Johns Hopkins Health Alert
Bipolar Disorder: Beyond Typical Mood Swings
Bipolar disorder involves mood swings that are more exaggerated than typical fluctuations. The "up" periods are known as manic episodes, mania, or hypomania (a less severe form of mania); the "down" periods are called depressive episodes, or depression.
What are typical symptoms of bipolar disorder? For people with bipolar disorder, manic episodes are characterized by aggression, agitation, or irritation; a decreased need for sleep; euphoria; high distractibility; an increased sex drive; inflated self-esteem; racing thoughts; rapid speech; spending sprees; and delusions, hallucinations, or psychosis.
Depressive episodes are marked by difficulty concentrating, remembering, or making decisions; eating disturbances; loss of appetite and weight loss, or overeating and weight gain; fatigue or listlessness; feelings of worthlessness, hopelessness, and/or guilt; loss of self esteem; persistent sadness; sleep disturbances; suicidal thoughts; or withdrawal from people and activities that were once enjoyed.
Mood swings vary in length and frequency. Some people with bipolar disorder suffer mostly with major depression, with only the occasional manic episode; others experience "rapid cycling," with at least four episodes of depression, mania, or hypomania occurring within one year.
Types of Bipolar Disorder According to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), there are four types of bipolar disorder, differing primarily in symptom severity and the length of time between manic and depressive episodes.
- Bipolar type I is the most severe and potentially dangerous form of bipolar disorder. Bipolar type I is characterized by manic or mixed episodes that last at least seven days or by manic symptoms that are so severe that the person needs emergency hospital care. Manic or mixed episodes are followed by episodes of major depression that last weeks or even years.
- Bipolar type II involves alternating hypomanic (lasting at least four days) and depressive episodes but no full-blown manic or mixed episodes. While "up" periods are marked by milder symptoms, depressive episodes may be severe and debilitating. Generally, people with bipolar type II can function in their normal daily routine while hypomanic. During the depressive phase, the level of functioning varies significantly among individuals.
- Cyclothymia is an even more mild form of mood cycling with highs and lows that continue for at least two years but never reach the severity of major depression or mania. This can make it hard to distinguish from normal variations in mood and personality.
- Bipolar disorder not otherwise specified (BP-NOS) is diagnosed when symptoms don't meet the criteria for bipolar I or II or cyclothymia. Symptoms may not last long enough, or the person may have too few of them. But the symptoms are clearly out of the person's normal range of behavior.
Posted in Depression and Anxiety on February 15, 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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