Bipolar Disorder Symptoms, Causes, Signs & Side Effects

Learn More About Bipolar Disorder

Bipolar disorder involves shifts in moods between mania and depression. At times, there may be neutral states between these extremes, though some individuals switch back and forth between the extremes without experiencing a return to neutral.

Part of the difficulty in diagnosing bipolar disorder is that there is no defining pattern for mood states and each individual can display a different pattern or change patterns over time. The mania phase involves a highly energetic, euphoric state during which individuals have a decreased need for sleep, talk excessively, and make grandiose plans which are often delusional. The depressed phase is characterized by opposite symptoms, including excessive sadness, lack of energy, decreased speech production, and lack of motivation. While most adults don’t cycle very frequently, the periods between the cycles are often characterized by extreme anxiety caused by anticipation of the next extreme mood state. This anxiety is often as distressing as the extreme moods, due to its constancy between phases. Thus, no matter what pattern the individual exhibits, there really is no period free of some type of problematic symptoms, which causes the disorder to grow worse over time. Despite how devastating this problem can be, it can be successfully treated with the proper medication, psychotherapy, and monitoring.

There are three primary types of Bipolar Disorder. Bipolar I requires the person to have experienced at least one manic episode, with or without the lifetime occurrence of a major depressive episode. Sometimes individuals with Bipolar I experience hypomanic or depressive episodes preceding or following the manic episode. Individuals with Bipolar II experience at least one hypomanic episode, a milder form of mania, and one major depressive episode. Those with Cyclothymic Disorder experience hypomanic-like symptoms that don’t meet criteria for Major Depressive Episodes.

Statistics of Bipolar Disorder

The past year, the prevalence rate for Bipolar I in U.S. adults was estimated at .6%. There is little gender difference in this type of the disorder. Estimates place the male to female lifetime prevalence ratio at 1.1 to 1. The past year’s prevalence rate estimate for Bipolar II in adults in the U.S. was .8%. No gender differences were reported. In regards to Cyclothymic Disorder, the lifetime prevalence rate was estimated as ranging between .4% to 1%. Outside of clinical settings, the prevalence rate of Cyclothymic Disorder appears to be equal among males and females, though gender differences are more pronounced inside clinical settings, indicating a higher rate in women than men. However, this may be due at least in part to a reporting bias, as women are more likely to seek treatment for mood related disorders.

Learn About Co-Occurring Disorders

There are a number of disorders, both psychiatric disorders and substance-use conditions that tend to co-occur with Bipolar Disorders. These include:

• Selective mutism
• A history of separation anxiety in childhood
• Specific phobia
• Social Anxiety/Social Phobia
• Agoraphobia
• Panic
• Generalized Anxiety Disorder
• Substance/medication induced anxiety disorder
• ADHD
• Intermittent Explosive Disorder
• Opposition Defiant Disorder
• Conduct Disorder
• Any Substance Abuse Disorder
• Metabolic Disorder
• Migraines
• Alcohol Abuse
• Stimulant Abuse
• Benzodiazepine Abuse
• Eating disorders (binge eating, anorexia, bulimia)

Causes of Bipolar Disorder

The specific causes of Bipolar Disorder are unknown. However, there is support indicating that certain factors are linked to the development of this group of disorders.

Genetic – Bipolar Disorder, like most mental disorders, has been recognized to run in families. In identical twins, when one twin has the disorder there is a 40%-70% likelihood the other twin will also develop the disorder. Someone with a regular sibling or fraternal twin who has the disorder is at greater risk of developing the disorder than those in the general population.

Brain Chemistry – There are specific chemicals, called neurotransmitters, that are responsible for communication in the brain. Some of these neurotransmitters, norepinephrine, dopamine and serotonin, have been linked to messages involving emotional responses. When levels of these chemicals are unbalanced, research has shown that positive and negative moods are disrupted and may lead to both manic and depressed mood states.

Environmental Factors – Children of parents with Bipolar Disorder suffer through a chaotic upbringing.  It is not unusual for them to become confused over the parent’s mood swings, potentially combined with other mental and substance abuse disorders, financial hardship, and parental absence due to hospitalization. When added to the genetic predisposition, these lifetime stressors can lead to the development of the disorder.

This self-medication may lead to substance abuse or alcoholism.

Signs and Symptoms of Bipolar Disorder

The symptoms of the two general mood states found in bipolar disorder are listed below.

Manic/Hypomanic Symptoms-(The two types of symptoms differ by degree of severity)

• Psychological/Mood symptoms:
  • Substantially elevated mood
  • Significant intensification of self-esteem, self-confidence and belief that it is possible to complete tasks the person has knowledge about
  • Irritability
  • Delusions of grandeur, or the belief that the individual has more influence and power over others than they do
  • Anxiety
  • Agitation
  • Feeling extremely optimistic about everything
  • Being extremely distractible
  • Racing thoughts
  • Impaired judgment
  • Inability to concentrate
  • Delusions and hallucination

• Behavioral symptoms:
  • Frequently attempting to complete complex projects that are never completed
  • Forced speech or increased talkativeness
  • Participating in activities that have a high risk for causing harm

• Physical symptoms:
  • Increase in energy and activity levels
  • Motoric agitation
  • Decreased appetite
  • Less need for sleep

Major Depressive Symptoms (must occur minimally over a two week period)

• Psychological/Mood symptoms:
  • Depressed mood (can be based on self-report or observation)
  • Feeling hopeless/helpless
  • Feeling numb or empty
  • Inability to enjoy activities that were once experienced as pleasurable
  • Feelings of insignificance, disgrace or feelings of constantly being at fault without cause nearly every day (may be delusional)

• Behavioral symptoms:
  • Motoric agitation or retardation (must be observed by others)
  • Social Withdrawal
  • Inability to perform well at work or school
  • Decreased productivity

• Physical symptoms:
  • Decrease in weight when not dieting or unintentional increase in gain (change in body weight by at least 5% in a single month)
  • Increased or decreased hunger
  • Insomnia or hypersomnia
  • Weight Changes
  • Physical sluggishness
  • Exhaustion, lack of energy

• Cognitive symptoms:
  • Memory difficulties
  • Frequent intrusive thoughts of death or suicide
  • Trouble thinking, focusing, attending, or making decisions
  • Loss of goal focused motivation
  • Difficulty concentrating

• Mental sluggishness

Effects of Bipolar Disorder

The effects of bipolar disorder can be quite severe, both during the extreme mood states and during the neutral states, due to the significant side effects of the disorder. These include:

• Feeling unable to function
• Increased need for health related services
• Interpersonal problems
• Divorce
• Problems impacting the lives of family and friends
• Impulsivity resulting in increased risk of incarceration
• Feeling hopeless/helpless
• Caregiver burnout
• Loss of friends due to the individual’s attempts to tell them what to do and direct their lives
• Feelings of worthlessness Unwarranted shame and guilt due to blaming themselves for others’ problems
• Significant debt
• Needing a guardian to make financial and other decisions
• Inability to function normally in daily life
• Belief they always know best, leading to social estrangement and work problems
• Problems carrying out job-related tasks or remaining employed
• Impulsive behaviors without consideration of potential negative consequences of their  actions