Bipolar isn't simple; there can be many sets of symptoms

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With Mayo Clinic psychiatrist Gabrielle J. Melin, M.D.

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August 22, 2008

Bipolar isn't simple; there can be many sets of symptoms

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By Gabrielle J. Melin, M.D.

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Bipolar affective disorder is a disorder of mood that involves a depressive phase and a nondepressed or manic phase. Bipolar means literally two opposite poles, thus explaining the meaning of the word. It isn't quite that simple, though. People can experience the nondepressed or manic phase in more than one way. The mood during the manic phase can be euphoric or irritable or even a combination of the two. Furthermore, people can experience a "mixed episode" and can have both depressive and manic symptoms during the same episode of illness.

The specific set of symptoms is important as some medications, such as Lamictal, are better for a mixed bipolar episode. Medications used to treat bipolar (mood stabilizers) are different than moods used to treat depression.

The manic phase is characterized by elevated or irritable mood plus 3 to 4 of the following symptoms happening during the same time period (at least one week continuously):

Decreased need for sleep (feeling refreshed on little sleep)
Decreased appetite
Grandiosity (inflated sense of self worth)
Distractibility
Excessive involvement in pleasurable activities that have a high potential for painful consequences (buying sprees, sexual indiscretion, foolish business ventures)
Flight of ideas (talking and thinking that jumps from one topic to another-racing thoughts)
Increase in activities involving school, work or social life
Agitation

The person may also experience psychosis, which means being out of touch with reality. The manic phase is a change in previous life functioning that is not caused by drugs or alcohol. The manic phase alternates with a depressive phase.

The Mood Disorder Questionnaire (MDQ) is a self-screening tool that can be used in conjunction with a visit to a mental health provider. Mood swings alone do not mean you have bipolar. Borderline personality symptoms can look like bipolar and other mental illness, too. Time and accurate information help to make the correct diagnosis and provide the best treatment.