Bipolar Moods & Symptoms

Overview of bipolar moods and symptoms

All individuals go through mood variations, yet those with bipolar disorder may find these changes particularly troubling and significantly affecting their lives.

You might notice that your high and low feelings are very strong, and changing from one mood to another can feel too much to handle. How you feel and act can change a lot depending on whether you’re feeling up or down, which can be hard and confusing to deal with.

These changes in mood are sometimes called ‘mood episodes’ or ‘mood states’. They can vary in length and not everyone experiences these in the same way.

Hypomanic and manic episodes

Manic and hypomanic episodes are times when people feel very upbeat or “high.” Both kinds of episodes can make you feel or act in similar ways, but there are important differences:

• How bad the symptoms are: Manic episodes are more serious and might need treatment in a hospital. Hypomania also changes how you feel or act but isn’t as extreme.
• How they affect your life: Manic episodes can make it really hard to do everyday things, sometimes stopping you from doing them at all. Hypomanic episodes can mess with your life too, but you might still be able to work or hang out with friends.
• How long they last: A manic episode lasts at least a week, while hypomania lasts at least 4 days. Both can go on for much longer, though.
• What symptoms you have: With mania, you might take bigger risks or have very strong symptoms, like seeing or believing things that aren’t real. This doesn’t happen with hypomania.

Both mania and hypomania are tough to deal with. Whether you’re dealing with one or the other, or if you’re not sure, it’s always okay to ask for help.

Behaviours and feelings

In the midst of a manic or hypomanic episode, you may experience:

• Feelings of irritability or restlessness
• A reduced need for sleep
• An increase in sexual desire
• A belief that you are invincible or immune to harm, which is more common during mania
• An intense concentration or commitment to finishing specific tasks or projects
• A feeling of happiness, joy, or overall well-being
• A sense of boldness or a willingness to take risks
• Difficulty staying focused due to rapidly shifting thoughts or a lack of concentration
• Extreme excitement or feeling overly thrilled
• A struggle to speak quickly enough to express your thoughts
• An impression that your physical and mental capabilities are enhanced

Behavioral Patterns During periods of mania or hypomania, individuals may exhibit behaviours such as:

• Engaging in actions or speech that are uncharacteristic and potentially inappropriate
• Displaying aggressive or impolite behaviour
• Engaging in activities more frequently than is typical
• Demonstrating unusually high levels of sociability
• Experiencing minimal need for sleep or foregoing sleep entirely
• Communicating excessively, rapidly, or in a manner that might be confusing to others
• Engaging in substance abuse
• Making extravagant or atypical financial decisions
• Showing a reduction in social restraints
• Undertaking activities that jeopardise personal safety

What will I feel like afterwards?

After an episode of mania or hypomania, individuals might experience a range of feelings and physical effects, which can vary widely from person to person. Here are some common feelings and states that people may encounter post-episode:

• Exhaustion: Manic or hypomanic episodes often involve a high level of activity and reduced need for sleep, which can leave someone feeling physically and mentally drained once the episode subsides.
• Emotional Turmoil: Individuals may feel emotionally unstable or sensitive following an episode. It’s common to experience a mix of relief that the episode has ended, alongside feelings of depression, guilt, or shame about actions taken during the episode.
• Depression: It’s not uncommon for a depressive episode to follow a period of mania or hypomania, as part of the cycle in bipolar disorder. This can include feelings of sadness, hopelessness, and a lack of interest in activities once found enjoyable.
• Anxiety: Worrying about the consequences of decisions made during the episode or about the possibility of future episodes can lead to anxiety and stress.

It’s important for individuals who have experienced manic or hypomanic episodes to seek professional help for recovery and management of their condition, as well as to maintain open communication with their support system to help navigate the aftermath of an episode.

Depressive periods

Depressive periods are characterised by a persistent low mood, lasting at least two weeks and potentially extending for several months. Similar to manic or hypomanic periods, they can significantly interrupt daily activities. In cases of severe depression, treatment may involve medication or hospitalisation.

For some, the experience of depressive periods may be more challenging than that of manic or hypomanic periods. The stark contrast between periods of elevated and lowered mood can intensify the perception of depression.

During a depressive period, individuals may experience feelings of:

• Sadness, distress, or frequent crying
• Fatigue or lack of energy
• Disinterest in previously enjoyable activities
• Low self-worth, confidence issues, or feelings of inadequacy
• Feelings of guilt, worthlessness, or despair
• Irritability and nervousness
• Difficulty focusing or making decisions
• Thoughts of self-harm or suicide

Behaviourally, a depressive period may lead to:

• Avoidance of enjoyable activities
• Disturbances in sleep patterns, either too little or too much sleep
• Changes in appetite, either eating less or more
• Substance abuse
• Social withdrawal or isolation
• Persistent contemplation on distressing thoughts
• Lack of communication or responsiveness to others
• Reduced physical activity
• Self-harm or suicide attempts

In situations where personal safety becomes a concern, it constitutes a mental health crisis.

Depressive lows can vary, ranging from feeling numb and colourless to experiencing acute, tormenting intensity. At times, the internal turmoil and pain are so severe that no physical pain can compare.

Mixed Episodes

Mixed episodes, also referred to as mixed states, occur when an individual simultaneously experiences symptoms associated with both elevated and depressed moods. This means one might simultaneously feel symptoms typical of depression and mania or hypomania.

For instance, a person could feel highly energetic and impulsive yet simultaneously experience feelings of sadness or agitation.

It’s also possible for someone to change rapidly between these emotional states, experiencing both highs and lows within a short period, such as within a single day or hour.

Navigating mixed episodes can be particularly challenging because:

• Distinguishing between conflicting emotions becomes more complex.
• Determining the appropriate form of assistance can be more complicated.
• Managing emotions may be more demanding and exhausting.
• It can be difficult for friends, family, or healthcare providers to provide the right support.
• There is an increased risk of acting on suicidal thoughts or impulses.

In situations where personal safety is a concern, this represents a mental health crisis.

Mixed episodes are notably challenging due to their unpredictability and potential danger. They are often the hardest to describe and manage.

Psychotic symptoms

Not everyone who has bipolar experiences psychosis, but some people do. It can be more common during manic episodes but can also happen during depressive episodes.

The kind of feelings you will experience can feel very real to you at the time, which can make it hard to understand other people’s concerns about you. 

These symptoms can include:

• Hallucinations, such as hearing voices.
• Delusions, such as paranoia.

Stable Episodes

It’s not uncommon to experience periods of stability or neutrality amidst episodes. This doesn’t imply an absence of emotions during these intervals. Rather, it signifies that episodes of mania, hypomania, or depression are not present, or that symptoms are being effectively managed. These times of stability can last years or may be considerably shorter in duration.

Such times can offer a sense of relief, yet they may also present their own set of challenges. During these phases, you might experience a range of feelings, including happiness, calmness, or relief, alongside concerns about potentially becoming ill again. 

Feelings of embarrassment or guilt over actions taken or words spoken while ill, a sense of having much to organise or catch up on, pressure to immediately return to ‘normal life’, nostalgia for certain aspects of life or personality traits experienced during illness, and uncertainty regarding the continuation of medication or other treatments are common.