Bipolar disorder is marked by extreme high and low mood swings. During the highs, you experience a sense of mania. During the lows, you find yourself in a period of depression. ¹

If you or someone you love struggles with bipolar disorder, you’re not alone. Nearly 2.6% of Americans currently struggle with bipolar symptoms. ²

If you’re still not sure, we invite you to follow along as we identify 14 signs of bipolar disorder.

Signs of a Depressive Episode

One of the identifying traits of bipolar disorder is known as a depressive episode. Simply put, this is when you’ll experience lower mood levels, fatigue, and negative thought patterns. These can last anywhere from days to weeks to months. Signs of a bipolar depressive episode include:

1.) Loss of Interest in Activities You Once Enjoyed

Have you lost interest in the things that once made you happy? This is one of the first signs of a major depressive disorder (MDD) and a depressive episode in bipolar patients.

The tricky part is many still have an interest in specific activities. However, they lack the motivation to go out and participate in activities.

It may help to force yourself to regularly participate in an activity, even if you don’t want to. As such, you’ll be developing a habit rather than a hobby. Studies show it takes about six weeks to form a habit and that habits may be able to create interest once again. ³

2.) Lack of Energy

Part of the reason you may have lost interest is due to strong sensations of fatigue. Do you have trouble getting up in the morning? Do you find it difficult to go about your day without feeling exhausted?

Fatigue is one of the most difficult elements of a depressive episode because there is no simple cure. Like redeveloping interest in activities, it takes a certain mental energy to not feel so tired.

We suggest you look into activities that boost dopamine, such as exercising. ⁴ Dopamine helps us stay awake and counteracts negative feelings associated with depression. It may also help to develop healthier eating habits. This provides the brain with proper nutrients for these activities.

3.) Breaking Connections with Family and Friends

If you’re struggling through a depressive episode, it’s natural to avoid people. When feelings of low mood strike, we tend to prefer being alone. However, we cannot forget that people can become the support system we need to push through these episodes.

Close family members and friends may feel personally attacked by depressive episodes. You may feel your loved one is disconnecting not out of spite. Of course, this is far from the truth.

Chances are your loved one is having trouble managing their symptoms and they feel shame in revealing them to you. It can help to reach out and show your support. The right support for someone with bipolar disorder can go a long way in the recovery process.

If you find yourself withdrawing from friends and family, it’s important to remember that these people care and want the best for you. Their support may be just what you need to get some energy back and reorganize your life.

4.) Feeling Sad, Hopeless, and Helpless

Still, you may have difficulty reaching out if you feel helpless. It’s common for people going through a depressive episode to feel like there’s no way out.

Of course, there is a way out. If you’re receiving traditional treatment, you’re most likely going through psychotherapy. This aims to help identify your thought patterns and change them to a more positive perspective. ⁵

If you aren’t receiving traditional treatment and find yourself feeling overwhelmingly sad, hopeless, and helpless. As such, it’s highly suggested you look into psychotherapy.

5.) Difficulties with Memory, Concentration, and Making Decisions

Are day-to-day activities much more difficult than they should be? Do you have difficulty concentrating? Can’t seem to make a proper decision?

People with bipolar disorder are bound to come across these obstacles during a depressive episode. In the same light, psychotherapy can help to readjust your memory and make it easier to perform daily tasks.

6.) Changes in Appetite

Do you find yourself eating less than you used to? Or, are you eating more than normal?

Depressive episodes change the way the brain processes information. Such changes can strongly affect our appetites, leaving us to eat too much or too little. Since your appetite plays a major role in your overall health, it’s important to consult a doctor if you’re noticing changes in your appetite.

7.) Suicidal Ideation

If you struggle with a depressive episode, you’re also prone to developing suicidal ideation. This aspect of depression is sometimes overlooked by loved ones due to its extremity. When the brain is met with such severe circumstances, it can’t imagine them happening.

However, it’s vital not to overlook suicide’s potential. For loved ones, there are a few signs of suicidal ideation to keep an eye out for.

If a person talks about:

• Killing themselves
• Feeling hopeless
• Having no reason to live
• Being a burden to others
• Feeling trapped
• Unbearable pain

If a person picks up the following behaviors:

• Increased use of drugs or alcohol
• Looking for ways to end their life (i.e. online searches)
• Withdrawing from activities
• Separating contact from friends and family
• Oversleeping or not getting enough sleep
• Giving away possessions
• Aggression

If you’re considering suicide, we highly advise you either:

• You call 911 or go to your local emergency room.
• Reach out to the 988 Suicide & Crisis Lifeline.

