DepressionDepression is the main mood disturbance for most people with bipolar disorder and is evident by:
- Loss of interest and pleasure in activities enjoyed before.
- Overwhelming sadness.
- Withdrawing from friends and avoiding social activities.
- Ceasing self-care tasks like shopping and showering.
- Changes to appetite and sleep patterns.
- Lack of concentration, extreme tiredness, and feelings of guilt or worthlessness.
- Development of false beliefs (delusions) of persecution or guilt for some people.
This makes treatment more complex, so that effectively managing alcohol and other drug use is important.
Risk of suicide is heightened for people experiencing depression.
For more information on depression, read the brochure: What is a depressive disorder?
ManiaThe term 'mania' is used to describe the most severe state of extreme elation and overactivity. A small number of people with bipolar mood disorder experience only episodes of mania and do not experience depressive episodes.
Common symptoms of mania include varying degrees of the following.
- Elevated mood - the person feels extremely high, elated, and full of energy. The experience is often described as feeling on top of the world and invincible.
- Increased energy and over-activity.
- Reduced need for sleep.
- Irritability - the person may get angry and irritable with people who disagree or dismiss their sometimes unrealistic plans or ideas.
- Rapid thinking and speech - thoughts are more rapid than usual. This can lead to the person speaking quickly and jumping from topic to topic.
- Recklessness - this can be the result of the person's reduced ability to foresee the consequences of their actions, such as spending large amounts of money buying items that are not really needed.
- Grandiose plans and beliefs - it is common for people experiencing mania to believe they are unusually talented or gifted, or are kings, film stars or prime ministers for example. Often religious beliefs intensify or people believe they are an important religious figure.
- Lack of insight - people experiencing mania may not recognise that their behaviour is inappropriate, although they may understand that other people see their ideas and actions as inappropriate, reckless, or irrational.
- Mania is diagnosed when symptoms have been present for a week or more. Hypomania is less severe and may have shorter duration.
Normal moodsMost people who have episodes of mania and depression experience normal moods in between. They are able to live their lives productively and manage home and work commitments.
It is when moods become extreme and interfere with a person's life that assessment and treatment for mental illness becomes necessary.