Signs and Symptoms Of Bipolar Disorder

There is an active debate about the increasing diagnosis of bipolar disorders in the population. One argument holds, that cited symptoms are too far ranging to make a specific diagnosis. A counter argument is that there are many different presentations of bipolar disorder that are now being recognized. The traditional profile of bipolar disorder is that of extreme mood swings that alternate equally between mania and severe depression. However, more people likely present with a broad array of complex symptoms. In fact, people with bipolar disorders experience many more depressive symptoms during their lifetime than manic episodes. For this reason, it is not unusual for a patient to be first prescribed an antidepressant and or an anti-anxiety medication only, before a more effective mood stabilizing medication is considered. In fact, years of taking antidepressant medications that never work, never work completely, cause more mood swings or frequently stop working, is a common experience for individuals with bipolar disorder. Bipolar disorder has been called “the great masquerader” because it shares so many features of other psychiatric conditions.

20% to 40% of adults with bipolar disorder often realize the onset of symptoms in childhood.  Early-onset bipolar disorder, which is defined as the onset before 18 years old, appears to increase in presentation during the late years of adolescence.  The most common symptoms associated with elevated mood in adolescents are mood instability, easy distractibility, irritability, increased energy, over focus on certain activities, impulsiveness, and hypersexuality.

The diagnosis of bipolar disorder still carries a greater stigma than unipolar depression (depression without manic episodes), because it is associated with instability of mood, erratic, irresponsible, less trustworthy, and unpredictable behavior. For this reason, people may initially reject the diagnosis, and recommendations for treatment. In contrast, it is not unusual that when someone confides that they have unipolar depression, other people respond more empathically, sympathetically, and possibly disclose that they too, or someone they know has also suffered from unipolar depression. Finally, because of the fear of stigma and poor prognosis, the diagnosis of bipolar disorder is often rejected by parents, and health care providers of children, and adolescents.

Self care, and management strategies for bipolar disorder include: Sleep, rest, diet, avoidance of alcohol and other substances, exercise, regular monitoring and adjustment of medication, reflective, meditative and spiritual practices, avoidance of stress, understanding the disorder, educating others about the disorder, and staying connected to meaningful people.

Following below, grouped into categories, are some of the many symptoms of bipolar disorders. This list is a compilation from many sources including the new DSM V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition):

Distress and Stress Feelings:

  • Distressed anxiety feelings
  • Edgy, overdriven feelings
  • Feeling keyed up, and tense all the time
  • Feeling up, and down at the same time
  • Feeling that you are going to loose control of yourself
  • Anxiously zoned out feeling
  • Collapsing during celebrations or holidays
  • Feeling close to tears or tearful, for no clear reason

Fearful Feelings:

  • Chronic feelings that things will go wrong
  • Difficulty concentrating due to constant worry
  • Panicky feelings
  • Excessive guilty feelings
  • Fear of travel because of concern about not being able to adjust and cope
  • Fear of making future plans or commitments that you won’t be able to keep
  • Feeling like an impostor who is always disguising your mood
  • A constant wish to avoid, or hide from people
  • Constant feelings that people dislike you, or wish the worse for you

Angry Feelings:

  • Angry tirades
  • Road rage
  • More righteous indignation, and humiliated fury
  • Impatience, and irritability
  • Annoyance, because you feel people are stupid or too slow
  • Feeling everything going on in the world is ridiculous
  • A feeling that people are always wasting your time
  • Hostile comments, and frequent complaints
  • Feeling envious, and jealous of happy people
  • Feeling cheated out of life because of mood swings

Unstable Feelings:

  • Rapid shifts in mood over short periods of time
  • Sudden onset of depression followed by quick improvement
  • Never feeling that you can trust your mood
  • Fear that anything can overwhelm or throw your mood off
  • Constant feelings of not being able to cope
  • Frequent suicidal thinking
  • Feeling constantly betrayed by your unstable mood
  • Difficulty enjoying the moment because you feel it won’t last
  • Pulling away from people often because you don’t feel like a reliable person
  • Not being able to describe how you feel

Ability to Think:

  • Sudden inability to think clearly for no good reason
  • Difficulty with expressing yourself clearly
  • Name, and word finding difficulty
  • Feeling disorganized and foggy headed
  • Difficulty setting goals and priorities
  • Difficulty getting organized
  • Absentmindedness, and forgetfulness
  • Over thinking, or thinking too deeply about issues all of the time

Loss of Energy:

  • Sudden onset of fatigue, and loss of energy
  • Loss of drive, and ability to start tasks
  • Difficulty maintaining effort after starting a task
  • Loss of interest in doing things
  • Feeling routine tasks are overwhelming
  • Inefficiency at getting things done
  • Doing things too slowly
  • Periods of excessive sleep
  • Feeling that you are always recovering from mood changes

Feelings of Sadness:

  • Feeling sad, dead, and empty inside
  • Inability to feel happiness, or pleasure
  • Feeling left behind in life
  • Feeling chronically alone
  • Feeling you provide no joy to others
  • Feeling like a constant failure or loser

Overdriven Feelings:

  • Feeling too much on top of the world, and feeling nothing is out of reach
  • Getting involved in too many social, work, political, and religious activities
  • Excessive list making, and planning
  • Daydreaming about too many things
  • Sleeping less, and not feeling tired
  • Difficulty falling asleep
  • Being up, and active at all hours of the night
  • Frantic efforts to make up for time lost when depressed
  • Trying to do too much when normal feeling in order to prepare for depression
  • Creating too many expectations of what you can or will do
  • Having too many balls in the air
  • Jumping from task to task without getting anything done
  • Getting easily distracted
  • Perceived as too intense


  • Speech that is rapid, pressured, forceful, loud, and cannot be interrupted
  • Interrupting other’s speech, without regard for their need to talk
  • Speech that rapidly shifts from topic to topic
  • Using more profanity
  • Having multiple conversations at the same time, with different people
  • Dramatic speech with many jokes, puns, and amusing tales


  • More gestures, and mannerisms
  • Excessive goofiness, and silliness
  • Asking inappropriate questions
  • Marked increase in social behavior
  • Interrupting, and invading other people’s privacy
  • Embarking on complex tasks, and ventures, in the absence of experience or talent
  • Seeking publicity for a minor creative product
  • Writing excessive letters, e-mails, and texts
  • Excessive spending, giving away or lending money, foolish investments
  • Driving recklessly
  • Alcohol, and substance abuse
  • Unusually increased sexual activity
  • Falling in, and out of love frequently
  • Increased flirtatiousness, sexually impulsive, and promiscuous behavior
  • Wish to be center of attention, and thinking you know it all
  • Displaying an elevated mood that is infectious, and entertaining to others
  • Irritating others because you are too intense
  • Unwillingness to compromise


  • Uncritical self-confidence
  • Feeling overly charming, and witty
  • Feeling you are the smartest, and wisest
  • Feeling like everyone is your friend
  • Feeling you have more enemies because people are envious, and jealous of you
  • Feeling you have or will develop a special relationship with a famous person

Keep in mind, given the many biological, developmental, and life changes that humans experience, the symptom profiles of bipolar disorder, may vary over time.

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