You can experience episodes of:
• mania, and
• depression.
You may feel well between these times. When your mood changes, you might see changes in your energy levels or how you act. Bipolar disorder used to be called manic depression.
Symptoms of bipolar disorder can be severe. They can affect areas of your life, such as work, school and relationships.
You usually develop bipolar disorder before you are 20. It can develop in later life but it rarely develops after the age of 40.
You can have symptoms of bipolar disorder for some time before a doctor diagnoses you. A doctor might say you have something else such as depression before you get a bipolar disorder diagnosis.
Bipolar I disorder
A diagnosis of bipolar I disorder means you will have had at least 1 episode of mania that lasts longer than 1 week. 90% of people will also have periods of depression. Manic episodes will generally last 3-6 months if left untreated. Depressive episodes will generally last 6-12 months without treatment.
Bipolar II disorder
A diagnosis of bipolar II disorder means it is common to have symptoms of depression. You will have had at least 1 period of major depression. And at least 1 period of hypomania instead of mania.
Bipolar I or II disorder with mixed features
You will experience symptoms of mania or hypomania and depression at the same time. You may hear this being called ‘mixed bipolar state’. You may feel very sad and hopeless at the same time as restlessness and being overactive.
Bipolar I or II disorder with rapid cycling
Rapid cycling means you have had 4 or more depressive, manic, hypomanic episodes in a 12 month period.
Bipolar I or II with seasonal pattern
Seasonal pattern means that either your depression, mania or hypomania is regularly affected in the same way by seasons. For example you may find that each winter you have a depressive episode but your mania does not regularly follow a pattern.
Cyclothymia
A diagnosis of cyclothymic disorder means you will have experienced regular episodes of hypomania and depression for at least 2 years. You wont be diagnosed with Bipolar because your symptoms will be milder. But they can last longer.
Cyclothymia can develop into bipolar disorder.
Symptoms of mania can include:
• feeling happy or excited, even if things are not going well for you,
• being full of new and exciting ideas,
• moving quickly from one idea to another,
• hearing voices that other people can’t hear,
• being more irritable than normal,
• feeling much better about yourself than usual,
• talking very quickly, jumping from one idea to another, racing thoughts,
• being easily distracted and struggle to focus on one topic,
• not being able to sleep, or feel that you don’t want to sleep,
• thinking you can do much more than you actually can,
• make unusual, or big decisions without thinking them through, and
• do things you normally wouldn’t which can cause problems.
Symptoms of depression can include:
• low mood,
• having less energy and feeling tired,
• feeling hopeless or negative,
• feeling guilty, worthless or helpless,
• being less interested in things you normally like doing or enjoying them less,
• difficulty concentrating, remembering or making decisions,
• feeling restless or irritable,
• sleeping too much or not being able to sleep,
• feeling more or less hungry than usual,
• losing or gaining weight, when you do not mean to, and
• thoughts of death or suicide, or suicide attempts.
Sometimes you can have psychotic symptoms during a severe episode of mania or depression. Symptoms of psychosis can be:
• hallucinations. This means that you may hear, see, or feel things that are not there, and
• delusions. This means you may believe things that are not true. Other people will usually find their beliefs unusual.
Psychotic symptoms in bipolar disorder can reflect your mood. For example, if you have a manic episode you may believe that you have special powers, or are being monitored by the government.
If you have a depressive episode, you may feel very guilty about something you think you have done. You may feel that you are worse than anybody else or feel that you don't exist.
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