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Can You Be Manic And Depressed At The Same Time

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The Keys To Bipolar Disorder Self

Can You Have Bipolar Disorder + Borderline Personality? |Heres Why It Matters

Get educated. Learn as much as you can about bipolar disorder. The more you know, the better youll be at assisting your own recovery.

Get moving. Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise that activates arm and leg movement such as running, walking, swimming, dancing, climbing or drumming may be especially beneficial to your brain and nervous system.

Keep stress in check. Avoid high-stress situations, maintain a healthy work-life balance, and try relaxation techniques such as meditation, yoga, or deep breathing.

Seek support. Its important to have people you can turn to for help and encouragement. Try joining a support group or talking to a trusted friend. Reaching out is not a sign of weakness and it wont mean youre a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them, and it will only strengthen your relationship.

Stay closely connected to friends and family. Nothing is as calming to the nervous system as face-to-face contact with caring supportive people who can just listen to you talk about what youre experiencing.

Make healthy choices. Healthy sleeping and eating habits can help stabilize your moods. Keeping a regular sleep schedule is particularly important.

Monitor your moods. Keep track of your symptoms and watch for signs that your moods are swinging out of control so you can stop the problem before it starts.

Coming Up: Schizoid Symptoms

In Part II, I will discuss the schizophrenic side of schizoaffective disorder, something that I have not felt comfortable to talk about much before, publicly or privately. I will cover auditory and visual hallucinations, dissociation and paranoia.

Finally in part III I will tell you what to do about mental illness why its important to seek treatment, what therapy is all about, and how you can make a livable new world for yourself. I will conclude with an explanation of why I write so publicly about my illness and give a list of websites and books for further reading.

This article originally appeared on and is reprinted here by permission of the author.

Last medically reviewed on May 17, 2016

What Is Bipolar Disorder How Do I Know If I Have It

Bipolar disorder is a psychiatric illness that presents with an unusual shift in energy level, mood swings, ability to perform daily activities, and extreme mood changes. A patient may be excessively happy one instance and completely depressed the other. These changes in mood can become mixed as well which makes a patient feel happy and depressed at the same time.

There are two phases of bipolar disorder mania and depression. The period when a person is overly happy, elated is referred to as Mania while when a person is feeling overly low, it is called depression. A person with bipolar disorder can oscillate between these two phases.

What are the signs and symptoms of bipolar disorder?

One suffering from bipolar depression may present with episodes of unusual & intense emotions and uncharacteristic/risky behaviors. These periods of unusual behaviors and emotions are called “mood episodes”. These mood episodes can last for days or weeks.

Manic Episode

  • Feel “extremely happy” elated, or irritable

  • Feel full of energy

  • Talk about many different topics

  • Feel like thoughts are racing

  • Feel like or start multiple projects

  • Risky behaviors

  • Feel like “I am very important .. I am superman/women

Depressive Episode

  • either not sleeping or sleeping > 10-12 hours

  • Increased or decreased appetite with significant weight gain

  • Lack of motivation

  • Loss of interest in hobbies

  • Suicidal / self-harm thoughts

Types of Bipolar Disorder

Bipolar 1 = Manic episode + Hospitalziation



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How Long Do Manic Depressive Episodes Last

Untreated, an episode of mania can last anywhere from a few days to several months. Most commonly, symptoms continue for a few weeks to a few months. Depression may follow shortly after, or not appear for weeks or months. Many people with bipolar I disorder experience long periods without symptoms in between episodes.

Who Gets Mixed Bipolar Episodes

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Virtually anyone can develop bipolar disorder. About 2.5% of the U.S. population — nearly 6 million people — has some form of bipolar disorder.

Mixed episodes are common in people with bipolar disorder — half or more of people with bipolar disorder have at least some mania symptoms during a full episode of depression. Those who develop bipolar disorder at a younger age, particularly in adolescence, may be more likely to have mixed episodes. People who develop episodes with mixed features may also develop “pure” depressed or “pure” manic or hypomanic phases of bipolar illness. People who have episodes of major depression but not full episodes of mania or hypomania also can sometimes have low-grade mania symptoms. These are symptoms that are not severe or extensive enough to be classified as bipolar disorder. This is referred to as an episode of “mixed depression” or a unipolar depressive episode with mixed features.

Most people are in their teens or early 20s when symptoms from bipolar disorder first start. It is rare for bipolar disorder to develop for the first time after age 50. People who have an immediate family member with bipolar are at higher risk.

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Patterns Of Depression And Mania

If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.

