What Bipolar Disorder Looks Like
Bipolar Disorder signs and symptoms differ based on type. Bipolar disorder is a disorder of mood. Bipolar I Disorder requires the presence of one or more manic episodes and typically includes a major depressive episode. Bipolar II Disorder consists of one or more major depressive episodes and at least one hypomanic episode. Depressive symptoms predominate in Bipolar II Disorder while Bipolar I Disorder is a combination of both manic and depressive features.
Corcoran & Walsh (2006) define a manic episode as a distinct period in which a person’s predominant mood is elevated, expansive, or irritable to the degree that there is serious impairment in occupational and social functioning. During mania a person may go without sleep for an extended period of time before crashing and sleeping for a prolonged amount of time. Author Patrick E. Jamieson described his personal account of Bipolar I Disorder in the book Mind Race. Jamieson (2006) said, “When manic, I am more confident, more irritable, and more verbally aggressive. My thoughts bombarded me from every direction. When manic, I am happy when alone and happier when others are attracted to my energy.” Mania may be characterized by a euphoric state that inevitably has to end and typically does so in depression. In more severe manic episodes, a person may jeopardize their current life and future by taking unnecessary risks. Mania can also be uncomfortable due a distorted sense of reality (Jamieson, 2006). Manic episodes must include at least three of the following symptoms: unrealistically inflated self-esteem, a decreased need for sleep, pressured speech, racing thoughts, distractibility, an increase in unrealistic goal directed activity and involvement in activities with a potential for painful consequences (DSM-IV-TR). Mania is represented by excess, occurs rapidly, and may persist for months.
A hypomanic episode is a distinct period during which there is abnormally and persistently elevated, expansive, or irritable mood that lasts for at least four days and includes at least three of the manic symptoms. Hypomanic episodes differ from manic episodes because they are not severe enough to cause marked impairment in social or occupational functioning (DSM-IV-TR). During hypomania a person may feel elevated and convince themselves that they no longer need their medication. Again, hypomania must be present in Bipolar II Disorder.
A major depressive episode must occur for at least two weeks and features depressed mood and loss of interest in formerly enjoyed activities. Diagnostic symptoms include five or more of the following: depressed mood, diminished interest or pleasure in most activities, significant and unintentional weight loss or gain, insomnia or hypersomnia, feelings of physical agitation or retardation, loss of energy, feelings of worthlessness or excessive guilt, a diminished ability to think or concentrate, and persistent thoughts of death or suicide (DSM-IV-TR). Depressive symptoms are present in both Bipolar I and Bipolar II Disorder, but dominate in the occurrence of Bipolar II Disorder.
Bipolar Disorder Symptoms In Every Day Life
How do Bipolar Disorder signs and symptoms present in daily functioning terms? Jamieson’s book should be referenced by anyone seeking a snapshot of the disorder as well as a professional and personal opinion. He provided metaphors for the manic state of exhilaration, speed, and lack of control which included a racing engine, a speeding train, a comet, being painted in every color of the palette onto a canvas of glowing yellow, and seeing the world through a kaleidoscope (Jamieson, 2006). These metaphors reflect the state which can be both compelling and terrifying at the same time. The severity of the manic state can determine which end of that spectrum the person experiences. Jamieson’s (2006) metaphors for depression were described as passive, dark, deep, and dangerous: falling down a well, dropping into a bottomless pit, sliding down an endless chute, being sucked into a black hole, being painted in shades of gray onto a gray canvas, seeing the world through darkened glasses and existing in a world of shadows. When a person seems to cycle through both manic and depressive symptoms they may be exhibiting Bipolar Disorder.
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th edition, (DSM-IV-TR). Washington, DC: American Psychiatric Association.
Corcoran, J. & Walsh, J. (2006). Clinical assessment and diagnosis in social work practice. New York: Oxford University Press.
Jamieson, P. E. (2006). Mind Race. New York: Oxford University Press.