7 Signs of Mania and Bipolar Disorder
Everyone has ups and downs. But imagine the normal ups and downs stretched into a roller coaster of highs and lows: life at the extremes. Savvy Psychologist shares 7 signs of mania, the signature of bipolar disorder.
Ellen Hendriksen, PhD
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7 Signs of Mania and Bipolar Disorder
Today’s episode is a response to an email I received from listener Robin from Iowa. She asked about bipolar disorder.
“Bipolar” is a term that gets thrown around a lot these days, often in a demeaning way as shorthand for “indecisive” or “inconsistent.”
But true bipolar disorder – which used to be called manic depression – is quite distinct.
Individuals living with bipolar disorder often feel well and function just fine. But during an episode, their mood and behavior swings to the manic or the depressive end of the spectrum, each of which is drastically different than their usual self.
During an episode, people living with bipolar disorder are most often depressed, but some time may be spent in a manic state. And it’s this presence of mania that sets bipolar disorder apart from plain old depression..
7 Signs of Bipolar Disorder
How to recognize mania? Look for these 7 signs:
Sign #1: Euphoria. We’ve all felt giddy at one time or another -an extra spring in your step or just high on life. Now amplify that, not just with a microphone, but through a stadium concert sound system. You are literally shouting from the rooftops.
Sign #2: Grandiosity. Nothing is impossible for you. No one is better qualified. You’re a genius. You’re convinced your 3am scribblings will go down in history as on par with Shakespeare. You have the confidence of Kanye on steroids.
Sign #3: Impulsive decisions and bad judgment. You find yourself doing risky, impulsive things, like buying a whole new wardrobe in one shopping trip, sinking all your money into a business scheme, trying to sleep with the local hockey team, or thinking it would be a good idea to jump from balcony to balcony in your apartment complex like Spiderman. For example, one of my former patients, while manic, was driving home from the store and decided on a whim to keep on driving and move to Wyoming; on another occasion he was so taken by a woman he met on a long flight, that he proposed to her before the plane landed.
Sign #4: Feeling rested after little or no sleep. You stay up all night to work on a project or roam around town.
Sign #5: Racing thoughts and non-stop talking. You jump from subject to loosely associated subject, punctuated with plays on words, laughter, or singing.
Sign #6: Irritability. Mania isn’t necessarily happy; it can be irritable and explosive as well. Extreme irritability may turn into aggression, but it’s important to remember this doesn’t necessarily mean danger to others. In fact, a 2001 study in the prestigious journal The Lancet found that folks with mental illness are far more likely to be the victims of homicide or fatal accidents than the perpetrators. Remember, when manic, folks think they’re invincible and have bad judgment – not the greatest combination for staying safe.
Sign #7: Mania gets in the way of life. Unsurprisingly, all these signs in combination interfere with life, whether that includes getting to class, focusing on work, or taking care of kids. Mania is officially diagnosed if it lasts longer than 7 days or you land in the hospital, whichever comes first.
So put it all together and what does mania look like? Consider these two mash-ups of various patients. We’ll call them “Eli” and “Angela”…..
Eli is 20 and a junior in college. He’s taking a break from school this semester due to a debilitating depression, but over the last couple of weeks he’s been up all night typing away on his laptop. He’s been sleeping about 2 hours a night and says he’s never felt better. He has an idea for an app, he says, that will change the world. He’s sent long, rambling emails to the CEOs of Microsoft, Apple, Google, and several other companies outlining his idea and planning the IPO.
He’s also simultaneously writing an autobiography since this app will be so big he’ll need to remember this time for the history books. He talks loudly about his project non-stop, laughing at times that aren’t really funny. When his mom asks him to rest or expresses her concern, Eli gets angry and rambles loudly about how genius always starts young and is always misunderstood.
Like Eli, more than 50% of cases of bipolar disorder make themselves known by age 25, often in the late teens or college years. But bipolar sometimes escapes diagnosis for years and is discovered later in life.
Consider Angela:
Angela is 42 and has a son. She’s been married 4 times, twice to her son’s father. She’s been super-social for the past week, chatting with everyone she sees whether she knows them or not, and says she feels “Great with a capital G!” After cleaning her whole house top to bottom last Wednesday, she took her son to soccer practice and, instead of watching from the sidelines, joined in on the field to help “get this practice moving,” she said. She then tried to kiss the coach. Over the last few days, however, she’s been in bed most of the day. She has no energy and feels like a zombie. She does manage to get up when her son comes home from school, but making dinner, if it happens, is exhausting.
See also: 11 Little Known Signs of Depression
The depressive side of bipolar disorder, where we leave Angela, looks just like regular depression, called unipolar depression by mental health professionals. Bipolar disorder often gets misdiagnosed as unipolar depression because this is when folks seek help, but in people with a true bipolar diagnosis, medications for unipolar depression, ironically, can trigger a manic episode.
And unfortunately, bipolar disorder gets misdiagnosed more often than not. In fact, a 2008 study out of Brown University found that 57% of adults diagnosed with bipolar disorder – that’s more than half – turned out not to have the condition. So if you or a loved one has been diagnosed, consider seeking a second opinion.
And if bipolar disorder is your true diagnosis, have hope; even though bipolar disorder isn’t curable, it is treatable. And with celebrities from Demi Lovato to Catherine Zeta-Jones, to Richard Dreyfuss coming forward with their own diagnoses, stigma is crumbling and hope is rising.
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References
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, & Walters EE. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.
Hiroeh, U., Appleby, L., Mortensen, P. B., & Dunn, G. (2001). Death by homicide, suicide, and other unnatural causes in people with mental illness: a population-based study. The Lancet, 358, 2110-2112.
Zimmerman, M., Ruggero, C.J., Chelminski, I., & Young, D. (2008). Is bipolar disorder overdiagnosed? Journal of Clinical Psychiatry, 69, 935-40.
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Mania image courtesy of Shutterstock.
About the Author
Dr. Ellen Hendriksen was the host of the Savvy Psychologist podcast from 2014 to 2019. She is a clinical psychologist at Boston University’s Center for Anxiety and Related Disorders (CARD). She earned her Ph.D. at UCLA and completed her training at Harvard Medical School. Her scientifically-based, zero-judgment approach is regularly featured in Psychology Today, Scientific American, The Huffington Post, and many other media outlets. Her debut book, HOW TO BE YOURSELF: Quiet Your Inner Critic and Rise Above Social Anxiety, was published in March 2018.