Atypical Bipolar - Four Signs of Difficult to Diagnose Bipolar Disorder

Atypical bipolar disorder is barely spoken of, mainly because it does not have any defining features. The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, includes a category for NOS, that is, not as specified. Some forms of bipolar can be difficult to diagnose, as they don't fit into any standard pattern of behaviors. Here are the four signs that the APA classifies as indicating atypical bipolar disorder.

1.) Rapid Mood Fluctuations

Normally, a manic or depressive mood has to last for days to classify as bipolar disorder, but in some cases manic symptoms don't meet the minimal duration considered for a diagnosis. Of course, everyone doesn't fit into a nice little box, so different people with bipolar disorder will experience different severity and duration of their symptoms.

2.) Recurrent Hypomanic Episodes

Like a pendulum, when someone with bipolar disorder has a mood swing one way, they will swing back in the other direction. Usually this means a hypomanic phase will result in mild to severe depression. In atypical bipolar disorder, a person can go from a hypomanic phase to normal, and back again, skipping the depressive phase.

3.) Clouded Data

Sometimes drugs or medications can mimic the effects of bipolar disorder. For example, methamphetamines can mimic the appearance of mania, though the effects are the temporary side effect of a drug. If a psychiatrist is not sure whether the bipolar is caused by drugs, they will classify it as atypical.

4.) Co-existing Illnesses

Mental disorders are linked, so it can sometimes be difficult to tell which one someone has. Sometimes a person will show symptoms of schizophrenia and bipolar disorder together, making it hard to determine whether the person is schizophrenic or manic depressive. In instances where disorders are stacked on top of one another, someone can be classified as having atypical bipolar disorder.

Bipolar Symptoms - What Factors Can Trigger Bipolar Disorder Symptoms?

Bipolar disorder symptoms affect 44 million Americans. Bipolar symptoms are characterized by mood disorders that can be identified as a shift in a person's mood, energy and ability to function. It can further be distinguished by the person experiencing cycles of manic episodes. These episodes are characterized by an abnormally elevated mood and depressive episodes or symptoms. But what factors trigger these episodes?

Research indicates that some people are genetically predisposed to bipolar disorder. However, not everyone that has an inherited vulnerability develops the illness. This is a clear indication that there are also external factors that play a major role. These external risk factors are called triggers. Triggers can set off a bipolar disorder or prolong an existing mood episode. Many episode of mania or depression occur, however, without an obvious trigger.

Here are some triggers:

Stress - is something we all face from time to time. People with bipolar disorder who suffer severe stress or emotional trauma can find it even more difficult to deal with stress.

Major Life Event - Major life events both good and bad can trigger an episode of bipolar disorder. These events tend to involve drastic or sudden changes.

Substance Abuse - While substance abuse doesn't cause bipolar disorder, it can bring on an episode and worsen the course of the disease. Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression.

Medication - Certain medications, most notably antidepressant drugs, can trigger mania. Other drugs that may induce mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.

Seasonal Changes - Episodes of mania and depression often follow a seasonal pattern. Manic episodes are more common during the summer, and depressive episodes more common during the fall, winter, and spring.

Sleep Deprivation - Loss of sleep-even as little as skipping a few hours of rest-can trigger an episode of mania.

Not sure if you or someone you know may be suffering from bipolar disorder symptoms? Further warning signs of bipolar depression include:

• Feeling hopeless, sad, or empty


• Excessive crying


• Loss of interest in things you used to enjoy


• Fatigue or loss of energy


• Physical and mental sluggishness


• Appetite or weight changes


• Sleeping too much or too little


• Difficulty concentrating


• Feelings of worthlessness and hopelessness


• Thoughts of death or suicide

Bipolar disorder may also have manic episodes. These episodes can be different than the depressive phase of bipolar disorder. Bipolar disorder manic episodes symptoms include:

• Inappropriate sense of euphoria (elation)


• Racing thoughts; talking too much


• Extreme irritability


• Reckless behavior


• Abnormal sleep


• Excessive energy


• Out of control spending


• Difficulty concentrating


• Abnormally increased activity, including sexual activity


• Poor judgment


• Aggressive behavior

If you or someone you know suffer from or display any of these symptoms, consult a physician for the most accurate diagnosis on mental health.

Symptoms of Bipolar Disorder - Do You Have Any of These?

First off, if you are reading this, then it's unlikely that you have a severe case of bipolar disorder (a.k.a. "manic depression"), unless you happen to be in a normal mood level right now...

Because according to the NIMH--National Institute of Mental Health--people with bipolar disorder often don't realize they need help...or they assume their condition is due to something else entirely and will fiercely deny needing help.

