Manic depression is a an older term for bipolar disorder. Manic depression symptoms consist of major depressive episodes as well as manic episodes or milder hypomanic episodes. Like many other mental health professionals, when I see a new client who reports symptoms of depression, I also screen for bipolar disorder. Unless mental health clients are aware of the symptoms of bipolar mania, they are more likely to report only their depressive symptoms.
An accurate diagnosis is essential in order to receive the proper treatment. Therefore, recognizing the symptoms and signs of bipolar disorder and reporting them to your doctor or therapist are essential steps to receiving the help that you need.
Some individuals may have difficulty in recognizing bipolar disorder symptoms in themselves, so I often give clients a list of the symptoms and ask them to share the list with someone who knows them well and can give them appropriate feedback. If you think you may have bipolar disorder, you may find it helpful to review the signs and symptoms with someone you trust.
Mental Health: A Report of the Surgeon General lists the criteria for a major depressive and manic episodes, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Signs and symptoms of a major depressive episode include:
- Feeling depressed most of the day, nearly every day
- A loss of interest or pleasure in activities that were once enjoyable
- Significant weight gain or weight loss without dieting, or an increase or decrease in appetite
- Experiencing either insomnia or an excessive amount of sleep
- Psychomotor agitation (for example, pacing, nail biting, or difficulty sitting still) or psychomotor retardation (such as walking and working at slower paces or speaking more slowly and less frequently than usual)
- Fatigue or a loss of energy
- Feelings of worthlessness, excessive feelings of guilt, or feeling guilty about situations for which you are not at fault
- Difficulty thinking, concentrating, or making decisions
- Suicidal thoughts
Manic episodes include:
- An elevated or irritable mood
- Inflated self-esteem or grandiosity (which can be delusional)
- Decreased need for sleep, sometimes needing only two hours of sleep to feel rested, and in some cases, being able to go three days with no sleep at all without feeling tired
- Being more talkative than usual, an urge to keep talking, or rapid speech
- Racing thoughts that often shift from one topic to another
- Being easily distracted by unimportant situations
- An increase in goal-directed activity, and often the goals are grandiose and unrealistic
- Reckless or excessive involvement in activities that have a high potential for negative consequences (such as overspending, excessive gambling, or sexual indiscretions)
Some people with bipolar disorder experience mixed episodes, which, as the name implies, includes signs and symptoms of both major depressive and manic episodes. The mood swings of bipolar disorder tend to be more rapid during a mixed episode. states that a mixed episode is often informally described as “rapid cycling” bipolar disorder, but explains that rapid cycling technically consists of at least four major depressive, manic, mixed or hypomanic episodes within a 12-month period.
Bipolar symptoms in kids often present themselves differently than bipolar symptoms in adults. Demitri Papolos, MD and Janice Papolos, authors of The Bipolar Child, believe that the DSM-IV needs to be updated to reflect what bipolar disorder looks like in children. They assert that children with bipolar disorder may experience rapid mood shifts many times throughout the day. Papolos and Papolos say that children with bipolar disorder can be very oppositional, defiant, and easily frustrated. They often have difficulty making transitions. They may experience prolonged temper tantrums that often lead to aggression or violence. Many of them have horrible nightmares.
If you believe you or your child may have bipolar disorder, consult with a physician or mental health professional. He or she may choose to refer you to a psychiatrist for an evaluation to confirm or rule out the diagnosis and to discuss treatment options.