Bipolar disorder symptoms are characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of signs and symptoms can vary from mild to severe. There may even be periods when your life doesn’t seem affected at all.
Manic phase of bipolar disorder
Signs and symptoms of the manic phase of bipolar disorder may include:
Euphoria
Extreme optimism
Inflated self-esteem
Poor judgment
Rapid speech
Racing thoughts
Aggressive behavior
Agitation
Increased physical activity
Risky behavior
Spending sprees, credit card irresponsibility
Increased drive to perform or achieve goals
Increased sexual drive
Decreased need for sleep
Tendency to be easily distracted
Inability to concentrate
Drug abuse
Depressive phase of bipolar disorder
Signs and symptoms of the depressive phase of bipolar disorder may include:
Sadness
Hopelessness
Suicidal thoughts or behavior
Anxiety
Guilt
Sleep problems
Appetite problems
Fatigue
Loss of interest in daily activities
Problems concentrating
Irritability
Chronic pain without a known cause
Types of bipolar disorder
Bipolar disorder is divided into two main subtypes:
Bipolar I disorder. You’ve had at least one manic episode, with or without previous episodes of depression.
Bipolar II disorder. You’ve had at least one episode of depression and at least one hypomanic episode. A hypomanic episode is similar to a manic episode but much briefer, lasting only a few days, and not as severe. With hypomania, you may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine and functioning, and you don’t require hospitalization. In bipolar II disorder, the periods of depression are typically much longer than the periods of hypomania.
Cyclothymia. Cyclothymia is a mild form of bipolar disorder. Cyclothymia includes mood swings but the highs and lows are not as severe as those of full-blown bipolar disorder.
Other bipolar disorder symptoms
In addition, some people with bipolar disorder have rapid cycling bipolar disorder. This is the occurrence of four or more mood swings within 12 months. These moods shifts can occur rapidly, sometimes within just hours. In mixed state bipolar disorder, symptoms of both mania and depression occur at the same time.
Severe episodes of either mania or depression may result in psychosis, or a detachment from reality. Symptoms of psychosis may include hearing or seeing things that aren’t there (hallucinations) and false but strongly held beliefs (delusions).
Taken from the Mayo Clinic/Bipolar Disorder Symptoms site:
Evil has completely saturated the world of human beings. We are being drenched with a thousand variations of sin and rebellion. In olden times, an enemy would surround a city, and essentially let the inhabitants starve until they would surrender. I wonder at times, if this tactic is not working in us today, on some kind of level.
Clinical depression takes on many forms. It is very much like being surrounded and being brought to our knees. For those of us who go through this meat grinder, we find it completely dismantles us. Depression assaults us; and leaves us mute and deaf to His grace.
There seems to be three distinct varieties of depression. I’ve thought about this for some time now, and I’m coming to the point where I want to share.
1) There is a depression that comes from guilt.
There is a corrosive place that eats us up, it’s where we sin, and continue to sin. We fully understand our guilt and our sin. Sin however, will always will stain us. Banks will often place “dye packets” into stacks of money. A robber grabs the money, only to find that something explodes on him. He then, is marked indelibly. There isn’t anything he can do; he has been stained. The following verses explain this dynamic.
“When I kept things to myself, I felt weak deep inside me. I moaned all day long. 4 Day and night you punished me. My strength was gone as in the summer heat.
5 Then I confessed my sins to you and didn’t hide my guilt. I said, “I will confess my sins to the Lord,” and you forgave my guilt. “
Psalm 32, NCV
2) There is a depression that is organic.
It simply resides in us as if it were eye color, or a talent to play music. This type of depression is hard wired in us. It is just a natural inclination, or propensity toward melancholy. We typically gravitate toward a negative outlook. We are not ‘a cheery lot.’ The glass is always half empty, and that is our certain perspective.
Some have diabetes, and others are deaf. We have been saddled with certain issues. We did nothing to warrant such challenges. They are just the part and parcel of the human condition. We need to see our depression as sort of diabetes of the emotional world. Very often we will need to take meds to restore our sense of balance and wholeness. Sometimes all we need is to rest, as fatigue can become a serious issue.
3) There is a depression that is reactionary.
We find ourselves responding to trials and difficulties, and they just overwhelm us. Persecution and attacks slam into us, and our reaction is to hide, or shut down. Paul had to endure major attacks. This ‘depression’ is found in situations and issues. It can come about by Satan or ungodly authorities.