In any case, here's what we're going to go over in this article:

1. Some background info on bipolar disorder.

2. The sometimes scary symptoms of mania--a "manic" episode.

3. Symptoms of depression--a "depressive" episode.

4. A doctor speaks out about how manic-depression affects her--in her own words. (This is interesting by itself.) 5. What you should do.

6. The good news.

7. Important note on suicide.

Let's get started:

1. Background info: Bipolar disorder is a disease of extremes: A person is known as "bipolar" if he or she switches from an overly-happy mood to an abnormally sad mood within a relatively short period of time.

Bipolar disorder is also known as "manic depressive illness," with the manic episodes being the 'highs' and the depressive episodes being the 'lows.' Either extreme is bad, and can lead to suicide or doing things so extreme as to be a danger to oneself or others.

Serious cases require medication to dampen out the extreme highs and lows. Usually the medications must be taken for years--not just taken when an episode occurs, but daily regardless. (Lithium is the usual mood-stabilizing drug used, although there are several new drugs being tested.)

2. Typical symptoms of someone experiencing mania--a "manic" episode. (According to the NIMH, at least 3 of these symptoms must be present most of each day for one week or more to qualify as mania):

• High energy, restlessness


• Excessively euphoric mood


• Extreme irritability


• Racing thoughts and talking very fast, jumping from one idea to another


• Sleeping very little


• Easily distracted; can't concentrate


• Exercising poor judgment


• Going on spending sprees


• An unrealistic sense of power and invincibility


• Unusual increase in sex drive


• Aggressive, provocative and intrusive behavior


• Abuse of drugs--especially cocaine, alcohol and sleeping pills.


• A denial that anything is wrong.

3. Typical symptoms of someone experiencing depression--a "depressive" episode. (According to the NIMH, at least 5 of these symptoms must be present most of each day for two weeks or more):

• Sad, empty, or anxious mood.


• Feelings of worthlessness, guilt, or helplessness.


• Feelings of pessimism and hopelessness.


• Low energy state; extreme fatigue as if moving through molasses.


• Restlessness or irritability.


• Difficulty in making decisions, concentrating, and remembering.


• Abnormal sleep patterns; usually sleeping too much, but also inability to sleep.


• Overeating and weight gain or the opposite.


• Chronic body pains that are inexplicable; no injury caused them.


• Loss of interest or pleasure in things once enjoyed, including sex.


• Thoughts of suicide or death.

4. Quote from Dr. Kay Redfield:

"Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide. "I am fortunate that I have not died from my illness, fortunate in having received the best medical care available, and fortunate in having the friends, colleagues, and family that I do." -Kay Redfield Jamison, Ph.D., "An Unquiet Mind," 1995, page 6, Random House

5. What you should do:

O.K., so you've gone down the list of symptoms. And according to the NIMH rules for frequency and duration, you think you have the classic symptoms of bipolar disorder. Now what?

You should see a health professional immediately, if not sooner. Here's why:

Because if you DO have a severe case of manic depression, then obviously your condition is in "remission" for now, and you are able to actually do something about it. Or if you have a milder case, you should still see a doctor who is trained in treating bipolar disorder anyway...

Because like diabetes or heart disease, true manic depression requires a lifelong treatment plan; the disease is never really "cured," but controlled. But you can still live a completely normal, happy life with the right treatment and a desire to be well.

6. The good news:

Just the fact that you are seeking information on the subject is a good sign, and bodes well for your treatment and recovery. If you are seeking information on bipolar disorder for someone you know or love, get them help as soon as possible. (You are doing a wonderful thing--thank you!!)

7. Important note on suicide:

People with symptoms of bipolar disorder are often suicidal. If you are feeling suicidal or know someone who is, call 911 or a doctor immediately. Do not allow yourself or the suicidal person to be left alone. And make darn sure that there is no access to instruments of suicide--like guns, medication, and so forth.

Signs and Symptoms of Manic Depression

Someone who believes they may be suffering from Bipolar Disorder Syndrome should see a physician to determine if it is in fact, but you may want to have some idea before your visit. While the symptoms vary from individual to individual, there is a common signs checklist of general behavior that may help you to determine if it may be or rule out Bipolar Disorder for you or your loved one.

