Bipolar disorder

What are the early warning signs of bipolar disorder?

One early bipolar symptom may be hypomania. When someone is hypomanic, they can feel great, highly energetic and impulsive.

Common early warning signs for hypomania and mania, include:

• not sleeping (the most commonly experienced sign)
• agitation, irritability, emotional intensity
• energised with ideas, plans, motivation for schemes
• intense expression-laden behaviour with implied extra meaning
• inability to concentrate
• rapid thoughts and speech
• spending money more than usual
• increased sexual drive, flirtatiousness
• increasing incidence of paranoid thoughts
• neglecting to eat, losing track of time
• reading extra symbolism into words, events, and patterns (seeing ‘codes’)
• increased use of telephone or writing – making contact with many people
• insistent and persuasive
• increased intake – or binges – of alcohol and/or drugs
• arguments with friends or family
• increased ‘driven’ activity without stopping to eat, drink or sleep
• increased interest in religious/spiritual ideas or themes
• taking on more work or working to extremes in hours or projects.

Some common early warning signs of bipolar depression, include:

• change in sleep patterns – insomnia, or excessive sleeping
• fatigue
• staying up late to watch TV or work on projects
• increased irritability
• loss of concentration
• lack of motivation
• withdrawal – avoiding social contact, not answering the phone, cancelling social activities
• change in eating habits – loss of appetite, or overeating
• reduced libido
• increased anxiety and feelings of worthlessness
• loss of interest in leisure activities and hobbies
• listening to sad/nostalgic music
• taking sick days
• procrastinating and putting off responsibilities
• bursting into tears for no apparent reason
• thoughts of suicide.

If you recognise some of these changes in behaviour, it’s important to find help from a mental health professional.

Symptoms of bipolar disorder

Someone with bipolar disorder has episodes of depression and highs (feeling ‘hyper’ or ‘wired’). During the ‘highs’ they might feel like things are speeding up, having thousands of thoughts and ideas, and they may feel invincible or behave recklessly.
Bipolar symptoms during a manic phase may include:

• feeling incredibly ‘high’ or euphoric
• delusions of self-importance
• high levels of creativity, energy and activity
• getting much less sleep or no sleep
• poor appetite and weight loss
• racing thoughts, racing speech, talking over people
• highly irritable, impatient or aggressive
• inappropriate sexual activity or risk-taking
• dressing more colourfully and being less inhibited
• impulsiveness and making poor choices in spending or business
• grand and unrealistic plans
• poor concentration, easily distracted
• delusions, hallucinations.

Bipolar symptoms during a depressed phase may include:

• feelings of sadness or hopelessness
• loss of interest in usually pleasurable activities
• withdrawal from family and friends
• sleep problems (often excessive sleep)
• loss of energy, feeling exhausted
• physical slowing
• low self-esteem
• feelings of guilt
• problems concentrating
• suicidal thoughts.

Bipolar disorder can be difficult to diagnose as:

• its onset is often marked by a depressive period and it can therefore be misdiagnosed as depression
• depressive symptoms are common in bipolar disorder – usually more prevalent than hypomanic or manic symptoms
• ‘mixed mood’ episodes are common. These might obscure the detection of mania and hypomania, as people report more depressive symptoms when seeking treatment.

For some people, it can take years before their illness is accurately diagnosed and treated. Mental health professionals should carefully assess previous episodes of mania or hypomania when working with depressed patients. Some patients with treatment-resistant unipolar depression may possibly have been misdiagnosed with bipolar disorder.

Getting help early for bipolar disorder is important.

It’s very important to get help for someone you are concerned may have bipolar disorder or another mental health condition, or if you recognise the signs in yourself. We can’t diagnose bipolar disorder on our own. Accurately diagnosing bipolar disorder needs to be done by a skilled mental health professional. Make sure you see your GP. We can talk to you about your concerns, and get you to help from a psychiatrist or other mental health professional. Bipolar doesn’t go away by itself. It needs long-term management. There are well-trained professionals to help you manage bipolar disorder and other mental health conditions.