When most people think of bipolar disorder, they tend to think of super high highs and drastic low lows, but the disorder can be more complicated than that, and it's not always obvious. There are some subtle signs of bipolar disorder that are easy to miss, and paying attention to them can potentially help you or someone you love get a proper diagnosis.
"Mood disorders occur on a continuum, with unipolar on one end and bipolar on the other," says Patricia Allen, Psychiatric Mental Health Nurse Practitioner at Summit Behavioral Health, over email. "Symptoms may be very similar, and Bipolar Affective Disorder is difficult to diagnosis. All too often, the patient presents to their primary care physician with symptoms of depression. The patient may fail to recognize or report signs of hypomania or mania. Unfortunately, individuals misdiagnosed early in the disorder lose valuable time to onset of treatment and the remission of symptoms."
The combination of depression and mania are hallmark symptoms of bipolar disorder, but sometimes their symptoms are not obvious. Here are nine subtle signs of bipolar disorder that are easy to miss. If you or anyone you know are exhibiting these symptoms, it's best to see a mental health professional who can give an accurate diagnosis and proper treatment.
Those with bipolar disorder often have rapid speech and racing thoughts. "Individuals with this symptom often report that they are bombarded with multiple thoughts and that they jump rapidly from one topic to another," says Glenn Hirsch, MD, psychiatrist at the Child Study Center at NYU Langone, over email. "To others, they speak very rapidly and are hard to interrupt."
A person may exhibit on excessively upbeat mood or over-the-top overconfidence. "This mood state often borders on a sense of grandiosity, expansiveness, and a feeling of being ‘on top of the world,’" says Hirsch. They tend to set higher goals for themselves and express higher expectations of meeting these goals, according to a study published in the Journal of Research Psychology.
3Decreased Need For Sleep
Some patients with bipolar disorder have a decreased need for sleep. "These patients will describe getting much less sleep than is normal for them, but will also report not feeling tired the next day," says psychiatrist Dr. Scott Aaronson over email. On the other hand, on the other hand, during a depressed phase, excessive fatigue is also common.
"Whether in the manic or depressed phase of the illness, individuals will often find that they are more impatient and even very minor issues will get them annoyed and irritated," says Hirsch. They also may experience random mood changes without environmental or situational stimuli.
"During the manic phase, individuals may be more flirtatious, have increased sexual desire, use alcohol or drugs more, and spend money more easily," says Hirsch. Studies of the brain show "a dominance of the brain’s pleasure center” in patients with bipolar disorder, according to research published in the journal Brain. This causes them to seek out more pleasurable activities.
6Lack Of Focus
Bipolar disorder is often mistaken for Attention Deficit Disorder due to the individual's inability to focus. "They experience distraction because of lack of focus related to fluctuating moods," says Allen. "Behaviors include starting multiple projects or tasks without completion. Often work performance is impaired."
People with bipolar disorder often tend to be "overly social." "They can be gregarious or 'never knew a stranger,'” says psychiatrist Karen Ritchie, M.D. over email. "When we consider social phobia to be a disorder, it is ironic that the opposite — being overly friendly and sociable — is also considered such."
Bipolar disorder can cause people to act impulsively. "This can include spending too much money, shoplifting, speeding, and sexual indiscretion," says Aaronson. Research shows that in patients with the disorder, their brains prioritize lower-order, strongly desired outcomes above those that fit with long-term goals, according to the journal Brain.
Those with bipolar disorder may find themselves with a higher-than-usual sex drive or that they think about sex all the time, according to Everyday Health. This hypersexuality can result in unusual and risky sexual behavior," says Allen.