Bipolar Disorder is also called Manic Depression, and one suffering from this will often go in to a manic phase, which can last months, into a depressed phase. Diagnosing this illness can take some time. There is no blood test that can be performed to check for it, so your physician will look at the symptoms that you have experienced over a period of some time. It is helpful to keep note of any symptoms you experience so that you can be sure to give the physician extended accurate information. This will help in diagnosing Bipolar Disorder. Below is a common list of symptoms reported with Bipolar Disorder / Manic Depression:

Symptoms of Bipolar Mania:

Constant Irritability

Talking Fast

Inflated / High Self Esteem

Extreme Energy on Little Sleep

Being Irrational with Decisions / Impulsive Behavior

Symptoms of Bipolar Depression:

Inability to Concrete

Depressed Behavior

Lack of Energy

Fatigue / Constantly Sleeping

Low Self Confidence

Not interested in their normal activities / Seem Distant from Everyone

Suicidal Feelings

With all the ongoing research and studies being done on Manic Depression, there are always new treatment options available if you have yet to find the one to work for you. It is very important to keep in contact with your physician after this has been diagnosed. It is a life-long battle, but once the right treatment plan has been found, people suffering from this disorder can live a fulfilling and normal life, provided that they continue their medication and follow their physician's treatment plan. There is no cure, so treatment will be forever, but will more than likely get easier to cope with over time. The specific treatment for each patient will vary, and will also depend on the severity of bipolar the patient has. There are different types of bipolar, and your doctor will evaluate your symptoms to ensure a proper diagnosis.

Although all the information may seem overwhelming, most patients to have responses to their treatment. The medications you take may need tweaking, to increase or decrease dosages, to make it work effectively for you. Over time, most bipolar patients will find a good balance between their medications and their therapy, that will get them on the right road to recovery.

Bipolar Symptoms in Women

Definition of bipolar

Bipolar is a complex mental illness that causes extreme shifts in mood and is classified as a mood disorder. It is also called bipolar affective disorder, manic depressive disorder. A person with bipolar experiences wildly excited mood called mania which can last from days to months and occurs in different levels. These levels can be mild or severe hence can be life long and chronic and may require life-long treatment. People with bipolar are associated with depression periods with partial or full recovery. Bipolar disorder can either be manic or depressive episodes. Manic episode is where a person is over excited or joyful while depressed episode is where one is extremely sad or hopeless. Sometimes, this disorder includes both symptoms for both mania and depression a condition called mixed state.

Bipolar symptoms in women.

These symptoms can either be 'high' or 'low'. It is characterized by high energy levels. Women experience changes in energy levels and are extremely energetic, less need for sleep without experiencing fatigue because of the mood changes. There is always evident hyperactivity, talking a lot to people or over people. Also there is a recorded rush decision making, and always wanting to walk. These moods may take a long time and this may be confused with mood swings during periods in women tow bipolar symptoms include decreases activity and energy.

Women also show inappropriate behavior such as being over involved in other people's activities, indulging in activities that may be risky like alcohol and gambling. One can also say and at the same time do shocking things that are unusual, spends more money than usual in basic and non-basic needs and impulsive business investments. Women can also have increased sexual energy which can result in impulsive sex, may dress more colorfully unlike usual times and appetite changes. Others may have relationship problems and think of death or suicide hence may attempt suicide.

Bipolar symptoms in women under the age of 40 may experience symptoms such as racing thoughts where one may not concentrate on one thing at a time hence loss of focus. Others symptoms include sleeping more than usual and feeling agitated, restlessness and increased frustrations. All these are symptoms of high bipolar disorder. Low bipolar symptoms include fewer thoughts than the usual, thinking is slowed and one talks less and slows speech while problems with remembering things are experienced.

High bipolar symptoms

Other symptoms of high bipolar include increased physical activity, poor judgment and can distract people many times, reckless behavior, hallucinations and delusions, sense are inflated where a woman experiences inflation of self-importance and high aggressive and irritability behavior. Women experience elevated moods and intense emotional states.

Bipolar Disorder - Options For Treatments

There is no cure for those suffering from bipolar disorder. To make things worse, there is no "one sure" treatment or therapy that could stabilize your condition. It is a trial and error process that may take months or even years.

The two episodes of bipolar disorder will make the person either feel "high" or "low." Treatment for bipolar disorder can only be administered once the doctor identifies what may have triggered the attack. This means observing the patient for some time and in his or her absence, the person will have to write this down in a journal so this can be reviewed for analysis later on. There's that journal again. Think it's important?

The high is known as mania and here are some of the common treatments given to a patient. It is possible that the doctors will use an antipsychotic drug like benzodiazepine to quickly take control of your hostility, hyperactivity, irritability, or sleeplessness.

In some cases, mood stabilizers will also be prescribed to help control mood swings and to prevent them from happening and can even be taken by people who are at risk of committing suicide. Two of the most common around are lithium a few other anticonvulsant drugs.

Aside from medication, hospitalization may be necessary if doctors feel the patient is a threat to others or him or herself. If the situation does not improve, doctors will have no choice but to use ECT or electroconvulsive therapy.

Aside from drugs and hospitalization, there is also psychotherapy or talk therapy which enables the patient to interact with health professionals and their loved ones.

