Bipolar affective disorder is a mood disorder characterized by both depression and states of mania. Unfortunately, there is no test or diagnostic study that can be used to diagnose bipolar disorder. Therefore diagnosis is based on history and clinical presentation. This is why it is important to pay attention to your symptoms if you have been battling depression and mania. There are multiple subtypes of bipolar disorder, the most common being bipolar disorder type I and type II.

Bipolar disorder type I

Bipolar disorder type I  is the most severe form of the two types of manic depression. It is characterized by manic episodes lasting at least one week in duration or episodes that lead to hospitalization or other significant impairments in occupational or social functioning. Depressive episodes must also be present as well; however, in most cases of bipolar disorder type 1, manic episodes are the mainstay of the presentation.

Bipolar disorder type II

Bipolar disorder type II is the milder form of the two types of manic depression and is often misdiagnosed as depression. This disorder is characterized by depression with alternating episodes of hypomania, which is a milder form of mania. Individuals with bipolar type II often have severe depression in comparison to their hypomania. As a result, their hypomania overlooked, and they are diagnosed with major depressive disorder as a result. Hypomania is characterized by an elevated, expansive, or irritable mood of at least four consecutive days’ duration. However, it does not result in hospitalization or significant impairment in occupational or social functioning. Another major difference between mania and hypomania is people experiencing a manic state often lose the capacity to notice or understand that something is wrong or off with their behavior. While hypomanic states often leave that ability intact.

Symptoms of mania

  • Distractibility
  • Irresponsibility and erratic behavior
  • Grandiosity
  • Flight of ideas
  • Increased activity associated with weight loss and sexual libido
  • Decreased sleep
  • Pressured speech

Severe mania can involve psychosis, with hallucinations or delusions. Hallucinations can cause an individual to see, hear, or feel things that are not there. Delusions are distorted thoughts that cause individuals to believe that certain things are true when they are not. An individual in a manic state may not realize that their behavior is unusual, but others may notice a change in behavior. Some may see the individual’s outlook as sociable and fun-loving, while others may find it unusual or bizarre. The individual may not realize that they are acting inappropriately or be aware of the potential consequences of their behavior.

Symptoms of depression

  • Sleep disturbance
  • Loss of interest in activities
  • Feelings of guilt
  • Loss of energy
  • Difficulty concentrating
  • Change in appetite
  • Psychomotor agitation
  • Sadness
  • Suicide ideations

If you feel that your moods are comprised of ultimate highs and/or ultimate lows, you may be experiencing bipolar affective disorder. Bipolar disorder has a large hereditary component. Therefore if you have a first-degree relative such as a parent or sibling with bipolar disorder, you are more likely to inherit this mental health disorder as well. You do not have to have alternating episodes of mania and depression, but you can have episodes of mania or hypomania that occur every once in a while with bouts of depression. Because there are so many myths regarding bipolar affective disorder that raises the stigma around this mental health disorder, many individuals are ill-informed how this disorder can present.As a result, are less likely to seek professional treatment. Like with many other mental health disorders, treatment for bipolar disorder involves a combination of medications and psychotherapy. It may take a while to find the best combination and dosage of medication so treatment can initially feel like trial and error but within time, symptoms can be well controlled.


Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases including mental health disorders and the stigma associated with them. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.