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Johns Hopkins Health Alert

14 Signs of Bipolar Disorder

When properly diagnosed, bipolar disorder can be managed effectively with medications and therapy. In this excerpt from a recent Depression and Anxiety Bulletin, medical editor Karen L. Swartz, M.D. reviews 14 symptoms of bipolar disorder.

Formerly known as manic-depressive illness, bipolar disorder is a mental illness characterized by alternating periods of mania and major depression. Typically, the mood of a person with bipolar disorder will swing from overly "high" and irritable to sad and hopeless, and then back again, with periods of normal mood in between.

Manic episodes are characterized by a distinct period of abnormally and persistently elevated, expansive, or irritable mood. The episodes, with their restless energy and volatile mood swings, are severe enough to cause trouble at work and home. Episodes of milder manic symptoms are called hypomania.

Men with bipolar disorder tend to have more manic episodes; women are more likely to experience depressive episodes. The time between cycles can vary greatly. Bipolar disorder can begin with a bout of either depression or mania, but about two-thirds of bipolar disorder cases start with a manic episode, and mania tends to predominate. Signs and symptoms of mania include:

  • Excessively "high," overly good, euphoric mood
  • Extreme irritability
  • Increased energy, activity, and restlessness
  • Racing thoughts and talking very fast, jumping from one idea to another
  • Distractibility and inability to concentrate
  • Diminished need for sleep
  • Unrealistic, grandiose beliefs in one's abilities and powers
  • Poor judgment
  • Spending sprees
  • A lasting period of behavior that is distinctly different from usual behavior
  • Increased sexual drive
  • Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
  • Provocative, intrusive, or aggressive behavior
  • Denial that anything is wrong

Posted in Depression and Anxiety on June 4, 2008
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


The information provided in this alert is correct, of course. However you omitted a discussion of Type II bipolar and rapid cycling. This omission should be rectified to assist anyone concerned about mental health problems who might assume that bipolar is not a possible diagnosis based upon reading your alert.

Posted by: kathleen123 | June 7, 2008

I agree with "kathleen123" about the need to mention Bipolar II. It can be equally serious since it progresses over time, and it can even develop into Bipolar I, if untreated.

Mentioning that either form can be present in childhood would also be helpful.

Posted by: jih | June 8, 2008

As a Mom of a son that was diagnosed with bi-polar (possible schizco-affective disorder), there are many signs and symptoms of a child while he/she is growing up to indicate that he/she may eventually develop a mental disorder. These days, the doctors are so quick to label kids and prescribe meds; I wonder if parents and teachers can be educated properly so that, 1: kids that are at risk for future psychiatric problems can be screened and given proper psychological help before resorting to drugs, 2: children that have adhd or such disorders should be put on a proper diet and get help nutritionally in order to avoid drugs like Ritalin that have major side effects which the doctors & big pharma companies won't tell you about. What do you think about orthomolecular psychiatry if the side effects of drugs are unbearable?

Posted by: ES5224 | October 15, 2009



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Health Alert Special Report

  • 2009 Depression and Anxiety White Paper
    Includes major depression, dysthymia, atypical depression, bipolar disorder, seasonal affective disorder, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and phobic disorders. Read more...


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    When you're over 50, it's more important than ever to have access to reliable health information. You won't find a more authoritative source than The Johns Hopkins Medical Letter: Health After 50. Read more...


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