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Bipolar I Disorder: Symptoms & Overview

Instructor: Devin Kowalczyk

Devin has taught psychology and has a master's degree in clinical forensic psychology. He is working on his PhD.

It's an unfortunate habit of laypeople to start using psychological terms like ''antisocial,'' ''idiot,'' and ''bipolar'' in everyday situations. Those are currently, or once were, clinical psychology terms. But what does bipolar mean? What is it like to have a bipolar disorder?

Bipolar disorder is broken up into two types, easily identified as bipolar I and bipolar II. We will be exploring bipolar I disorder in this lesson. Bipolar disorder does not mean you have two minds or two thoughts about something. It's also not about hearing voices or believing you are Jesus (although this can happen).

Bipolar I disorder is a mood disorder, or a psychological disorder dealing with a person's moods and feelings. People diagnosed with bipolar I alternate between a normal demeanor, manic episodes, major depression, and mixed episodes.

Manic Episodes

Energy x 1,000
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A manic episode is when a person has a level of energy and hyperactivity to the point of being pathological. This is not someone who is being hyper; this is someone whose energy level is so extreme that they cannot control it.

A person in a manic episode has feelings and thoughts that they cannot control because they have so much energy. It's like drinking a pot of coffee, drinking two liters of soda, and then downing an energy drink. That's the kind of energy they are feeling. Commonly, people in manic episodes have particular behavioral patterns, like:

  • Reduced need for sleep (1-3 hours is sufficient per night)
  • Rapid speech, unusually loud talking, and/or inability to stop speaking
  • Inability to sit still
  • Difficulty or inability to sustain attention
  • Increased distractibility
  • Extreme confidence or excessive self-esteem
  • Extravagant or grandiose ideas, such as delusions of grandeur
  • Risk-taking behaviors that are often inappropriate, such as unprotected sex with multiple partners, excessive or compulsive shopping, and excessive or compulsive gambling
  • Sensation of being 'high'
  • Symptoms must last for one week or the person must hospitalized

Depression Episodes

Sad x 1,000
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A depressive episode is a single occurrence of a sad or negative mood that is powerful enough to keep you from your life. One way to think about major depression is as the opposite of a manic episode. It's when you effectively shut down and withdraw from the world.

A person must have most of the following symptoms to some degree:

  • Depressed or sad mood, including feelings of emptiness, hopelessness, guilt, tearfulness, or, occasionally, irritability or physical pain
  • Diminished ability to think clearly or concentrate
  • Loss of interest or feeling of pleasure in activities once enjoyed
  • Increase or decrease in eating, appetite, or weight
  • Change in sleep patterns, including insomnia and hypersomnia, as well as constant feelings of fatigue
  • Lethargy or slowed physical movements
  • Decreased feelings of self-worth, often paired with suicidal thoughts and actions
  • Symptoms of depression must be present for two weeks or the person must be hospitalized

Mixed Episode

A mixed episode is a kind of combination of a manic and a depressive episode, but is also something entirely different. Typically, a person in a mixed episode has:

  • Agitation
  • Appetite problems
  • Hallucinations and delusions
  • Suicidal thoughts
  • Mood problems that are sufficient to cause impairment in life (relationships, work, or fun activities)

Normal

You might assume that a person with bipolar disorder swings back and forth or that they are always exhibiting some kind of extreme behavior. But a person who suffers from this disorder can have lengthy times of relative normalcy on their own or because of medication. By 'normal', I mean they have good days and bad days, but their mood is not influencing them any more than yours would on a typical day. Meaning some days they're sad, some days they're happy, but never to the extreme seen in the episodes described above.

Cycle

The key feature to bipolar disorder is the cycle between manic, depressive, mixed, and normal. For most, the shift between the moods can happen a few times a year, where they occasionally have manic episodes and depressive episodes (or depressive episodes then manic episodes).

More rare is something called rapid cycling, in which the individual's mood bounces between manic and depressive very quickly, sometimes in a matter of days or weeks. TV and other mediums often depict bipolar disorder like this, with the person's mood jumping between happiness and sadness extremely quickly. But only about 10%-20% of people diagnosed with bipolar disorder have this, and rarely as severe as on TV shows.

Examples

This example is a composite of several people with bipolar disorder. These are real symptoms that have occurred and can occur with someone in these episodes. These are meant to show what a person might be like with this disorder.

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