Information about bipolar disorders

What symptoms are there?

In a bipolar mood disorder the mood of the person afflicted is characterized by swings between two opposite poles: the elation or mania occurs in rotation with the deepest depressiveness. In between, there are phases of less greatly pronounced mania (hypomania). The mixed form between mania and depression is perceived as particularly wretched.


• Lifted spirits or irascible mood
• Emotional excitement with euphoria or dysphoria
• Acceleration and excitement of all psychical processes – thought, speech, motor activity / action
• Increased risk-taking behaviour, exaggerated spirit of enterprise, increased need to make contacts, impromptu behaviour, impulsiveness, aggressiveness
• Increase in drive, surplus energy, urge to be active, increased creativity, reduced sleep requirement
• Increased self-confidence, ideas of grandeur


• Melancholia / gloom, depressed mood
• Inhibited emotions, numbness, anxieties, pessimism
• Deceleration and inhibition of psychic processes – thought, speech, motor activity / action
• Withdrawal, lack of interest and motivation, lack of ideas, concentration and attention disorders
• Lack of drive, decreased vitality, lack of energy, existential disorientation
• Self-doubt, feeling of guilt, feeling of insufficiency, despondency, taedium vitae, suicidal tendencies
• Sleep disorders or increased sleep requirement, waking up earlier, unrestedness after night sleep, morning dip

The diagram shows you the various mood phases in bipolar mood disorders and the typical symptoms normally occurring during these.

Manic episode (mania)

The first manic phase begins mostly following a depressive phase. Mostly the manic phase occurs within a short period, i.e. within several days and without a recognizable reason. The persons afflicted experience an elation, abnormal good mood, come across as hyperactive and adventurous, often however also irascible and aggressive. They feel very efficient, creative and inventive. Sleep is perceived as a waste of time. The frequently also erratic dynamism leads to permanent activity. Often the relationship to reality is lost. For example, persons afflicted shop excessively, sometimes up to several cars on one day, or found new companies. At the same time, it can also occur that the persons afflicted hear voices (acoustic hallucinations) or see things (optical hallucinations) which are not real or feel as though they were destined only for a "great challenge". One then speaks of a psychotic mania. Even uninhibited behaviour and sexual invasiveness are part of the symptoms.

It should not be surprising therefore that people in such a state do not feel ill and also cannot be convinced of the opposite. Even if already significant consequences of their mania have arisen, e.g. high debts or self-destructive behaviour, persons afflicted cannot be convinced that they are ill. This can lead to persons afflicted having to be treated in a psychiatric hospital against their will.

The following symptoms are typical for a manic episode

  • Intensive elation
  • Increased efficiency and productivity and creativity
  • Clearly reduced sleep requirement
  • Quick swing back from elation to irascibility, above all if the patient experiences opposition.
  • Invasiveness and urge to speak in contact with other persons
  • Mental leaps; persons afflicted leap from one topic to another in a conversation. Outsiders can no longer follow the content of the conversation.
  • Flightiness in one’s dealings: many projects are commenced, but not completed. It is practically impossible for manics to sit still and do nothing even for a short time.
  • An inhibition in various areas, from sexual activities to excessive shopping frenzies, whereby at the same time the financial possibilities are completely exceeded; particularly these inhibitions are often starkly at odds with the actual basic moral principles of the person afflicted and lead to feelings of shame and guilt after the subsiding of the mania.

Depressive episode (depression)

Depressive people are not simply merely sad. They cannot feel if something wonderful occurs; they cannot laugh. If something is sad, they cannot cry. Everything is equally grey. A depression is therefore more than simply merely a frame of mind of sadness. Depression is an illness in which the mental and psychic balance is lost, thought, action and the body are just as affected as the frame of mind. For this reason, persons afflicted not only suffer from sadness and depressed mood, this also leads to physical symptoms, for example exhaustion, sleep disorders, weight loss or weight increase. The most difficult sign of a depression are suicidal thoughts. This should always be an alarm signal and lead to a doctor being called immediately.

The following symptoms are typical for a depressive episode

  • Increased feeling of sadness, lack of drive, lack of interest in things that would normally please the ill person.
  • Loss of sexual interest
  • Tendency to constant brooding and pessimistic future perspectives
  • Sleep disorders, waking up early in the morning or increased sleep requirement
  • Loss of appetite or increased food intake
  • Concentration and attention disorders
  • Inability to make decisions
  • Feelings of worthlessness, feelings of guilt, lack of self-confidence
  • Suicidal thoughts
  • Various physical discomfort, such as tightness in the chest area, diarrhoea or constipation

Hypomanic episode (hypomania)

A hypomania is a weakened form of mania. The same symptoms occur as in the case of a mania, however these are significantly less pronounced. The person afflicted is still able to grasp reality and comprehend his / her personal situation. He / she feels good, but is not exalted. A hypomania is unpredictable in its development. It can occur as a brief and momentary increase in the normal mood; it can however also be the precursor of a pronounced mania. If in the first case an outpatient therapy and / or an adjustment of the medication is sufficient, in the second case the person afflicted must be treated consistently. Each new episode of the illness deteriorates the course of the illness overall and the distances between the individual episodes become increasingly shorter. Both of these reasons render necessary a therapeutic intervention as soon as possible even in the case of a hypomania.

Mixed episode (mixed state)

During the mixed episode manic and depressive phases can occur either in brief rotation or even at the same time. The persons afflicted are exited or driven to the same degree; they feel despondent and depressed. Particularly due to the combination of increased activity and depression in this form the suicide risk is particularly high.

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