Bipolar Disorder Signs & Symptoms

Learn About Bipolar Disorder

People who struggle with bipolar disorder typically find themselves experiencing extreme emotional shifts. They tend to fluctuate between two opposite emotional states, known as mania and depression. During a manic episode, people with bipolar disorder have excessive energy. They may engage in grand, unrealistic projects and forego sleep for days. They also tend to demonstrate poor judgment by engaging in spending sprees or risky sexual behavior. Conversely, during a depressive episode, they lose energy and experience a drop in mood. They may become tearful and lose interest in things they used to enjoy. They may experience changes in sleep, sexual desire, and appetite, and they may feel excessively guilty.

The emotional fluctuations of manic and depressive episodes associated with bipolar disorder are not exceptionally rapid; manic and depressive episodes tend to last for days or weeks as opposed to minutes or hours. People with bipolar disorder may spend a few days or weeks riding a high of excessive energy only to crash and spend the next few weeks profoundly depressed.

When a person is struggling with co-occurring substance abuse, the effects of bipolar disorder combine with the effects of the substance use, producing a much greater degree of impairment and severity of negative effects. When substance abuse is a part of someone’s life, both manic episodes and depressive episodes can be much more intense. The excess of manic episodes becomes more excessive and the descent of depressive episodes descends much deeper.

Mental health clinicians distinguish between three forms of bipolar disorder: Bipolar I, bipolar II, and cyclothymia. The three types of bipolar disorder are described below:

Bipolar I: Bipolar I is the most severe of the bipolar disorders. People with bipolar I experience full depressive episodes as well as full manic episodes.

Bipolar II: People with bipolar II experience full depressive episodes, but they experience a milder form of mania called hypomania. Hypomanic episodes are much less severe and have less of an effect on a person’s ability to function in everyday life.

Cyclothymia: Cyclothymia is the most mild of the bipolar disorders. People with cyclothymia experience symptoms of hypomania alternating with symptoms of depression, but their symptoms are not severe enough to warrant a bipolar I or II diagnosis.

Although overcoming bipolar disorder in conjunction with substance abuse can be an uphill battle, there are resources available to help you or your loved one find freedom and emotional stability.

Bipolar Disorder Statistics

The average age that people begin experiencing symptoms of bipolar disorder is 25 years old. Of the 2.6% of American adults who live with bipolar disorder in any given year, the vast majority of them, about 83%, struggle with severe bipolar disorder. Slightly less than 4% of people will be diagnosed with bipolar disorder during their lives, and slightly less than half of those diagnosed with bipolar disorder receive treatment in a given year.

Causes and Risk Factors for Bipolar Disorder

While there is no one singular cause of bipolar disorder, mental health experts agree that both genetic and environmental factors affect a person’s chances of developing bipolar disorder, as described below:

Genetic: People with family members who struggle with bipolar disorder are more at risk of developing the disorder. When compared with other siblings and fraternal twins, an identical twin is 40% to 70% more likely to develop bipolar disorder if the other twin has the disorder. Similar rates of bipolar disorder are also known to occur when an individual’s parent suffers from this mental health condition.

Environmental: Certain environmental factors can also increase the chance a person is diagnosed with bipolar disorder when a genetic predisposition exists. Exposure to traumatic experiences, unemployment, homelessness, violence, abuse, poverty, and other chronic stress can increase a person’s chance of eventually being diagnosed with the disorder.

Risk Factors:

• Having a history of trauma
• Being homeless
• Experiencing poverty
• Suffering childhood neglect
• Having a family history of mental illness or substance abuse
• Having a personal history of mental illness or substance abuse
• Being exposed to severe chronic stress, such as long-term abuse

Signs and Symptoms of Bipolar Disorder

The signs and symptoms of bipolar disorder vary according to whether a person is experiencing a manic episode of the disorder or a depressive episode. These signs and symptoms can include the following:

Behavioral symptoms:

• Demonstrating unwarranted aggression
• Missing work
• Withdrawing from friends and loved ones
• Self-harm
• Restlessness
• Rapid speech
• Quickly switching topics when in conversation
• Demonstrating poor impulse control
• Engaging in potentially dangerous behaviors
• Hypersexuality
• Instigating verbal arguments or physical altercations with others

Physical symptoms:

• Appetite changes leading to weight loss or gain
• Vocal tics
• Motor tics
• Hypersomnia or insomnia
• Having a great deal of energy and feeling lethargic
• Grinding one’s teeth
• Changes in one’s body temperature

Cognitive symptoms:

• Paranoia
• Hallucinations
• Delusions
• Poor concentration
• Rapid thought processes
• Fleeting ideas
• Difficulty forming and storing memories
• Suicidal ideation

Psychosocial symptoms:

• Agitation
• Irritability
• Anxious feelings
• Drastic mood changes
• Feelings of grandiosity

Effects of Bipolar Disorder

On its own, bipolar disorder can seriously disrupt a person’s life, but when combined with a co-occurring substance use disorder, the negative effects of the two disorders can be staggering when left untreated. These negative effects can include:

• Infection or injury caused by risky behavior, such as contracting HIV from an unwise sexual encounter
• Strained or damaged relationships
• Divorce
• Poor performance at work
• Loss of job
• Financial troubles
• Homelessness
• Deterioration of physical health
• Legal problems
• Long-term unemployment
• Suicide attempts
• Onset of additional mental health concerns

Bipolar Disorder and Co-Occurring Disorders

Tragically, people with bipolar disorder often also meet criteria for other mental health disorders. People with bipolar disorder frequently also struggle with substance use disorders. Other common co-occurring disorders can include:

• Eating disorders
• Anxiety disorders
• Obsessive-compulsive disorder
• Attention-deficit/hyperactivity disorder (ADHD)
• Posttraumatic stress disorder (PTSD)
• Schizophrenia