Manic depression; Bipolar affective disorder

The manic phase may last from days to months and include the following symptoms:

• Elevated mood
  • Racing thoughts
  • Hyperactivity
  • Increased energy
  • Lack of self-control
• Inflated self-esteem (delusions of grandeur, false beliefs in special abilities)
• Over-involvement in activities
• Reckless behavior
  • Spending sprees
  • Binge eating, drinking, and/or drug use
  • Sexual promiscuity
  • Impaired judgment
• Tendency to be easily distracted
• Little need for sleep
• Easily agitated or irritated
• Poor temper control

These symptoms of mania are seen with bipolar disorder I. In people with bipolar disorder II, hypomanic episodes involve similar symptoms that are less intense.

The depressed phase of both types of bipolar disorder involves very serious symptoms of major depression:

• Persistent sadness
• Fatigue or listlessness
• Sleep disturbances
  • Excessive sleepiness
  • Inability to sleep
• Eating disturbances
  • Loss of appetite and weight loss
  • Overeating and weight gain
• Loss of self-esteem
• Feelings of worthlessness, hopelessness and/or guilt
• Difficulty concentrating, remembering, or making decisions
• Withdrawal from friends
• Withdrawal from activities that were once enjoyed
• Persistent thoughts of death

There is a high risk of suicide with bipolar disorder. While in either phase, patients may abuse alcohol or other substances, which can worsen the symptoms.

Sometimes there is an overlap between the two phases. Manic and depressive symptoms may occur simultaneously or in quick succession in what is called a mixed state.

A diagnosis of bipolar disorder involves consideration of many factors. The health care provider may do some or all of the following:

• Observe your behavior and mood
• Obtain your medical history, including any medical problems you have and any medications you take
• Ask about your recent mood swings and how long you've experienced them
• Ask about your family medical history, particularly whether anyone has or had bipolar disorder
• Perform a thorough examination to identify or rule out physical causes for the symptoms
• Request laboratory tests to check for thyroid problems or drug levels
• Speak with your family members to discuss their observations about your behavior

Note: Use of recreational drugs may be responsible for some symptoms, though this does not rule out bipolar affective disorder. Drug abuse may itself be a symptom of bipolar disorder.