Family Advice: When mood swings aren't mood swings

A nother common form of depression in women is bipolar disorder, previously

called manic-depressive illness.

Bipolar disorder causes dramatic mood swings — from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. The periods of highs and lows are called episodes of mania and depression.

There are four types of mood episodes that can occur in bipolar disorder: mania, hypomania, depression and mixed episode.

Signs and symptoms of mania

In the manic phase of bipolar disorder are feelings of increased energy, creativity and happiness, and overconfidence. People experiencing a manic episode often talk a mile a minute, sleep very little and are hyperactive. They may also feel like they are on top of the world, invincible or destined for greatness.

But while mania feels good at first, it has a tendency to spiral out of control. People often behave recklessly during a manic episode — gambling away savings, engaging in inappropriate sexual activity or making foolish business investments, for example. They may also become angry, irritable and aggressive, picking fights, lashing out when others don’t go along with their plans and blaming anyone who criticizes their behavior.

Common signs and symptoms of mania include:

ne_STnSI feel like I’m on top of the world and powerful.

n I don’t seem to need much sleep.

n I feel restless all the time.

n I have a lot of sexual energy.

n I can’t focus on anything for very long.

n I sometimes can’t stop talking, and I talk really fast.

n Friends tell me that I’ve been acting differently. They tell me that I’m starting fights, talking louder and getting more angry.

Signs and symptoms of hypomania

Hypomania is a less severe form of mania. People in a hypomanic state feel very good, energetic and productive, but their symptoms are milder than those of mania and much less disruptive. They are able to carry on with their day-to-day lives. To others, it may seem as if the person with hypomania is merely in an unusually good mood. But unfortunately, hypomania often escalates to full-blown mania or is followed by a major depressive episode.

Signs and symptoms of bipolar depression

The depressive phase of bipolar disorder is very similar to that of major depression. However, there are some differences. When compared to major depression, bipolar depression is more likely to include symptoms of low energy. People with bipolar depression tend to move and speak slowly and sleep a lot. They are also more likely to have psychotic depression, a condition in which they’ve lost contact with reality.

Common symptoms of bipolar depression include:

n I don’t enjoy doing the things I’ve always enjoyed doing.

n I am always tired. I find it hard to get out of bed.

n I don’t feel like eating much or I feel like eating all the time.

n I have lots of aches and pains that don’t go away.

n I have little to no sexual energy.

n I find it hard to focus and am very forgetful.

n I am mad at everybody and everything.

n I feel like there isn’t much point to living, nothing good is going to happen to me.

n I don’t like myself very much. I feel bad most of the time.

n I think about death a lot. I even think about how I might kill myself.

Signs and symptoms of a mixed episode

A mixed episode of bipolar disorder features symptoms of both mania and depression. Common signs of a mixed episode include agitation, irritability, insomnia, appetite changes, loss of contact with realityand suicidal thoughts. This combination of high energy and low mood makes for a particularly high risk of suicide.

Other signs of Bipolar disorder:

I go back and forth between feeling really “up” and feeling really “down.”

My ups and downs cause problems at work and at home.

Bipolar disorder is more than the usual ups and downs of life. The course of bipolar disorder varies widely from person to person, with unpredictable differences in the pattern and frequency of the manic and depressive episodes. The duration and severity of each episode also differs. But we need to remember that Bipolar disorder is a treatable illness.