Bipolar disorder warning signs
People with bipolar disorder can experience both “high” and “low” moods, which are episodic. It is helpful to know the warning signs of the high moods like mania and hypomania as well as the low moods like depression.
What are the warning signs of mania and hypomania?
Mania symptoms can look like:
- Feeling “high” or on top of the world
- Having more energy than usual
- Feeling excessively happy, cheerful, even euphoric
- Being more talkative than normal; talking extensively to strangers
- Feeling irritable or angry; getting into frequent arguments
- Demonstrating hostile or threatening behavior
- Starting many new projects
- Having very high self-esteem and self-confidence; possibly grandiose delusions
- Speaking loudly or being difficult to interrupt; dramatic speech or singing
- Having racing thoughts
- Shifting from one topic to another
- Feeling easily distracted, restless or agitated
- Experiencing increased sex drive or sexual behavior; infidelity
- Dressing in a more flamboyant style than usual
- Having spending sprees or giving away possessions
- Driving recklessly, gambling or other impulsive, risky behaviors
- Seeing or hearing things that aren’t there
It is important to speak to a mental health professional if you are experiencing any of these symptoms to determine if you are experiencing a manic/hypomanic episode or your symptoms have an alternative cause.
Identifying mania
People in a manic state often need less sleep than before. Not getting enough sleep may be associated with, or even trigger, a manic episode, especially in females.[1] In some cases, people with mania may become psychotic and hospitalization may be necessary. Mania lasts longer than hypomania and is more severe. In order to meet criteria for a full manic episode, symptoms must have lasted at least seven days.
Identifying hypomania
Hypomania symptoms are similar to the symptoms of mania listed above. However, hypomania lasts four or more days. Also, hypomania does not result in psychosis and is less likely to require hospitalization.
I spoke with Maddy, who lives with bipolar disorder. She shared about the difficulties of experiencing mania.
“When struggling with mania, you feel invincible. You feel like these behaviors will not harm you like other people. You may stop taking your medications for mental and physical health. You might even cancel appointments and lie to your loved ones.”
What are the warning signs of depression with bipolar disorder?
Most people with bipolar disorder spend more time in depressive episodes than manic/hypomanic episodes. Signs of depression in someone with bipolar disorder include:
- Sadness, emptiness or hopelessness
- Changes in weight or appetite
- Changes in sleep, fatigue or having less energy
- Trouble completing daily tasks
- Loss of interest in hobbies or other activities one used to enjoy
- Feeling worthless or guilty
- Tearfulness, crying
- Moving more slowly than normal
- Trouble concentrating and/or making decisions
- Thoughts of dying or of taking one’s life
- Body aches or pains
- Social withdrawal
- Low libido
- Craving carbohydrates
- Trouble falling asleep or waking in the middle of the night
- Neglecting basic self-care (grooming, washing, dressing)
- Drop in grades or work performance
In order to be diagnosed with bipolar disorder, these symptoms must affect one’s ability to function at school, at work, at home or in personal relationships.
Can drugs or medications cause mania or hypomania?
Yes. Some of the substances known to trigger symptoms of hypomania or mania include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Cocaine
- Amphetamines
- Steroids, including prednisone
- Stimulants
- Cannabis
- Opioids
- Hallucinogens, including mushrooms
- Sedatives, including benzodiazepines
- Alcohol
Can cannabis cause mania?
Multiple studies have shown a relationship between cannabis use and manic episodes. Researchers found that regular (daily or weekly) cannabis use is associated with an increased risk of bipolar disorder. Those who start using cannabis by age 17 may be at a higher risk for bipolar disorder. Additionally, cannabis use in people with a history of child abuse could further increase one’s risk for bipolar disorder.[2]
Bipolar disorder and co-occurring medical issues
Research suggests that people with bipolar I disorder may experience more medical concerns than the general population. This could partially explain their shorter lifespan, on average. People with bipolar disorder may be more likely to experience:
- Cardiovascular symptoms
- Autoimmune disorders
- Sleep disorders
- Metabolic disorders, such as diabetes
- Migraines[3]
Maddy speaks to the challenges of having depression and a co-occurring eating disorder.
“When my depression got bad, I would lean on my eating disorder to cope with the feelings. It became exhausting to struggle with both the highs and lows that bipolar disorder throws at you, along with eating disorder thoughts and urges. I had to remind myself that an eating disorder is not going to make the situation better. If anything, it was going to make me more miserable. Thankfully, feelings don’t last forever.”
Increased suicide risk with bipolar disorder
People with bipolar disorder are 10-30 times more likely to die by suicide than the general population. An estimated 20-60% of people with bipolar disorder will attempt suicide [4]. If a person with bipolar disorder also has an alcohol use disorder, their risk of suicide is increased.[5]
If you or someone you care about is considering suicide, please call 911 now. Call 988 to reach the Suicide and Crisis Lifeline 24 hours a day, seven days a week.
Bipolar disorder symptoms in females
Women with bipolar disorder are more likely to experience mood issues during times of hormonal change. This includes the following periods:
- Premenstrual (days leading up to one’s menstrual period)
- Perimenopause (years leading up to menopause)
- Postpartum (the months following childbirth)[6]
Bipolar disorder risk factors
Studies show that adverse childhood experiences (ACEs) can increase one’s risk of developing bipolar disorder later in life. If you have experienced one of the following, you may have a higher risk for bipolar disorder:
- Emotional, physical or sexual childhood abuse
- Witnessing violence
- Losing a parent or being separated from one’s parents[2]
Stressful life events can also increase the risk of a manic or depressive episode in people with bipolar disorder. Examples of life events that can worsen mental health include childbirth, death of a loved one, marriage or divorce. These life events are known to exacerbate other mental health symptoms as well, like anxiety and depression.[2]
Living well with bipolar disorder
Bipolar disorder may still carry a negative stigma. But many people with this condition are able to live long, meaningful and rewarding lives. Maddy shares, “I educated myself on what my own warning signs are. It was so helpful to let professionals, friends and family know about my personal warning signs for bipolar disorder.”
If you or someone you care about is struggling to manage life with bipolar disorder, please reach out for professional help. The combination of therapy and medication treatment can be life-changing.
To learn about bipolar disorder treatment options at Pathlight Mood & Anxiety Center, please call 866-622-5914 or send us a message using this form.