Understanding Bipolar Disorder: Signs, Symptoms, and Treatment

This is a complex condition, so let’s open with some basics. The term bipolar disorderdoes not refer to the usual “ups and downs” most people experience throughout their lives. It is a brain disorder — formerly known as manic-depressive illness — that impacts nearly six million American adults. Its symptoms are challenging and ongoing, but most importantly, bipolar disorder can be effectively treated. Those living with this condition are enjoying productive, full lives thanks to a blend of medication and talk therapy. To begin understanding bipolar disorder, it helps to learn how to recognize its symptoms.Bipolar

Signs and Symptoms

It bears repeating that bipolar disorder is not to be confused with being moody or edgy due to the inevitable emotions caused by major events in one’s life. Everyday stressors bring about common, almost predictable symptoms. Bipolar disorder, on the other hand, presents with chronic signs that should never be brushed aside or written off.

During “manic” episodes, an individual often experiences a sense of euphoria and may be described with words like wired, up, touchy, high, or jumpy. Visible increases in terms of energy, activity, irritability, sex drive, and risk-taking will be apparent. More important signs to look for include:

  • Difficulty sleeping (or a belief that little or no sleep is needed)
  • Distractibility, poor concentration, racing and scattered thoughts
  • Fast Talking , jumping from topic to topic
  • Exaggerated sense of one’s abilities
  • Denial that any behavioral changes are occurring
  • Engagement in risky behavior, e.g. substance abuse, irrational spending, unsafe sex, generally poor judgment

“Depressive” episodes, obviously, will display many opposing qualities, but some symptoms are similar to mania. For example, sleep remains erratic and problematic but more so based on anxiety. Also, risk-taking is frequent. Common “mood” descriptions might include words like sad, empty, tired, hopeless, and guilt. More typical signs to look for include:

  • Low energy, decreased activity, forgetful, nervous, withdrawn
  • Belief that one cannot enjoy any activities
  • Appetite swings — from intense overeating to general disinterest
  • Physical symptoms (particularly pain) with no apparent cause
  • Physical symptoms do not respond to treatment
  • Chronic focus on death or suicide

In extreme cases, bipolar disorder symptoms could include psychosis in the form of hallucinations and delusions that will reflect either one’s manic or depressive state. Behavior focusing on grandiosity tends to occur during mania while a false sense of guilt and/or worthlessness may reflect depression. These psychotic episodes can lead to a false diagnosis like schizophrenia.

Understanding bipolar disorder has come a long way and part of this progress includes identifying its different forms. Bipolar I Disorder presents with mania and depression and is the most common and recognizable form. Bipolar II Disorder presents with hypomania (a milder form of mania) but its primary symptom is major depression. Cyclothymia is a blend of hypomania and mild depression. It is less intense than the other two forms but can develop into a more extreme version. With all forms of bipolar, early detection is essential, as bipolar tends to get more intense over the lifetime, wreaking havoc on the brain and one’s life when untreated.


Fortunately, bipolar disorder is highly treatable condition, and people can live full and gratifying lives once they learn how to manage it. Effectively addressing bipolar disorder almost always requires the use of mood-stabilizing drugs and such medication will likely be needed for a patient’s entire life. Besides well known medications such a lithium, there is a wide variety of medications that can treat various degrees of depression and mania. If you are working with a counselor or other mental health professional without prescriptive authority, a release can be set up to allow your therapist to collaborate with your doctor or psychiatrist to maintain continuity of care.

Along with mood-stabilizing drugs, it is quite helpful for some form of psychotherapy treatment (interpersonal and social rhythm therapy, cognitive behavioral therapy, family-focused therapy, dialectical-behavioral therapy, and psycho-education) to be utilized. Research has found that those diagnosed with bipolar disorder are able to recover faster and continue feeling better when talk therapy is combined with medications.

Are you worried you may be struggling with bipolar disorder? Please contact me for a free evaluation to find out how therapy can be one of the first steps in assessing and treating bipolar.