Symptoms:

The manic phase may last from days to months. It can include the following symptoms:

• Easily distracted
• Little need for sleep
• Poor judgment
• Poor temper control
• Reckless behavior and lack of self control
  • Binge eating, drinking, and/or drug use
  • Poor judgment
  • Sex with many partners (promiscuity)
  • Spending sprees
• Very elevated mood
  • Excess activity (hyperactivity)
  • Increased energy
  • Racing thoughts
  • Talking a lot
  • Very high self-esteem (false beliefs about self or abilities)
• Very involved in activities
• Very upset (agitated or irritated)

These symptoms of mania occur with bipolar disorder I. In people with bipolar disorder II, the symptoms of mania are similar but less intense.

The depressed phase of both types of bipolar disorder includes the following symptoms:

• Daily low mood or sadness
• Difficulty concentrating, remembering, or making decisions
• Eating problems
  • Loss of appetite and weight loss
  • Overeating and weight gain
• Fatigue or lack of energy
• Feeling worthless, hopeless, or guilty
• Loss of pleasure in activities once enjoyed
• Loss of self-esteem
• Thoughts of death and suicide
• Trouble getting to sleep or sleeping too much
• Pulling away from friends or activities that were once enjoyed

There is a high risk of suicide with bipolar disorder. Patients may abuse alcohol or other substances, which can make the symptoms and suicide risk worse.

Sometimes the two phases overlap. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.

Signs and tests:

Many factors are involved in diagnosing bipolar disorder. The health care provider may do some or all of the following:

• Ask about your family medical history, such as whether anyone has or had bipolar disorder
• Ask about your recent mood swings and for how long you've had them
• Perform a thorough examination to look for illnesses that may be causing the symptoms
• Run laboratory tests to check for thyroid problems or drug levels
• Talk to your family members about your behavior
• Take a medical history, including any medical problems you have and any medications you take
• Watch your behavior and mood

Note: Drug use may cause some symptoms. However, it does not rule out bipolar affective disorder. Drug abuse may be a symptom of bipolar disorder.