Bipolar Disorders
The American Psychiatric Association's Diagnostic and Statistical Manual IV-TR (DSM IV-TR) describes three main Bipolar Disorders which are a class of mood disorders. It should be noted that the DSM IV-TR represents an American definition for the disorder; the World Health Organization's ICD-10 has an alternate description of symptoms. Both systems of classification though note similar signs of bipolar disorders: depressive episodes, manic or hypomanic episodes, mixed episodes, and the idea that an individual cycles between them. This synopsis will focus on the signs and symptoms of bipolar disorders recognized in the United States.
Bipolar Disorders include Bipolar I, Bipolar II, and Cyclothymic Disorder or Cyclothymia. There are many variants of these disorders depending upon whether an individual is currently depressed, manic, hypomanic, or experiencing a mixed mood state. Cycling times between these states can be highly variable. And an individual's behavior depending upon what mood state they are in, can be associated with erratic and potentially dangerous behaviors including thoughts of suicide and suicidal behaviors.
Depressive Episodes
A depressive episode is characterized by emotional, behavioral, and social problems. An individual who is depressed may feel excessive sadness for long periods of time. They may have a decreased drive to seek out pleasurable activities and socially isolate themselves. They may have low self esteem, feel like they are failures and unloved by anyone. Often a person's sleeping and eating become affected and weight loss or weight gain can occur. Insomnia, and difficulty staying asleep can occur. There are likely numerous other symptoms of depression that get manifested depending upon a person's life situation. Learn more about symptoms of depression.
Manic Episodes
A manic episode can be understood as a period of excited, euphoria, and frequently out of control behavior. A person in the midst of a manic episode may experience a decreased need for sleep and may stay up for extended periods of time. It can be a time of great pleasure and creative output but has a downside in that it can also be a time of risk taking, unsafe behaviors, and poor judgement and impulse control. People close to a person who is having a manic episode will be aware that something is amiss. They will note that their loved one is talking too much to everyone around them, that they seem scattered or flighty. They will know that their loved one's energy level is much too high. bipolar disorders with manic episodes can be trying times for families and leaves them wondering where to turn for help.
Hypomanic Episodes
Hypomanic episodes are similar to manic episodes but are not as severe. A person experiencing a hypomanic episode does not have all of the features present in a true manic episode. They may have one or two symptoms that raise flags in family members, but not full blown, out of control behaviors seen above. Still, a person experiencing hypomania may feel especially important or excessively happy so much so that family members begin to question their judgement. Hypomanic episodes can still lead to a diagnosis of a bipolar disorder: Bipolar II.
Mixed Episodes.
One of most debilitating of all bipolar disorders involves mixed episodes. Mixed episodes occur when a person is exhibiting both manic and depressive episodes within a short period of time. They may cycle between them rapidly and present as extremely distressed individuals. They may appear out of control to loved ones -- family members will be sure to know that something is not right. Mixed episodes are particularly dangerous times for individuals with bipolar disorders.
Bipolar I
Main features: Presence of at least one manic or mixed episode. Remember that a mixed episode includes manic behavior. There must be an identifiable period where a person's mood swings from one pole to the other. Or there must be at least a couple of months between manic episodes. It is likely that this person has experienced a depressive episode in the past. There is no diagnosis for solely manic behavior. Bipolar I is probably what most people consider being the stereotypic "bipolar" disorder, though there are two more listed below:
Bipolar II
Main features: Presence of at least one hypomanic episode with depressive episodes. Note the difference in the above disorder is in the intensity of the manic behavior. Remember that hypomania refers to behavior that falls somewhat short of a full blown manic episode. Recently, there has been rise in this particular diagnosis with some differences of opinion on what truly constitutes a hypomanic episode. Clearly, diagnosis hinges on making this determination. It is unknown whether there is much consistency in diagnosing hypomanic states and whether is unclear what divides hypomania from from transient elevations in mood that are within the normal range of experience.
Cyclothymic Disorder
Main features: Think of this as a low grade cycling mood disoder. Present are hypomanic episodes and periods of depressed mood, but not so much as to warrant calling it a depressive episode.