What To Know About Early Signs Of Bipolar Disorder
According to the National Institute of Mental Health, approximately 4.4% of US adults will develop bipolar disorder at some point in their lives. Bipolar disorder, a mental illness that can cause intense mood swings, often first emerges in young adulthood. Here, we’ll explore common warning signs that may indicate the need to seek medical or mental health support for a possible bipolar disorder diagnosis.
Bipolar disorder: An overview
Bipolar disorder is a mental illness that can cause people to shift between a highly excited and energized mood and a low-energy, depressed mood. These mood swings can be intense and may last anywhere from days to weeks. To get a better idea of what bipolar disorder can be like early on, it may help to take a closer look at the two main bipolar disorder symptoms: mania or hypomania and depression.
Mania and hypomania
During a period of mania, also referred to as a manic episode, an individual may feel extremely happy, energized, excitable, and even invincible. As a result, they may take needless risks or make big decisions and plans without thinking them through. Some other common signs of a manic episode may include:
- Not sleeping
- Feeling extremely creative or productive
- Engaging in reckless behavior, like unsafe sex or shopping sprees
- Becoming easily distracted
- Having hallucinations or delusions
- Talking quickly
Hypomania is a less severe form of mania associated with milder forms of bipolar disorder. It often lasts for less time than a full manic episode. While at first it may seem pleasantly euphoric for some, it can also manifest as irritability and other intense symptoms that can be difficult to manage. Plus, the energy it requires can lead to burnout and exhaustion, and this phase may also switch abruptly into depression.
Depression
On the other end of the spectrum, people with bipolar disorder may also experience depressive symptoms, often referred to as a “depressive episode.” During a depressive episode, someone with bipolar disorder might feel numb, tired, or sad. They might also lose interest in activities and relationships they used to enjoy. Other signs of a depressive episode may include:
- Sleeping or eating too much or too little
- Losing the ability to feel pleasure
- Feeling persistently down, worthless, and/or guilty
- Struggling to concentrate or make decisions
- Feeling fatigued or lacking energy
Types of bipolar disorder
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are a few main types of bipolar disorder, including:
- Bipolar I disorder, which causes manic episodes lasting at least a week. People with bipolar I disorder may also experience depressive episodes, but these are not required for a diagnosis of bipolar I disorder.
- Bipolar II disorder, which causes depressive episodes and episodes of hypomania but not full manic episodes
- Cyclothymic disorder, which causes symptoms of depression or hypomania that are not severe or long-lasting enough to qualify as bipolar disorder
Researchers are still studying the exact causes of bipolar disorder. That said, a few risk factors have been identified. Because bipolar disorder tends to run in families, genetics may play a role. Other factors like drug use, childhood trauma, and major life stressors may also trigger episodes of depression or mania.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
What are the early signs of bipolar disorder?
Most people with bipolar disorder start showing signs in adolescence or young adulthood. According to the National Alliance on Mental Illness, the average age of onset for bipolar disorder is 25, but in rare cases, children or teens may also be diagnosed.
Some people with bipolar disorder go through what’s called a “prodrome.” A prodrome is a period of early warning signs that emerge before symptoms are intense enough for an official diagnosis. According to a 2019 research summary, symptoms of the bipolar disorder prodrome period may include:
- Less severe mood swings than with full bipolar disorder
- Depression with symptoms of psychosis (like delusions and hallucinations)
- Panic attacks, especially at a young age
- Behavioral issues
- Impulsivity
- Symptoms of anxiety
- Irritability
- Trouble thinking or concentrating
- Low energy levels
How long these early symptoms last can vary, but the review cited above suggests that the bipolar disorder prodrome tends to last an average of two years before the disorder fully develops.
As you can see, these symptoms may look similar to symptoms of other mental health conditions. This can sometimes make it hard to figure out their root cause. In fact, it’s common for people with bipolar disorder to initially be diagnosed with depression before they have their first manic or hypomanic episode.
Watching for symptoms of bipolar disorder
Not everyone with bipolar disorder may go through a prodrome period. Either way, it can still be helpful to be on the lookout for symptoms related to your mood and thinking. These may include:
- Mood swings
- Changes in sleeping patterns
- Racing thoughts, ideas, and plans
- A loss of interest in activities or relationships you used to enjoy
- Having trouble concentrating
- Feeling unusually happy, energetic, or creative
- Feeling unusually low on energy
People experiencing bipolar disorder may not always realize that something is wrong, which can be a barrier to seeking help. If you notice symptoms that concern you or your loved ones, it’s recommended that you speak with a mental health professional or a doctor, who may be able to provide a diagnosis and advise you on next steps.
Although symptoms of bipolar disorder can be disruptive to a person’s life, they can often be effectively managed. A range of medications are available that may help reduce symptoms and improve quality of life. Your doctor may also recommend working with a therapist. Therapy can be useful for learning to recognize manic and depressive episodes and developing healthy strategies for managing them.
That said, ongoing mental health support may not always be easy to connect with. According to a 2023 report from Mental Health America, for the majority of Americans with an unmet mental healthcare need, cost was the reason they didn’t receive care. Compared to in-person therapy, online therapy may be a more affordable option. Platforms like BetterHelp enable you to meet with a therapist from your own home, with plans starting at $65 per week. Note that online therapy isn’t right for everyone. For example, if you’re experiencing symptoms that require immediate medical support, such as psychosis, it’s important to seek it out.
Research indicates that online therapy may benefit people with bipolar disorder. For example, findings of a 2023 study suggest that online therapy can be an effective form of routine care for addressing anxiety and depression symptoms in people with bipolar disorder.
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