Between episodes of depression and mania, you may sometimes have periods where you have a “normal” mood.

The patterns are not always the same and some people may experience:

  • rapid cycling where a person with bipolar disorder repeatedly swings from a high to a low phase quickly without having a “normal” period in between
  • mixed state where a person with bipolar disorder experiences symptoms of depression and mania together for example, overactivity with a depressed mood

If your mood swings last a long time but are not severe enough to be classed as bipolar disorder, you may be diagnosed with a mild form of bipolar disorder called cyclothymia.

How Do You Treat Patients Who Present With Mixed Depression

Dr. Nierenberg: Treating the phenomenon of mixed depression is complicated.,,, The initial treatment plan must always rely upon and reflect the patient’s history. If a patient has a clear and well-documented history of mania or hypomania, which would qualify him or her as having a diagnosis of bipolar I or II disorder, then the clinician would treat the patient for bipolar I or II in the present episode. In the absence of unequivocal, documented manic or hypomanic episodes in the past, the assumption is that the patient will more than likely present with manic or hypomanic episodes in the future, but we do not really know for sure.

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What It Feels Like

Dysphoric mania can feel like a manic episode, but with some symptoms of depression, like a negative mood and sadness. Or you may feel depressed, but with extra energy, restlessness, and emotional discomfort. Your mind might be racing, and you could have trouble sleeping. At the same time, you may feel sad and down on yourself.

A mixed episode can feel intense. You might notice changes in your energy, activity, and behavior. Others around you, like family or friends, may be able to notice it, too.

Mixed episodes can be disruptive, unpredictable, hard to figure out, and challenging to cope with. Since you feel so many emotions, you may feel emotionally exhausted.

Who Experiences Bipolar Disorder

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Bipolar disorder usually begins in older teens and young adults, with at least half of all cases appearing before age 25. Children and adolescents, however, can develop this disease in more severe forms and often in combination with attention deficit hyperactivity disorder . Some studies have indicated that bipolar depression is genetically inherited, occurring more commonly within families.

While bipolar disorder occurs equally in women and men, women are more likely to meet criteria for bipolar II disorder. Women with bipolar disorder may switch moods more quickly this is called “rapid cycling.” Varying levels of sex hormones and activity of the thyroid gland in the neck, together with the tendency to be prescribed antidepressants, may contribute to the more rapid cycling seen in women. Women may also experience more periods of depression than men.

An estimated 60 percent of all people with bipolar disorder have drug or alcohol dependence. It has also been shown to occur frequently in people with seasonal depression and certain anxiety disorders, like post-traumatic stress disorder .

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Other Mental Health Conditions

Bipolar depression may be more likely if a person has another mental health condition, such as obsessive-compulsive disorder or traits of borderline personality disorder .

Bipolar disorder usually appears during adolescence or early adulthood, but it can occur at any age, including childhood.

Some statistics show that, on average, it starts between ages . Other research suggests its more likely to occur after the age of 25. One large study found evidence that higher numbers of first episodes appear in people ages 15 to 24 and in those ages 45 to 54.

Global statistics suggest bipolar I disorder affects around

Hypomania involves symptoms similar to mania but less severe. The biggest difference between the two is that symptoms of hypomania have a less significant effect on your life and your ability to work, study, and carry out daily tasks.

In addition, for a diagnosis of mania for bipolar I, the episode must last at least 7 days . For a diagnosis of bipolar II hypomania, an episode must last at least 4 days.

Manic episodes can involve psychosis and may lead to hospitalization, but this is unlikely to happen with hypomania.

Some people with bipolar disorder experience mixed mood states in which depressive and manic symptoms coexist. In a mixed state, a person will often have symptoms that include:

  • agitation

diagnoses of bipolar disorder, depending on how the features and symptoms appear.

What Is Bipolar Mania And What Does It Feel Like

Bipolar mania is a period of mood elevation thats generally characterized by high energy and activity levels-although its much more complicated than that. When a person with bipolar disorder is experiencing a manic episode, they may feel up, or jumpy or wired, the National Institute of Mental Health says.

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What Is The Treatment For Mania Hypomania And Depression

You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.

NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:

The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.

What medications are recommended?

Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.

The mood stabilisers we talk about in this factsheet are:

  • Lithium
  • Certain benzodiazepine medication

Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.

If you are taking antidepressants your doctor may advise you to withdraw from taking them.

You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:

  • Haloperidol
  • Quetiapine
  • Risperidone

If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.

If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.

Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.

