In a manic episode, some people with Bipolar Disorder may experience an elevated (extremely happy) mood, often described as feeling "on top of the world." Others may feel very agitated and act uncooperatively and aggressively, which can be frightening for themselves and others. Patients often report that these episodes result in consequences that must be dealt with after the symptoms fade.
A diagnosis for a manic episode includes either an elevated or an irritable mood lasting at least a week, plus three or more of the following symptoms:
- Talking too fast or too much
- Risky or impulsive behavior, like sexual promiscuity or excessive spending sprees
- Needing little sleep
- Being easily distracted (your attention shifts between many topics in just a few minutes)
- Having an inflated feeling of power, greatness, or importance
- Intense focus on goal-directed activity
- Racing thoughts
Depressive episodes
A diagnosis for a major depressive episode requires having a depressed mood or loss of interest or pleasure in activities a person used to enjoy. In addition, four of the following symptoms must also be present nearly every day for at least two weeks:
- Significant weight loss when not dieting or weight gain (i.e., a change of more than 5% of body weight in a month), or decrease or increase in appetite
- Insomnia or hypersomnia (excessive sleeping) nearly every day
- Feeling restless or sluggish to the point that others notice
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal thoughts without a specific plan, or a suicide attempt or specific plan for committing suicide
Mixed episodes
A mixed episode includes symptoms that are both manic and depressive.
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