Bipolar disorder can be present even when mood swings
are less extreme. For example, some people with bipolar
disorder experience hypomania, a less severe form of
mania. During a hypomanic episode, you may feel very
good, be highly productive, and function well. You may
not feel that anything is wrong, but family and friends
may recognize the mood swings as possible bipolar disorder.
Without proper treatment, people with hypomania
may develop severe mania or depression.
Bipolar disorder may also be present in a mixed state, in which you might experience
both mania and depression at the same time. During a mixed state, you might
feel very agitated, have trouble sleeping, experience major changes in appetite,
and have suicidal thoughts. People in a mixed state may feel very sad or hopeless
while at the same time feel extremely energized.
Sometimes, a person with severe episodes of mania or depression has psychotic
symptoms too, such as hallucinations or delusions. The psychotic symptoms tend
to reflect the person’s extreme mood. For example, if you are having psychotic
symptoms during a manic episode, you may believe you are a famous person,
have a lot of money, or have special powers. If you are having psychotic symptoms
during a depressive episode, you may believe you are ruined and penniless, or you
have committed a crime. As a result, people with bipolar disorder who have psychotic
symptoms are sometimes misdiagnosed with schizophrenia.
People with bipolar disorder may also abuse alcohol or substances, have relationship
problems, or perform poorly in school or at work. It may be difficult to recognize
these problems as signs of a major mental illness