Bipolar Disorder - Symptoms

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What are bipolar disorder symptoms and signs in adults, teenagers, and children?

In order to qualify for the diagnosis of bipolar disorder, a person must experience at least one manic episode. Characteristics of mania must last at least a week (unless it is part of mixed features) and include

  • elevated, expansive, or irritable mood;
  • racing thoughts;
  • pressured speech (rapid, excessive, and frenzied speaking);
  • decreased need for sleep;
  • grandiose beliefs (for example, false beliefs of superiority or failures);
  • tangential speech (repeatedly changing conversational topics to topics that are hardly related);
  • restlessness/increased goal-directed activity;
  • impulsivity, poor judgment or engaging in risky behavior (like spending sprees, promiscuity, or excess desire for sex).

Symptoms of the manic episode of early onset bipolar disorder tend to include outbursts of anger, rage, and aggression, as well as irritability, as opposed to the expansive, excessively elevated mood seen in adults. The adolescent with bipolar disorder is more likely to exhibit depression and mixed episodes with rapid changes in mood. Despite differences in the symptoms of bipolar disorder in teens and children compared to adults, many who are diagnosed with certain kinds of pediatric bipolar disorder continue to have those symptoms as adults. Symptoms of bipolar disorder in women tend to include more depression and anxiety and a rapid cycling pattern compared to symptoms in men.

Although a major depressive episode is not required for the diagnosis of bipolar disorder, such episodes often alternate with manic episodes. In fact, persistent sadness occurs more often than mania in many people with bipolar disorder.

Characteristics of depressive episodes include a number of the following symptoms: persistently depressed or irritable mood; feelings of apprehension; frequent crying, inability to feel pleasure; loss of interest in previously pleasurable activities; apathy, low motivation; increased or decreased appetite, weight loss or weight gain, difficulty falling asleep; excess sleepiness, agitation or lack of activity; fatigue/low energy; feelings of worthlessness; lack of concentration; slowness in activity and thought; inappropriate feelings of guilt; hopelessness; thoughts of death, self-harm or suicidal thoughts, plans, or actions.

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See what others are saying

Comment from: chistletoe, 55-64 Male (Patient) Published: May 25

No doctor, therapist, hospital, or medication ever helped me at all, although I suffered their treatments for over 40 years and spent several hundred thousand dollars on them. The stigma is more harmful than the illness. The medicines have left my body permanently damaged, but fortunately not too severely. Many years ago I decided to take charge of my own life, to take responsibility for my own actions and feelings, no matter what they might be. No one around me now would ever suspect that I had ever been regarded as "crazy".

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Comment from: jessie, 35-44 Female (Patient) Published: June 28

I was chasing my niece around the couch when I lost my balance and before I hit the floor I tried to catch myself ramming my pinky finger into the couch. It bruised up for a month or two and now the bruising is gone but in the mornings my finger is constricted closed and it is getting harder every day to get it to open.

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