Signs of a Manic Episode

The other trait of bipolar disorder is known as a manic episode. These produce strong feelings of euphoria and energy. They can last anywhere from days to months, depending on the individual. Signs of a manic episode include:

8.) Having Rapid Thoughts

Do you have difficulty trying to grasp what you’re thinking about? Or even worse, what you’re trying to say?

One of the signs of a manic episode is having racing thoughts that may surface when you talk to people. You might find it difficult to slow down your sentences and to consider the point you’re trying to make.

Though this isn’t the most detrimental of signs, it can have consequences in certain situations. For example, if you’re at a job interview and can’t properly answer questions.

9.) Restlessness

One of the most notable manic symptoms is impulsivity and restlessness. You may find it hard to keep still and appear agitated if asked to sit patiently in one spot for too long.

You might make the most of this and be as productive as possible. However, you also may find yourself constantly running into dead ends, partly due to the inconsistency of your rapid thoughts.

10.) Prone to Distraction

You may sometimes feel like you’re struggling with attention-deficit/hyperactivity disorder (ADHD) due to the parallels in symptoms. The most notable is your struggle to pay attention.

For children and teenagers, this can make school a nightmare. For adults, a tedious job may drain their motivation. ⁶

Distractions can also work alongside other signs, such as impulsivity. In effect, this can lead to unintended consequences. For example, if you’re in an important meeting, your lack of attention can make you look bad and result in a demotion.

If she notices, this can lead to complications at work.

11.) Participating in Risky Behavior

There are several risky behaviors you may participate in as a result of a manic episode, including:

• Binge eating
• Compulsive sexual relations
• Gambling
• Spending large sums of money

Decisions made within a manic episode can have consequences further down the line. Consequences that may be reflected in a depressive state. In fact, some researchers have found connections between bipolar disorder and substance abuse disorder. ⁷

12.) Lack of Sleep

Since a manic state is matched with restlessness, insomnia is common. Naturally, the lack of sleep can have several consequences on the human brain, including:

• Bad performance
• Lack of motivation
• Lower mood
• Poor judgment

Luckily, this is one of the easier signs to work with. Sleep supplements such as melatonin can help regulate the body’s sleep cycle back to its normal state.

13.) Feeling Extreme Happiness

It may seem odd we’d mention extreme happiness as a problem of manic episodes. In truth, isn’t that what most of us seek?

The problem is this extreme happiness is brought upon by an extreme “high.” In other words, it’ll quickly vanish once the manic episode is over. Furthermore, while it’s going on, you may feel so overwhelmed with happiness that you don’t consider the consequences of risky behaviors.

14.) Overconfidence

With that extreme happiness, you may feel overconfident in yourself. And overconfidence can also lead to risky decisions.

References

¹ Jain A, Mitra P. Bipolar Disorder. 2023 Feb 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644424.

² Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):617-27. doi: 10.1001/archpsyc.62.6.617. Erratum in: Arch Gen Psychiatry. 2005 Jul;62(7):709. Merikangas, Kathleen R [added]. PMID: 15939839; PMCID: PMC2847357.

³ Gardner B, Lally P, Wardle J. Making health habitual: the psychology of ‘habit-formation’ and general practice. Br J Gen Pract. 2012 Dec;62(605):664-6. doi: 10.3399/bjgp12X659466. PMID: 23211256; PMCID: PMC3505409.

⁴ Lin TW, Kuo YM. Exercise benefits brain function: the monoamine connection. Brain Sci. 2013 Jan 11;3(1):39-53. doi: 10.3390/brainsci3010039. PMID: 24961306; PMCID: PMC4061837.

⁵ Swartz HA, Swanson J. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. Focus (Am Psychiatr Publ). 2014 Summer;12(3):251-266. doi: 10.1176/appi.focus.12.3.251. PMID: 26279641; PMCID: PMC4536930.

⁶ Hilty DM, Leamon MH, Lim RF, Kelly RH, Hales RE. A review of bipolar disorder in adults. Psychiatry (Edgmont). 2006 Sep;3(9):43-55. PMID: 20975827; PMCID: PMC2963467.

⁷ Kim YJ, Qian L, Aslam MS. The impact of substance use disorder on the mental health among COVID-19 patients: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020 Nov 13;99(46):e23203. doi: 10.1097/MD.0000000000023203. PMID: 33181701; PMCID: PMC7668455.