a manic episode is so atypical that it will be worrisome if not outright frightening. That’s a clue. Get help, the sooner the better.
What is a bipolar person like? How do they act?
People with bipolar disorder act just like everyone else. Most of the time, their mood is regulated and normal. Manic or hypomanic episodes are usually rare, especially if they’re taking medications. When their mood swings to an extreme, however, the change will be very obvious.
How do you diagnose bipolar disorder in children?
Children are diagnosed with bipolar disorder using the same criteria as adults. Again, the basic requirement is a history of one or more manic or hypomanic episodes without an identifiable cause. The mental health professional will be cautious, however, to not confuse manic symptoms with symptoms of other mental illnesses, such as anxiety disorders or attention deficit hyperactivity disorder (ADHD).
What’s next? Additional resources for people with bipolar symptoms
Test and diagnostics
Bipolar affective disorder, StatPearls
Bipolar disorder, National Institute of Mental Health (NIMH), National Institutes of Health (NIH)
Bipolar disorders: a review,American Family Physician
Mania, StatPearls
Treatments
Bipolar disorder: Treatment, National Alliance on Mental Illness (NAMI)
Bipolar disorder treatments and medications, SingleCare
Management of bipolar disorder, American Family Physician
Scientific studies and clinical trials
Epidemiology and risk factors for bipolar disorder, Therapeutic Advances in Psychopharmacology
More information on related health conditions
Borderline personality disorder, SingleCare
Borderline personality disorder vs. bipolar disorder: what’s the difference? Can you have both?, SingleCare
DSM-5 Criteria for Borderline Personality Disorder, Neurodivergent insights
Depression treatments and medications, SingleCare
Schizophrenia treatments and medications, SingleCare
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