“So we do not give up. Our physical body is becoming older and weaker, but our spirit inside us is made new every day.17 We have small troubles for a while now, but they are helping us gain an eternal glory that is much greater than the troubles.18 We set our eyes not on what we see but on what we cannot see. What we see will last only a short time, but what we cannot see will last forever.”
2 Cor. 4:16, 18, NCV
Summary
As we look at ourselves, we can honestly determine which of the three kinds of depression that we face. It seems we can have all three working in our lives. But it is very helpful to find our particular variety, or our certain inclination. Seldom will we identify with just one ‘variety’, as all three can be working at once. Understanding the three will hopefully give us a definite advantage.
We can ask ourselves: Is this depression coming from sin or guilt? Is this something organic or ‘hardwired’ in me? Could it be that I’m reacting to the evil that is coming at me so fast? Distinguishing between these three can be very useful, and direct us as we build our discipleship.
There are plausible arguments for the non-existence of mental illness. But there are still people who declare themselves to have a mental illness. After all, being sick mentally has no physical symptoms; it’s not like a kidney stone or an inflamed appendix. One can only hope it was this simple.
Yet depression is a progressive and debilitating disorder. It is like having a ‘bruised brain’ that refuses to heal. There is an substantial list of psychological disorders. Technically depression is a mood disorder that has a series of symptoms. These symptoms are the evidence that something is definitely wrong.
Depressed mood (such as feelings of sadness or emptiness).
Reduced interest in activities that used to be enjoyed.
Change in appetite or weight increase/decrease.
Sleep disturbances (either not being able to sleep well or sleeping too much).
Feeling agitated or slowed down.
Fatigue or loss of energy.
Feeling worthless or excessive guilt.
Difficulty thinking, concentrating or troubles making decisions.
The above list is a summary of something called the DSM-IV which doctors use to diagnose the mental disorder of depression. Having five or six of these may indicate a problem. Spinning off this, you will discover some other disorders, like:
Generalized anxiety disorder (GAD)
Panic disorder
Depersonalization/derealization
OCD (obsessive compulsive disorder)
Psychosis and paranoia
PTSD (post traumatic stress syndrome)
Specific Phobias (fears of something)
SAD (social anxiety disorder)
Schizophrenia
Eating disorders (bulimia, anorexia)
Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 Americans-who live with a serious mental illness. The National Institute of Mental Health reports that one in four adults–approximately 57.7 million Americans–experience a mental health disorder in a given year.
Unfortunately, there is a great deal of misunderstanding and stigma for those who have these disorders. I suppose it is akin to having VD (venereal disease) or AIDS. It seems that our culture is pretty quick at labeling people as deviant or undesirable.
I hope this post helps. I can see a 100 holes in it, and alas, it is a meager attempt. But perhaps it will be of some value. Both NAMI.org, Psychcentral.com, and WebMD.com all have excellent info on Mental Illness.
There are several types of schizophrenia, so signs and symptoms vary. In general, schizophrenia symptoms include:
Beliefs not based on reality (delusions), such as the belief that there’s a conspiracy against you
Seeing or hearing things that don’t exist (hallucinations), especially voices
Incoherent speech
Neglect of personal hygiene
Lack of emotions
Emotions inappropriate to the situation
Angry outbursts
Catatonic behavior
A persistent feeling of being watched
Trouble functioning at school and work
Social isolation
Clumsy, uncoordinated movements
Schizophrenia ranges from mild to severe. Some people may be able to function well in daily life, while others need specialized, intensive care. In some cases, schizophrenia symptoms seem to appear suddenly. Other times, schizophrenia symptoms seem to develop gradually over months, and they may not be noticeable at first.
Over time, it becomes difficult to function in daily life. You may not be able to go to work or school. You may have troubled relationships, partly because of difficulty reading social cues or others’ emotions. You may lose interest in activities you once enjoyed. You may be distressed or agitated or fall into a trance-like state, becoming unresponsive to others.
In addition to the general schizophrenia symptoms, symptoms are often categorized in three ways to help with diagnosis and treatment:
Negative signs and symptoms
Negative signs and symptoms represent a loss or decrease in emotions or behavioral abilities. They may include:
Loss of interest in everyday activities
Appearing to lack emotion
Reduced ability to plan or carry out activities
Neglecting hygiene
Social withdrawal
Loss of motivation
Positive signs and symptoms
Positive signs and symptoms are unusual thoughts and perceptions that often involve a loss of contact with reality. These symptoms may come and go. They may include:
Hallucinations, or sensing things that aren’t real. In schizophrenia, hearing voices is a common hallucination. These voices may seem to give you instructions on how to act, and they sometimes may include harming others.
