People with bipolar disorder experience changes in mood, and these changes can occur in distinct phases.
We all experience changing moods and have days that we consider better than others.
But when you live with bipolar disorder, these fleeting moments of good and bad days can be so intense they can lead to problems at work, home, and in relationships.
Bipolar disorder can look differently from person to person. Symptoms vary depending on the phase of bipolar disorder you’re experiencing.
Some people with bipolar disorder are more prone to either extreme ups (mania or hypomania) or extreme downs (depression). Others might be more likely to cycle between these two extreme mood changes equally.
Each phase of the condition has its own unique set of symptoms. Managing bipolar disorder starts with knowing more about your symptoms and triggers, and being able to recognize them.
During the mania phase — aka a manic episode — people have periods of inflated or “high” moods. It’s not uncommon to have heightened feelings of creativity, energy, and happiness.
When you’re in a mania phase, you might find yourself talking so fast that it’s hard for people to keep up. You might also feel like you’re invincible and can do anything.
Other features during mania include:
- Decreased need for sleep. Up to
99%of people with bipolar disorder experience less need for sleep during the mania phase.
- An exaggerated sense of self. During manic episodes, people often feel unusually gifted, important, or powerful. They may have grandiose beliefs about their talents.
- Flight of ideas. This is described as rapidly jumping from one topic to another. In some cases, speech becomes rapid and connections between ideas appear illogical.
- Excessive energy levels. Mania can lead to a sudden increase in energy levels above what’s normal for you. This might manifest as engaging in multiple projects at the same time.
- Heightened mood. In the mania phase, people with bipolar disorder alternate between intense happiness and irritable moods.
- Poor judgment. Some people engage in out-of-character or potentially harmful behaviors.
- Extreme anger, irritability, and aggressiveness. Some people find themselves picking fights or lashing out when others don’t agree with them.
During a mania phase, you may begin several activities at once, believing you can finish them all.
All of this energy and heightened mood can be exhausting — not only for someone with bipolar disorder but also for their family, friends, and co-workers who experience these phases alongside them.
There are no lab tests to diagnose bipolar disorder, but having three or more of these mania symptoms can be enough for a diagnosis, according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Mania and hypomania are two different phases of bipolar disorder with similar symptoms. However, the hypomania phase is less intense than the mania phase.
In other words, people in the hypomania phase may experience the same symptoms of high energy and euphoria, but they’re still able to work and carry on with everyday life without any major disruptions.
Other differences include:
- Mania is defined as lasting at least 7 days in a row, while hypomania is at least 4 days in a row.
- A manic episode may require hospitalization, while hypomanic episodes do not.
- Mania can lead to major problems at home and work, while hypomania doesn’t cause as much issue with daily functioning.
- Mania may trigger psychosis — an inability to differentiate reality from unreality. Hypomania does not.
Hypomania involves changes in behavior like:
- being overly talkative
- extreme friendliness
- substance use
- loss of social inhibitions
Similar to mania, people often feel bad or ashamed of their behavior after a hypomania episode. They may also discover that the episode is followed by a depressive phase.
Common symptoms for both include feelings of:
You might also have the following in both:
- sleep problems (too much or not enough)
- loss of interest in previously enjoyable activities
- suicidal thoughts
- changes in weight
- trouble concentrating
Despite the similarities between the two, there are some symptoms unique to the depression phase of bipolar disorder. For example, people with bipolar disorder might experience feelings of restlessness and unpredictable changes in mood during the depression phase. They might also be more prone to irritability.
Because it’s so difficult to tell the difference between depression and bipolar disorder, it’s critical to discuss both the mania or hypomania symptoms you’re experiencing and the depression ones.
Getting the right diagnosis is important to finding the right treatment plan.
For example, rapid bouts of happiness may be quickly followed by sadness or tears.
Mixed episodes (aka mixed features) are difficult to diagnose and tend to last for longer periods. Symptoms include:
- engaging in pleasurable activities but feeling depressed
- low mood with fast speech
- elevated mood characterized by an increase in suicidal thoughts
Not all mixed episodes have these symptoms. Some present with other symptoms like regret or low energy levels.
Typically, mood episodes occur once or twice a year. Rapid cycling, however, refers to someone who experiences four or more distinct phases of mania, hypomania, depression, and mixed episodes over a period of 12 months.
Rapid cycling isn’t an uncommon phenomenon. Among people with bipolar disorder, approximately
Episodes are random and can last anywhere from days to weeks. They also vary in duration and severity of symptoms.
Researchers aren’t clear on the exact cause of rapid cycling, but experts believe it might be associated with:
If you notice that you’re experiencing periods of rapid cycling, try to keep track of these episodes. You can use a journal, diary, or a symptom tracking app to track your symptoms and medications.
A few ways to track them include:
- documenting daily moods
- tracking medication use
- monitoring sleep patterns
- taking note of life events and stressors
- paying attention to symptoms
Keep these notes handy and be prepared to discuss them with your healthcare team at your next visit, whether that’s in person or online.
If you believe you’re experiencing any phases of bipolar disorder, you may want to start by talking with a mental health professional, or even your primary doctor. You might also begin by taking our brief bipolar disorder quiz.
Living with bipolar disorder can be challenging and frustrating, but you’re not alone.
It can be helpful to connect with others facing similar experiences and challenges. You can do this by:
- checking out blogs devoted to people with bipolar disorder
- finding an in-person or online support group through the Depression and Bipolar Support Alliance
- reaching out to a healthcare professional for a referral to a local group
If you know someone with bipolar disorder, you can find ways to help them here: How to Help a Loved One with Bipolar Disorder.