Bipolar Disorder Symptoms and Diagnosis Bipolar Disorder Guide Bipolar Disorder Guide Symptoms & Diagnosis Causes Treatment Living With In Children ADA Eligibility Differentiating Subtypes of Bipolar Disorder Examining Symptoms of Depression, Mania, and Hypomania By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on July 27, 2024 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / Hugo Lin Table of Contents View All Table of Contents Signs and Symptoms Complications and Comorbidities FAQ Next in Bipolar Disorder Guide Understanding the Causes of Bipolar Disorder Trending Videos Close this video player Bipolar disorder isn't just about having mood swings. It's a serious mental health condition that used to be referred to as manic depression. There are two main types of bipolar disorder that differ in terms of severity, duration, and nature of their symptoms. This article discusses the symptoms of bipolar disorder, including symptoms of both mania and depression. It also covers potential complications that may occur. Information presented in this article may be triggering for some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Overview of Bipolar Disorder Signs & Symptoms of Bipolar Disorder People with bipolar disorder experience dramatic shifts in mood that may include periods of depression and mania. The nature and severity of these symptoms depend on the type of bipolar disorder that they have. Bipolar I: Individuals with bipolar I experience at least one manic episode in their lives. Although not required for the formal diagnosis, the vast majority will also experience major depressive episodes during the course of their lives.Bipolar II: Individuals with bipolar II have at least one hypomanic episode (a less serious form of mania) and at least one major depressive episode. Differences Between Depression and Bipolar Disorder Bipolar Mania or Hypomania Symptoms Symptoms of a manic or hypomanic episode include: Being easily distracted Decreased need for sleep Delusions or hallucinations Elevated or expansive mood Grandiosity or inappropriate behavior Impulsive risk behaviors (including gambling and lavish spending) Increased sexual desire Irritability, hostility, or aggression Physical agitation and relentless movement Racing thoughts Talking excessively Manic episodes must last at least seven days to meet the criteria for bipolar I disorder and can last much longer. Hypomanic episodes involve the same symptoms, but the individual's functioning isn't markedly impaired, and there are no psychotic symptoms. Bipolar Depression Symptoms During a depressive episode, an individual may experience the following symptoms: Crying for no reason or prolonged periods of sadnessDifficulty concentrating or indecisivenessExtreme fatigue, including the inability to get out of bedFeelings of guilt or hopelessnessLoss of interest in activities that usually give you pleasureLoss of interest in health, nutrition, or physical appearanceSleeping excessively or difficulty sleepingSuicidal thoughts or an impulse to self-harm Problems with cognitive skills, such as subjective memory trouble, difficulty concentrating, and indecision, can be the first things noticed by others when someone has bipolar depression. Cognitive difficulties can interfere with an individual's thinking and make hard for them to complete tasks. Physical Symptoms Associated With Depressive Episodes During depressive episodes, individuals may experience a variety of physical symptoms, including unexplained aches and pains. Changes in weight are also common. While some people struggle to eat when they're feeling down, others turn to food for comfort. Thus, both weight loss and weight gain can be symptoms of a depressive episode. Psychomotor agitation, an increase in activity caused by mental rather than physical tension, or psychomotor retardation, slowing of both thought and physical activities, may also occur. Rare Symptoms While less common, people may sometimes experience a mood disorder known as cyclothymia. This condition causes mood changes that are not as severe as those in bipolar I or bipolar II disorder. Cyclothymia often emerges in adolescence. In many cases, it can be a precursor to bipolar I or II disorder. Recap There are two primary types of bipolar disorder, which are different in terms of how symptoms present and their severity. Bipolar I involves having manic episodes marked by symptoms such as delusions, hallucinations, excessive energy, decreased need for sleep, and elevated moods. Bipolar II causes depressive episodes and hypomania, which is a less severe form of mania. Complications & Comorbidities Bipolar disorder can lead to complications in a person's life. It can also present differently in certain groups. There is no cure for bipolar disorder, but the symptoms can be managed effectively with appropriate treatment. Some potential complications that can occur if the condition is not treated include: Difficulties in school or work Financial and legal problems More severe symptoms, including psychosis Relationship problems Self-medicating with drugs or alcohol Suicide or attempted suicide Differences in Men and Women Bipolar disorder occurs in men and women at approximately the same rates. However, the presentation of symptoms and course of the condition may differ depending on the sex an individual was assigned at birth. Men are often diagnosed at an earlier age, experience more severe episodes, and are more likely to have co-occurring substance use issues. Women tend to have more depressive episodes and more rapid cycling between manic and depressive episodes. Note that symptoms of bipolar disorder are the same in women and men, but societal and gender roles can affect how they manifest or how others perceive them. In Children While bipolar disorder is most frequently diagnosed in adults over the age of 18, it can also occur in children. The course of the condition tends to be more severe when this diagnosis happens during childhood. Symptoms also often manifest