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Bipolar I disorder is diagnosed when you experience extreme and severe mood swings and exhibit behavior that is completely different from behavior you would typically have. One moment you might be on Cloud 9, giddy, or in a state of euphoria. And then all of the sudden, without anything triggering it, you can feel incredibly sad, hopeless, or even suicidal. The manic and depressive episodes last for at least a week or with symptoms so severe and debilitating, you need to be hospitalized.
Some people think of bipolar I disorder like riding a slow-motion roller coaster. You may spend weeks feeling like you are on top of the world, before plunging into a deep, dark depression. And imagine this goes on and on.
Bipolar disorder involves mood variability which entails the presence of both depressed mood and elevated mood. The diagnosis is rendered based on broad patterns of variable mood and energy that are not readily explained by other psychiatric diagnoses or other physiologic conditions.
Bipolar disorder involves the presence of at least one major depressive episode. This entails five or more of the following symptoms over a two week period with at least one symptom being depressed mood or diminished interest and pleasure:
- Depressed mood – a strong feeling of being sad or down
- Diminished interest and pleasure from most activities
- Significant weight loss or weight gain
- Insomnia or hypersomnia (excessive sleep)
- Physical agitation or slowed physical movement
- Fatigue or loss of physical energy
- Feelings of worthlessness, unfounded guilt and harsh self-criticism
- Impaired attention and concentration
- Recurrent thoughts of death and/or suicide
In addition to having had at least one major depressive episode, an individual must have had one manic episode which lasts one week or longer. Symptoms of a manic episode are:
- Abnormally persistent elevated, expansive or irritable mood.
- During the period of mood disturbance, three or more of the following symptoms:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual – an internal sense of pressure to keep talking
- Flight of ideas – racing thoughts.
- Increased goal directed activity – sometimes being drawn into activities or projects to the exclusion of other activities that one should be pursuing.
- Impulsivity leading to excessive involvement in pleasurable activities that have a high potential for negative consequences
- The mood disturbance must be sufficiently severe enough to cause marked impairment in occupational and/or social functioning or to require psychiatric hospitalization.
- The symptoms should also not be caused by the direct physiological effects of a substance or a general medical condition.
The symptoms of bipolar I disorder can be divided into two categories: the highs of mania, and the lows of depression.
Symptoms of mania include elation, euphoria, high self-regard, very fast speech, more physical activity than usual, less need for sleep, great optimism, risk-taking, and poor judgment. People with bipolar I disorder experience serious mania. Symptoms of depression include feeling hopeless and sad, fatigue, nervousness, irritability, loss of interest in day-to-day matters, and possibly thoughts of suicide. The depressive episodes of bipolar I disorder are not typically severe.
People with bipolar I disorder may sometimes experience psychosis, or a lack of connection to reality. Severe depression or mania can also lead one to have hallucinations - hearing voices that don't really exist - or delusions - strongly believing in things that aren't true.
Some people with bipolar I disorder experience mania or mixed mania and depression that lasts seven days (mania is a feeling of intense joy or agitation along with unrealistic expectations). Sometimes severe mania requires hospital-based treatment. Most people with bipolar 1 disorder also have bouts of depression lasting at least two weeks.
People with bipolar I (one) experience severe depressive and full-blown manic episodes. Some people switch directly from manic to depressive episodes (or vice versa), but many will have times between episodes when there is no apparent mood problem; such times are called euthymia (a neutral mood state). Approximately 1% of the general population has bipolar I.
This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.