Delusions, or beliefs that have no basis in reality. For example, you may believe that the television is directing your behavior or that outside forces are controlling your thoughts.
Thought disorders, or difficulty speaking and organizing thoughts, such as stopping in midsentence or jumbling together meaningless words, sometimes known as “word salad.”
Movement disorders, such as repeating movements, clumsiness or involuntary movements.
Cognitive signs and symptoms
Cognitive symptoms involve problems with memory and attention. These symptoms may be the most disabling in schizophrenia because they interfere with the ability to perform routine daily tasks. They include:
Problems making sense of information
Difficulty paying attention
Memory problems
When to see a doctor:
People with schizophrenia often lack awareness that their difficulties stem from a mental illness that requires medical attention. So it often falls to family or friends to get them help.
Suicidal thoughts and behavior
Suicidal thoughts and behavior are common among people with schizophrenia. If you have a loved one who is in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Professor Mitchell, what is the difference between being depressed and just feeling bad about yourself?
Sometimes it’s easy to tell the difference; sometimes you’re not certain. I look for clinical indicators of depressive illness: whether the person’s life is becoming impaired by these bad feelings, when it’s starting to interfere with people’s sleep, appetite and weight, when it’s interfering with their work and concentration, they’re having suicidal thoughts, they can’t buck up. Those symptoms help me to sort out whether it’s just life problems or whether it’s more.
So depression is an illness?
Yes. Even though there are both psychological and physical parts to it, it makes sense to think of severe depression as an illness. There are good medical and psychological treatments that can help people get out of it.
What proportion of the population is depressed?
Figures vary, but over a lifetime about 15% of the population are prone to getting depression on at least one occasion. So it’s relatively common. Some people only have one episode, but for at least half of those who suffer depression once, it is a recurring experience.
Is depression the sort of thing that certain personality types are likely to suffer?
I think that’s true. Anybody is vulnerable to becoming depressed, if things get difficult for them, but some personality types are more prone than others. For instance, if you tend to look for your own failings and weaknesses, if you expect disasters, you are prone to becoming depressed. People who have fragile self-esteems are prone; people who are excessively perfectionistic can be thrown when things don’t go quite right; people who have long-term high levels of anxiety.
Can you describe what it is like to be depressed?
Patients find it quite hard to describe. They often use analogies, like there is a ‘black cloud’ or a ‘weight’ on them. They say that they just can’t enjoy things any more, that they can’t get the drive to do anything; they stay in bed because they just have no energy or enthusiasm. They tend to ruminate and think about their failings, their hopeless situation. But many people find it hard to communicate the experience; even very articulate people have told me how difficult it is to communicate the experience to other people.
On the other side of the fence, what is it like to be close to someone who is depressed?
I think it’s very wearing. It never ceases to amaze me how couples stay together, particularly when it’s prolonged. Even with the best of good will and human kindness, long-term depression can be a very tiring experience for a spouse or close friend. You may get little response from a depressed person, little enthusiasm, withdrawal. They don’t want to interact socially and sometimes they can be quite irritable. Within a marriage, tension may be increased because the depressed person has no interest in sexual activity. So these things exacerbate the problem.
I sometimes hear it said that depressed people ought to just ‘snap out of it’. Can they do that?
Not when the depression is severe in the way we have been talking about. If someone can snap out of it, usually they have by that stage. In general, a depressed person doesn’t like the experience and if it was a matter of just getting on and doing something, they would have tried it. Sometimes people need to learn psychological ways of getting out of the depressed state. But sometimes there is a biochemical process going on that means the person isn’t physically able to snap out of it, without professional help.
Often there is a mixture of the physical and the psychological. It’s very rarely one or the other. The more I see depression, the more I see a complex interplay between personality, the biology of our brains and our life experience.
So depressed people can’t snap out of it, but they also can’t explain very easily what is actually troubling them. It’s a very frustrating illness!
Absolutely. It’s hard for people who haven’t dealt with it professionally to have any idea what it’s like to be depressed. So people have this difficulty understanding it, and this tendency to think that the person should be able to get out of it, and the depressed person has difficulty explaining the experience and feels frustrated and stigmatized when people are telling them to snap out of it, because they know they can’t snap out of it. There is enormous tension.
I suppose the big question is, for both the depressed person and those around them, can depression be cured?
Most people with depression can either be cured or significantly helped by available treatments. These days, we have very good treatments. We can’t help everybody, but we can help the vast majority of people we see.
Is it always a long-term cure, or can it happen quickly?
It varies. Often within a few weeks many people have benefited significantly. Some forms of depression require more long-term psychological treatment, others respond very quickly to medication. And there are grades in between.
Is depression like alcoholism, where you can get it under control but never really be beyond its reach?
For most people, that’s probably a realistic comparison. I tell people that they are always going to be prone to becoming depressed, so they need to be wary about relapses in the future. They need to be sensible about their medications, learn techniques to help them, think about whether there are aspects of their lives that they need to change. We can’t always prevent future episodes, but we can usually make them less likely.
William Cowper, Poet 1731-1800
The poet Les Murray recently has been very public about coming out of his depression. It’s interesting that some of the best poetry is written by people who have been depressed. Look at William Cowper, a Christian poet and hymn writer who wrote some of his most moving material during periods of profound depression. So depression can be both creative and destructive.
This raises an important issue for Christians. How do we connect our mental and our spiritual lives?
Cowper became very doubting at times, during his depression. One thing many Christian patients say is that God seems very distant during such periods. I’ve come to accept that as part of the depressive experience rather than a problem with their faith. I’ve seen people with a very deep faith, who yearn to be close to God, and who when depressed feel very barren and remote from God. For instance, J. B. Phillips, the Bible translator, was profoundly depressed for much of his adult life. He has described this sense of distance from God.
JB Phillips, 1906-1982
That is very distressing for Christians. They begin to worry that it is a lack of faith or lack of spiritual growth. But having seen it enough, I think it is just an expression of the depressive experience. Many Christians also feel that depression is a sign of weakness, of spiritual inadequacy, and they have a strong sense of guilt. Unfortunately, I think that often the church, explicitly or implicitly, has encouraged that—that if you have depression, it’s a reflection on your spiritual life. This adds an incredible burden to people who are already feeling guilty and self-critical. It’s a bit like Job’s encouragers, who basically made him feel worse.
Why does there seem to be a large number of depressed people in our churches?
It’s often the more sensitive people who become depressed, and there are often a lot of obsessional and sensitive people in churches. My experience is that there is a lot of depression in our congregations and that we don’t handle it at all well. We often infer, explicitly or implicitly, that the Christian shouldn’t have the experience of depression—that it’s not part of the victorious Christian life. And that causes enormous guilt and makes people less likely to talk about it. I think we have a lot of silent suffering going on in our churches. People just aren’t getting helped, because they feel guilty about having depression. We need to bring out into the open the fact that depression is a common experience, even within the church. And that being a Christian doesn’t stop you from getting depression. And that having depression is no more a failing than having diabetes.
In general, the church deals very badly with mental illness. In the middle ages, it was considered demon possession; in the late 20th century it’s considered a symptom of spiritual inadequacy. But it isn’t necessarily either of these things.
Are people in very demanding ministries especially prone?
They are prone; I don’t know about especially. They are in line for so many of the factors that contribute to depression: burn-out, demoralization, excessive demands, not looking after your own emotional needs, not having time to yourself. I see some of the casualties, and often by then it’s too late because someone has resigned from the ministry or become completely disillusioned. And it’s all too hidden, too hush-hush. We’re dealing with it no better than the secular world; in some ways we’re doing worse.
What then are the ways that a depressed person can be helped, both by individuals and by the church?
Well, especially in the early days, one can be supportive, help people get back into their lives—those normal things of friendship and support, being a sounding board, willing to listen to difficulties. These things might be sufficient to alleviate the early experience of depression.
But if we’re looking at a fully formed depression that’s been going on for a while, the person should be encouraged to seek proper professional help. That doesn’t always mean a psychiatrist; it might mean a GP or a counsellor. Just someone with the skills and training to help. So that’s the first thing, when the support networks have been stretched to the limit.
While that process is happening, it’s important to be around for the depressed person, accepting the fact that it might be a frustrating experience until that person picks up. Not feeling that you have to do everything yourself. There has to be a point where a friend accepts that they can’t provide everything the person needs. That point is usually indicated by signs like someone crying constantly, their work falling apart, withdrawing inexplicably, perhaps losing weight. These things indicate that the depression is getting severe.
Finally, do you think depression has become more of a problem today than it used to be?
It’s an area of debate. There’s no doubt that depression has always existed. The old Greek medical writers are clearly describing patients with depression. There was a book written in the 17th century called The Anatomy of Melancholy which described what we would call depressed patients. So it goes back through the ages; it’s part of the general human experience.