Unlike mania, depressive episodes are far more challenging and controversial. This is because the use of antidepressants may make the person experience a mania episode. In October 2004, the FDA came out saying that antidepressant drugs may increase the risk of suicidal thinking in children and teens suffering from depression.

To avoid this from happening, the doctor should carefully prescribe the dosage and then decide later on whether to increase or decrease it.

Six years ago, the American Psychiatric Association has suggested using lithium or anticonvulsant drugs like Lamictal to help patients suffering from depressive episodes. If this does not work, the doctor may recommend Zyprexa, another antipsychotic drug or something similar but tests have shown that this is only effective in varying degrees.

As a last result, the doctor may also recommend ECT or electroconvulsive therapy. Studies have shown that it has helped 75% of patients.

Again, non-drug treatments like psychotherapy can also be used to help patients experiencing depressive episodes.

The type of treatment for each patient depends on the type of bipolar disorder. If episodes are not that frequent, the best to prescribe is lithium. However if the individual experiences 4 or more mood swings in one year, then it is best to use anticonvulsant mood stabilizers.

The drugs given will not work instantly and it may take several days or weeks before they take effect. This is the reason that the doctor must observe the patient carefully together with the help of their family to determine the next course of action.

Should things workout for the better, the doctor will recommend a maintenance drug that the patient must take regularly. At times, more than one is given for best results but if things go the other way, then it is time to find a better solution.

Until such time that there is a cure of bipolar disorder, doctors and patients will have to rely on medication, psychotherapy and ECT. Given that this illness is a long-term condition, it requires lifelong treatment even when the person has not felt an episode take place after a long period of time.

Apart from the psychotherapist who is the authority figure in this matter, the patient may also seek help from psychologists, health workers, nurses and family members. The person should just keep an open mind and not lose hope because if modern medicine has been able to find cures for some illnesses, it is only a matter of time before there will also be an answer for this one.

How to Detect Bipolar Disorder

Bipolar disorder, which is also known as manic-depression or manic-depressive illness, is a curable psychological condition characterized by alternating patterns of mania and depression. It often begins in early adulthood and may last throughout life. The illness has no cure but it can be managed through appropriate treatment regimen. The illness has two forms. Bipolar I Disorder, which is the most severe form, is described as having one or more manic episodes that may cause substantial impairment in functioning. Bipolar II Disorder is described as having one or more depressive episodes with at least one mild to moderate manic episode that does not cause impairment in functioning.

Bipolar disorder has two phases. The manic phase, or a period of emotional highs, is characterized by the following signs and symptoms: increased energy and activity, euphoric mood, extreme irritability, an inflated sense of self-esteem, a reduced need for sleep, a high degree of talkativeness, racing thoughts, taking on multiple projects at once, and distractibility. Loss of normal judgment, unusual or risky behavior that is different from the normal and disorganized thoughts are symptoms of more severe manic episodes. Symptoms of the depressive phase include feelings of depression, loss of interest, significant weight loss, changes in appetite, changes in sleeping habits, agitation, fatigue, feelings of worthlessness, guilt, indecisiveness and suicidal thoughts or plans.

The illness is hard to differentiate from other conditions and there isn't yet a distinct way on how to detect bipolar disorder. Some people may suffer from the disorder for years before getting a correct diagnosis. The dual nature of bipolar disorder makes it hard for the condition to be detected immediately. In the manic or hypomanic phase, affected individuals seldom seek treatment due to feelings of euphoria and extreme optimism. But when they fall into the depressive phase, they often seek professional help. And when they do, they unfortunately take into account only the depressive symptoms. For this reason, they are usually incorrectly diagnosed with depression instead of bipolar disorder. The symptoms in bipolar disorder are also similar to other psychiatric disorders, thus the diagnosis is more complicated.

No laboratory test can help individuals in knowing how to detect bipolar disorder. But doctors can help determine if an individual has bipolar disorder symptoms through a questionnaire. The Mood Disorder Questionnaire, or MDQ, consists of a complete psychiatric history and a complete medical history and physical exam. A patient may be diagnosed with bipolar disorder if no physical cause is found, if there is no other psychiatric illness that can account for the symptoms, and if the symptoms impair the individual's functioning. Magnetic resonance imaging (MRI) and positron-emission tomographic (PET) scans may also be useful in helping to detect abnormalities in the brain that might identify bipolar disorder.

By educating themselves about the illness and its symptoms, people involved will know not only how to detect bipolar disorder, but they will also understand the effects it has on those suffering from it and how to help them manage their condition. It may also be beneficial for patients to become more aware of how to detect bipolar disorder through early signs and making notes of their episodes.