Everybody has their ups and downs in daily life, but with bipolar disorder these changes are extreme. During the manic phase, people may feel euphoric, full of a sense of their own importance and brimming with ambitious schemes and ideas. They may spend money extravagantly, and build up debts. They may eat and sleep very little, and talk so quickly that it's difficult to understand them. They may be easily irritable and angry. Their libido can go into overdrive.
A person may be quite unaware of these changes in their attitude or behaviour. After a manic phase is over, they may be quite shocked at what they've done and the effect that it has had. Sometimes, people experience a milder form of mania known as hypomania. During these periods people can actually become very productive and creative and so see these experiences as positive and valuable. (However, hypomania, if left untreated, can become more severe, and may be followed by an episode of depression.)
Mania may flare up periodically, but depression is the most consistent symptom. People may feel overwhelming despair, guilt and worthlessness. They may feel chronic fatigue and gain weight, or have difficulty sleeping. They lose interest in everything. Problems concentrating and remembering things can make life very difficult and undermine the simplest tasks. The experience of bipolar disorder may provoke suicidal feelings.
The current diagnoses in the UK are likely to be:
- Bipolar I or II, depending on the severity and the duration of the episodes of mania and/or depression.
- Cyclothymic disorder - with short periods of mild depression and short periods of hypomania.
- Rapid cycling - four or more episodes a year.
- Mixed states - periods of depression and elation at the same time