differently in children than in adults. Some of the symptoms that children may experience include: Aggressiveness Decreased need for sleep Depressed moods Frequent mood swings Hyperactivity Irritability Restlessness Risk-taking behaviors Temper tantrums During depressive episodes, children may exhibit somatic symptoms such as headaches, stomachaches, excessive sleep, changes in appetite, and lack of energy. Because these symptoms are not always specific to bipolar disorder and are often associated with other conditions, it is essential to receive an evaluation and diagnosis from a healthcare professional. Getting an accurate diagnosis early on can lead to more effective interventions and improve treatment outcomes. Temper Tantrums: A Sign of Disruptive Mood Dysregulation Disorder Co-Occurring Conditions There are a number of conditions that can co-occur alongside bipolar disorder or that have similar sets of symptoms that may complicate diagnosis. Some of these co-occurring conditions include: Attention Deficit Hyperactivity Disorder (ADHD) Hyperactivity and distractibility are two of the hallmark symptoms of attention deficit hyperactivity disorder (ADHD). However, they are also quite predominant in bipolar disorder, especially as it relates to children. To further complicate things, these conditions can often co-occur. Alcohol or Substance Use It is very common for those with bipolar disorder to struggle with alcohol and substance use. This is often an attempt, even on an unconscious level, to self-medicate. To make matters worse, alcohol may interact with the medications used to treat bipolar disorder. Borderline Personality Disorder Borderline personality disorder causes impulsivity, suicidal behavior, reactivity of mood, inappropriate anger, and transient paranoia, which are also associated with bipolar disorder. It is possible for an individual to be diagnosed with both of these disorders as well. Depression The one thing that distinguishes depressive disorders (unipolar depression) from bipolar disorder is mania/hypomania. If a patient with depression swings into an episode of mania, the diagnosis becomes a bipolar disorder. Misdiagnosed bipolar disorder is sometimes discovered after people start taking antidepressants, leading to the onset of mania. Eating Disorders It is not uncommon for those with bipolar disorder to experience eating disorders. Moreover, depression, anxiety, and irritability often result from eating disorders. Panic Disorder Panic disorder is characterized by recurrent, spontaneous panic attacks. Panic disorder is often comorbid (occurs together) with mood disorders and other psychiatric disorders. Panic attacks are also common in those with bipolar disorder. Schizophrenia Schizophrenia is a mental disorder that causes intense disturbances in cognition (thinking), behaviors, and emotions. Symptoms of the condition include delusions, hallucinations, disorganized speech and thinking, disorganized behavior, catatonic behavior, inappropriate moods, flattened emotions, lack of speech, and a reduction in goal-directed behavior. The symptoms of schizophrenia are easily confused with those of bipolar disorder. Schizoaffective Disorder Schizoaffective disorder involves having symptoms of major depression or mania, along with specific symptoms of schizophrenia. However, the delusions or hallucinations must persist for periods when the mood symptoms aren’t present. As you might expect, there is a great deal of confusion and controversy surrounding differentiating this disorder from bipolar disorder. Recap Co-occurring conditions can affect the course of bipolar disorder or contribute to misdiagnosis. Bipolar disorder is often misdiagnosed as depression, and people who have bipolar disorder may be more likely to use alcohol or other substances to cope with symptoms of their condition. Can Bipolar Disorder Be Cured? Frequently Asked Questions Frequently Asked Questions When should you see a doctor? If you or someone you know is experiencing symptoms of bipolar disorder, it's important to talk to a healthcare provider. They may want to rule out any potential physical health issues that could be contributing to your symptoms. Getting diagnosed and starting treatment can help minimize the risk of experiencing severe symptoms, such as psychosis. If psychosis—which is characterized by a break with reality in which the individual sees, hears, or believes things that are not real—does occur, it is important to seek medical attention immediately. Why is it important to distinguish between type I and type II bipolar disorder? The two types of bipolar disorder share common symptoms but differ in the way that mania presents. Because symptoms of mania are more severe in bipolar I disorder, people who have that condition may need different treatments in order to help manage their symptoms.In order to diagnose bipolar disorder, a healthcare provider will assess your symptoms, including their frequency, duration, and severity. If you are currently experiencing a depressive episode, be sure to mention whether you have experienced symptoms of mania or hypomania in the past. Why is it important to differentiate between bipolar disorder and major depressive disorder? Certain medications used to treat major depressive disorder can contribute to the onset of mania if a person has bipolar disorder. Unfortunately, it is not unusual for people with bipolar disorder to be misdiagnosed with depression.According to a study published in 2018, 60% of patients seeking care for recurring depression actually have bipolar disorder. This is often because people are more likely to seek treatment while experiencing a depressive episode. Living With Bipolar Disorder 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Culpepper L. 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Bipolar disorder diagnosis: Challenges and future directions. Lancet. 2013;381(9878):1663–1671. doi:10.1016/S0140-6736(13)60989-7 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit