To be diagnosed with bipolar disorder you have to have had a manic episode. The manic episode could have been led by and maybe followed by hypomanic or major depressive episodes. A manic episode is a distinct period of unusual and persistently elevated, expansive or irritable mood and increased goal-directed activity or energy. Lasting at least one week and present most of the day.
When mood disturbance is severe enough to cause problems in social or occupational functioning this could mean a manic episode is happening. Some of the warning signs to look out for during a manic episode are any noticeable change from normal behavior, some of the symptoms that happen are increased self-esteem, decreased need for sleep, being more talkative than usual, distractibility, increase in goal-directed activity, excessive involvement in activities that could have painful consequences. Some examples of these painful consequences could be shopping sprees, sexual indiscretions, or foolish business investments. You have to have three or more of these symptoms during a manic episode. Sometimes hospitalization is necessary in order to prevent harm to self or others.
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During a major depressive episode if you have five or more of the following symptoms during the same two week period and represent a change from normal activity. Depressed mood most of the day, pretty much every day, feeling sad, empty, or hopeless. Diminished interest or pleasure in all, or most activities. Weight loss when not trying to lose weight or significant weight gain (a change in at least 5% of body weight in a month). Insomnia or hypersomnia every day or almost every day. Psychomotor agitation or retardation almost every day which is observable by others and is not just simply feelings of restlessness or being slowed down. Fatigue or loss of energy most days. Feelings of worthlessness or guilt. Lack of ability to concentrate or being indecisive. And thoughts of death, recurrent suicidal thoughts without a specific plan, or a suicide attempt or a having a specific plan to commit suicide. At least one of the symptoms has to be either depressed mood or loss of interest or pleasure. These symptoms will cause clinically large distress in social, occupational, or other important areas of life.
Mood during a manic episode can be described as euphoric and excessively cheerful. In some cases the mood is so extreme that it is easily recognized as excessive and may be categorized by unlimited enthusiasm for social, sexual, and work relationships. Often the mood is irritable instead of elevated. Especially when the individual’s wishes are denied or they have been abusing any substances. Rapid changes in mood over short periods of time can occur and are referred to as lability (the alternation between euphoria, dysphoria, and irritability).
During a manic episode the individual does not know they are ill or in need of treatment. And they will heatedly resist treatment. The wide mood swings, excessive optimism, lavishness, and poor judgment usually lead to reckless involvement in things like shopping sprees, giving away possessions, reckless driving, foolish business investments, and sexual promiscuity. The sexual behavior can include infidelity or casual sexual encounters with strangers. The individual will often not care about the risk of sexually transmitted diseases or risk of pregnancy. The manic episode has to result in impairment in social or occupational functioning or require hospitalization to prevent them from harming themselves or others.
Individuals may change their appearance to a more sexual and flashy style. Some observe that they have a sharper sense of smell, vision, or hearing. Gambling and anti-social behavior can also be part of a manic episode. Sometimes an individual can become hostile and violent when delusional and may because physically aggressive or suicidal. This happens because the individual has poor judgement, loss of insight, and hyperactivity. Mood can shift very quickly from anger to depression. The suicide risk for an individual with bipolar disorder is at least fifteen times higher than the average person. Bipolar disorder accounts for a quarter of all completed suicides.
A common feature of bipolar disorder is increased impulsivity, which adds to the suicide attempts and substance use disorders. There may also be increased creativity in some individuals with a bipolar disorder. But the individuals attachment to heightened creativity during hypomanic episodes may contribute to hesitation about seeking treatment or undermine devotion to treatment.
Bipolar disorder is one of the world’s 10 most disabling conditions, taking away years of healthy functioning from individuals who have the illness. With no predilection for nation, race, or socioeconomic status, classic manic-depressive illness has a prevalence of approximately 1% across all populations. However, the personal and societal costs of bipolar disorders are not limited to the more traditional bipolar I subtype, which includes episodes of full-blown mania and major depression. Bipolar II disorder, involving episodes of less severe hypomania and major depression, and bipolar spectrum subtypes, which probably bring the prevalence of all bipolar disorders to more than 3% of US individuals, can also be devastating conditions. All bipolar disorders are chronically recurring illnesses associated with substantial morbidity and mortality.
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