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Nobody Knows ~Bipolar Mixed States ~Raven's State of the Union

Apr 8, '08 12:25 PM
for everyone

A 'symptom' is a subjective sense or feeling of being unwell. Only the person suffering notices symptoms.

On the other hand, a 'sign' is an objective, observable event that someone else can see.

Lists of symptoms are often used as a means of self-diagnosis, but this approach is unlikely to produce the right answer for the right reasons. If you want to find out if you might have bipolar disorder, take our free test for bipolar disorder. In bipolar disorder/manic depression, not all symptoms and signs are present in everyone. We have given a limited number of examples as an illustration. If you have bipolar disorder, you can learn how to identify your own signs of illness that are unique to you.

Symptoms & signs of mania
elation (symptom)
feeling invincible (symptom)
irritated (symptom)
irritability (sign)
busy (symptom and sign)
talking fast (symptom and sign)
thinking fast (symptom)
sleeplessness (symptom and sign)

Symptoms & signs of depression
dejected, pessimistic (symptom)
hard to concentrate or remember (symptom)
taking no fun/joy out of life (symptom)
no energy / can't get out of bed (symptom and sign)
belief that 'I am bad' (symptom)

When the symptoms & signs point to depression and mania
Bipolar disorder is not quite as simple as just mania and depression, as ten more groups of symptoms have been identified by Kraepelin in 1921. These are 'mixed states' with elements of mania and depression present at the same time. The suffering is different but equivalent to 'pure' depression or mania. They have some colorful names such as 'Black Mania' and 'Depression with flight of ideas.'

'Mixed' states occur in 40 to 50% of episodes, but may be more difficult to recognise as episodes of bipolar disorder and this may partly explain the low rate of diagnosis of bipolar disorder. More information on mixed states is available in Bipolar and the Art of Roller-coaster Riding.

Some mixed state symptoms and signs
depressed, hopeless outlook (symptom) with restlessness, fast pressured speech (sign)
depressed, anxious (symptoms) with constant talk flitting from one problem to the next
racing thoughts and speech, restless (signs) with inability to move / stupor (signs)