Signs of Manic Depression
Like many other mental health disorders, there are different types of bipolar disorder, or manic depression. In the Diagnostic and Statisticial Manual of Mental Disorder, DSM-IV-TR, the American Psychiatric Association recognizes four subtypes of manic depression, namely Bipolar Disorder I, Bipolar Disorder II, Bipolar Disorder Not Otherwise Specified and Cyclothymic Disorder, also referred to as Cyclothymia. Each of these subtypes share similar symptoms. The main features of bipolar disorder are the presence of mania or manic episodes and depression or depressive episodes, with these episodes cycling over the course of several weeks or months, although some patients experience these cycles more or less frequently.
Mania or a manic episode means that the person is suffering from an overly happy mood or an extreme “high”, manifested by rapid speech, racing thoughts, difficulty concentrating, irritability, insomnia, and an inflated sense of self. The inflated sense of self can cause the person to have unrealistic expectations of their abilities, such as feeling like they can fly if they were to jump off a building.
Depression or depressive episodes are usually the exact opposite of the manic episodes. They are characterized by an extremely low mood and feelings of worry, irritability, slowness, emptiness and a lack of interest in the activities the person used to enjoy. They may isolate themselves from the outside world and socially withdraw. Many people sleep more and experience a change in appetite. In some people, feelings of suicide or suicidal ideation are present.
The intensity and duration of these signs of manic depression vary depending on the subtype. Additionally, patients may experience periods of a relatively “normal” mood in between episodes of mania and depression.
Bipolar Disorder I
Bipolar disorder I is characterized mainly by the presence of more manic episodes than depressive episodes. The episodes last at least seven days, and at times, the mania can become so severe that the person needs to be hospitalized. Depressive episodes are also often present, lasting around two weeks and alternating with the episodes of mania.
Bipolar Disorder II
Bipolar disorder II manifests mostly as depressive episodes, with hypomanic episodes, meaning a less severe condition than full-fledged mania but still significant enough to impact the person’s functioning. Hypomania shares the same symptoms as mania but to a lesser extent.
Bipolar Disorder Not Otherwise Specified (NOS)
Bipolar disorder NOS is the term used to diagnose patients who have symptoms of bipolar disorder but do not meet the criteria for either bipolar I or II as required by the DSM-IV-TR. Episodes of mania and depression may be present but the symptoms are either not as severe or long enough.
Cyclothymia, or cyclothymic disorder, is a mild form of bipolar disorder characterized by mood fluctuations that do not quite meet the criteria for a manic or depressive episode. You may still experience mood swings that interfere with your ability to function, such as hypomanic episodes or episodes of depression, but these episodes are not as dramatic as those of the other forms of bipolar disorder.
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, DSM-IV-TR. 1994
National Institute of Mental Health: Bipolar Disorder https://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml
Mayo Clinic: Cyclothymia (Cyclothymic Disorder) https://www.mayoclinic.com/health/cyclothymia/DS00729