Bipolar Disorder Vs Major Depression

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You may have heard of people who were first diagnosed with depression but later diagnosed with bipolar disorder, and this can be confusing. How can you tell the difference? Keep in mind that the hallmark of bipolar disorder is the presence of episodes of mania or hypomania. These are not present in major depression.

Another common question that’s asked is “Can depression turn into bipolar disorder?” The answer to that question is no, depression doesn’t transition into bipolar disorder later on.

However, it is possible for someone to be diagnosed while they are in the depressive phase, which may result in a diagnosis of depression. At the time, they may not recall or be asked about symptoms of mania or hypomania that would lead to a bipolar diagnosis. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic episode, the diagnosis of bipolar may become clear.

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What Is Rapid Cycling

Some people with bipolar disorder develop rapid cycling where they experience four or more episodes of mania or depression within a 12-month period. Mood swings can occur very quickly, like a rollercoaster randomly moving from high to low and back again over a period of days or even hours. Rapid cycling can leave you feeling dangerously out of control and most commonly occurs if your bipolar disorder symptoms are not being adequately treated.

The different faces of bipolar disorder

Bipolar I Disorder This is the classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Usuallybut not alwaysBipolar I Disorder also involves at least one episode of depression.

Bipolar II Disorder In Bipolar II disorder, you dont experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.

Cyclothymia Cyclothymia is a milder form of bipolar disorder that consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.

What Happens During The Manic Phase Of Bipolar Disorder

People with bipolar disorder often feel overly ambitious during the manic phase of the disorder. During manic episodes, productivity seems to be amazing. However, as the manic episode begins to shift to a state of depression, it often becomes difficult to focus on the task at hand leaving many projects incomplete.

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Why Did Manic Depression Become Bipolar Disorder

In the past, “manic depression” was generally used to denote a wide array of mental illnesses. It was also a term that quickly became stigmatized. As classification systems became more sophisticated, the new term bipolar disorder allowed for more clarity in diagnosis, which has also provided a clinical term that is less emotionally loaded.

What About Inflated Self Esteem In Depressed Patients

What Does Bipolar I Feel Like?

Dr. Nierenberg: Depressed patients can also have an inflated self esteem or grandiosity. Sometimes the clinician needs to ask another person who knows the patient because the patient’s ability to self observe and self report can be quite limited in a depressed state. Of course, the clinician will need to differentiate between narcissistic personality disorder and grandiosity: It is one thing for a patient to think he or she is without fault, but it is another thing for the patient to have hypomanic symptoms such that he or she is not in his or her normal state of mind.

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What Are The Long

Bipolar disorder is a life-long and often recurring illness. You may need long term support to help manage your condition.

What medication options are there?

Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium.

Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely. If lithium doesn’t work well enough or causes you problems, you may be offered:

  • Valproate,
  • Olanzapine, or
  • Quetiapine.

Your doctor should monitor your health. Physical health checks should be done at least once a year. These checks will include:

  • measuring your weight,
  • checking your liver and heart, and
  • checking your pulse and blood pressure.

What psychological treatments are recommended?

You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy.

The aim of your therapy is to stop you from becoming unwell again. This is known as relapse. Your therapy should help you to:

If you live with your family or are in close contact with them, you should also be offered family intervention.

Family intervention is where you and your family work with mental health professionals to help to manage relationships. This should be offered to people who you live with or who you are in close contact with.

Is It Possible To Be Hypomanic And Depressed At The Same Time

Certainly! Some studies, the most common mood state in bipolar disorder is a mixture of hypomanic/manic and depressed symptoms. In fact, the classic picture of bipolar disorder having a course alternating between the poles of high and low moods is an over-simplification. The very name, bipolar disorder is probably less accurate than the older term, manic-depressive disorder. How can this be?

Although bipolar disorder has been classified as a mood disorder, ample research shows that the core symptom of hypomania and mania is not high mood, but rather hyperactivation. The mood, as many people have experienced, can either be elevated or irritable. But what always appears in manic or hypomanic episodes is a sense of being sped up physically and/or mentally. Racing thoughts, pressured speech, decreased need for sleep, starting lots of projects, and impulsive decision-making all derive from being overly activated, overly driven. Many times this sense of hyperactivation is pleasantwhen one is feeling particularly on my game the person is self-confident, more likely to act decisively, and often more likely to take risks. However, sometimes being hyperactivated simply is a sense that ones motor cannot be turned off. This can lead to restless irritability, especially if one is confronted by reality or other individuals that do not match expectations. Thus what is common in mania or hypomania is the sense of hyperactivation, or being driven, but the mood can be variable.

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