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Symptoms of Depression and Mania in Bipolar Disorder

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    The dramatic mood episodes of bipolar disorder do not follow a predictable pattern. Depression does not always follow mania. A person may experience the same mood state several times -- for weeks, months, even years at a time before experiencing a remission or change in mood state. Also, the severity of mood phases can differ from person to person.

    The periods of depression can be equally intense. Sadness and anxiety affect every aspect of life -- thoughts, feelings, sleeping, eating, physical health, relationships, and ability to function at work. If depression is not treated, it often only grows worse until it may suddenly go away. However, there may seem to be no way out of this overwhelming mood.

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    These depressed feelings have been described this way:

    Depression:I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless... . [I am] haunt[ed] ... with the total, the desperate hopelessness of it all. Others say, "It's only temporary, it will pass, you will get over it," but, of course, they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think, or care, then what on earth is the point?

    An episode of depression involves five or more of these symptoms most of the day -- nearly every day -- for two weeks or longer:

    Symptoms of depression:

    • Feeling sad or blue
    • Loss of energy
    • Feelings of guilt, hopelessness, or worthlessness
    • Loss of interest or enjoyment from things that were once pleasurable
    • Difficulty concentrating
    • Low energy
    • Feeling physically or mentally sluggish or restless and agitated
    • Increased need for sleep or inability to sleep (insomnia)
    • Change in appetite causing weight loss or gain
    • Thoughts of death or suicide or attempting suicide

    In addition, people experiencing a major depressive episode may also feel anxious, irritable, and tearful or have trouble making everyday types of decisions.

    When a person experiencing a depression has psychosis, there may be delusions of guilt or worthlessness -- perhaps there is an inaccurate belief of being ruined and penniless, or having committed a terrible crime or sin.

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