The issue is whether it has become more frequent. People have looked at the occurrence of depression in groups of people born in different decades in this century, and the frequency of occurrence seems to go up as the decades continue. People born in the 60s are more prone to depression than those at similar ages, but born in the 30s. Now, the significance of that is debated. It could be that people in recent decades simply have become more willing to admit to their depression, hence the higher rate of reports. Or it could be true that it is becoming a more common experience, and presumably that reflects changes in society. What those changes are is a very difficult question to answer.
So it’s hard to say whether the loneliness of urban living is a major factor?
Well yes, and it’s a very interesting area of debate. The World Health Organization has released predictions of the impact of different illnesses over the next century. They are saying that depression will be the 21st century’s most disabling condition, in terms of the impact on the individual, frequency and cost to society, on a worldwide basis. That survey included all medical conditions, including cancer and heart disease. So there is a recognition that it is a very prevalent condition, and that it is a very disabling condition to have. Whatever is causing it, we’re going to have to deal with it.
Philip Mitchell is a Professor at the School of Psychiatry, Prince Henry Hospital in Sydney, Australia.
As we wrestle with our embedded issues, we realize that the battle is in largely inside of us. The last few days have been very hard, and I have a dark presence pressing on me; there is a subsequent reaction in my heart.
As a “born-again” believer who gets deeply challenged by depression, I simply cannot fathom life outside my faith in Jesus. How do unbelievers do it? The Holy Spirit meets me, holds me, and speaks peaceful things to me. I have been promised things of wonder and of grace.
I’ve discovered that self-pity and discouragement are main ingredients into my excursions through bleakness and sadness. In my more profound plummets into the pit, I find myself seeing the physical world around me drained of color. Everything around me is in “black and white.” (I have been told this is one of many symptoms of depression.)
Charlie Brown hits the nail on the head. Often I catch myself smiling, and I immediately stop and say, “Wait. I’m very depressed. I can’t be seen smiling, or talking with a dear friend.” Often we choose to act in ways that reinforces our illness. We think we have to be a certain way, stand in another, or even walk like we think a depressive walks. (After all, we have an image to live up to.)
Depression is very real. Medication is mandated for many. But truthfully, there is this other element of extending this image to others. Our self-pity works hand-in-hand with our image and identity. It seems we have to be somebody, even if we are “crazy people.”
I know this blog has been a challenge at times. I write these daily blogs out of my attitudes, and issues and problems. But there is a “Charlie Brown Depression,” the type where we feel like we are inconsolable all the time. (Maybe Mr. Brown should be our new patron saint of “lost causes?”)
If while in the pit, and for some reason you think of something that’s funny, go ahead and smile, its okay. I’m learning that things are never as sad or grim as I think, nor are they rosy and joy saturated either. Be real. Be real to yourself. Walk in the truth. And take your meds, lol.
I once admired the earrings my friend, Ann, was wearing – they were square, smooth, flat, and made of gold. When I remarked how beautiful they were, she replied, “They’re yours!” Ann then proceeded to take them off and put them on my ears! Humbled by her gift, the earrings became a treasure. Once while wearing them at work, one slipped off my ear – looked but couldn’t find it, so I wheeled to my office door to ask for help.
That’s when I felt a clunk-clunk-clunk. The earring was impaled on my tire; it was ruined! That weekend I took it to a jeweler and asked, “Sir, can you make this mangled earring look like the smooth one?” He rubbed his chin and said, “I can’t make that one look like this one… But I can make this one look like that one!” He then took a mallet and hammered the smooth, square earring into a mangled mess! At first I was horrified, but now I realize that the misshapen earrings reflect the light more beautifully than when they were ‘normal.’ It’s a lesson reflected in this timeless poem:
When God wants to drill a man, And thrill a man, and skill a man, When God wants to make a man To play the noblest part, When He yearns with all His heart To build so great and bold a man That all the world shall be amazed, Then watch His methods, watch His ways!
How He ruthlessly perfects, Whom He royally elects; How He hammers him and hurts him, And with mighty blows converts him Into shapes and forms of clay Which only God can understand While man’s tortured heart is crying And he lifts beseeching hands…
Yet God bends but never breaks When man’s good He undertakes; How He uses whom He chooses, And with mighty power, infuses him, With every act induces him to try His splendor out, God knows what He’s about.
When you visit this site you will find a lot of helpful resources to some pretty useful materials on the disability needs on an international level.
Emails, Facebook, Podcasts, TV Series, and great teachings are just part of the daily ministries available. Anyone interested in being discipled with a strong disability emphasis not always heard anywhere else really should visit.
Manic phase of bipolar disorder
