6 Unusual Symptoms of Bipolar Depression

How to recognize extreme emotions common to the condition.

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Bipolar disorder is a complex mental illness characterized by periods of depression alternating with mania or hypomania (inability to sleep, taking on too much work or responsibility, talking rapidly, grandiosity, and other symptoms).

Sadness and lack of pleasure (dysthymia) are two of the most common manifestations of depression in bipolar disorder, but they aren't the only ones. When they reach extreme levels, there are six other emotions that can indicate the condition.

If these feelings progress from reasonable responses to over-the-top reactions, it can be a sign that there's cause for concern. If you or someone you love has bipolar disorder, it's important that you learn to recognize how these six emotions can be transformed by the condition.

Irritability

Everyone gets cranky occasionally—and often with good reason. The list of stressors that can cause a person's mood to take a nosedive is endless: for example, a bad headache, a sleepless night, or an unexpected bill.

When to be concerned: Garden-variety irritability can be a sign of bipolar depression if a relatively "little thing" such as a minor interruption explodes into a major annoyance for no obvious reason. In other words, the response is out of proportion to what appears to be the trigger.

Depression can also cause persistent irritability that lasts for days or weeks at a time.

Anger

Anger is a natural (and frequently reasonable) response to situations encountered in day-to-day life. For example, you may feel angry when a coworker is blatantly unfair or disrespectful. Anger also can be viewed as irritability that's been pushed "to the limit."

When to be concerned: When anger is a symptom of bipolar depression, a person may seem to "explode" over a situation or event that would otherwise be considered a mild irritation. They may even become angry in the absence of an external trigger.

Someone exhibiting anger as a symptom of bipolar depression may seem (or even say that they feel) angry for no reason. Feelings of anger may seem to erupt out of nowhere. However, they may have been "brooding" for some time; only coming to a head after reaching a tipping point, which may have been a seemingly harmless trigger.

If you or a loved one is experiencing persist anger or anger that is frightening or escalates to violence, it's time to reach out for help from your doctor or therapist.

Worry and Anxiety

As with anger, there are many situations in which it's natural to feel anxious or worried. Under normal circumstances, these emotions disappear once the cause for concern is resolved. When these emotions don't get better or get worse, it may be a sign someone is dealing with a mental illness.

When to be concerned: Worry that feels incessant or out of control (or out of proportion) can be a symptom of depression. Someone dealing with depression or an anxiety disorder may worry excessively about common everyday issues.

For example, someone might perseverate on concerns like: Do I have enough sleeping pills? What will we have for dinner? Did I put gas in the car?

A person with bipolar disorder may also express depression with extreme anxiety in response to the routine aspects of everyday life.

For example, they might obsess about household tasks or their commute to work. Thoughts such as I have to call the plumber—but what if he can't come today? or I'd better leave early for my appointment in case the traffic is bad, could stem from underlying anxiety and depression.

To complicate the symptom further, anxiety can also make someone indecisive. They may enter into a cycle of thinking about what they need to accomplish but finding it difficult to commit to a solution.

Some people with bipolar depression experience generalized anxiety. This type of anxiety can be accompanied by racing thoughts; a common symptom of manic/hypomanic episodes.

Pessimism

Even the most optimistic person you know likely doesn't have a "glass half full" attitude all the time. There are times when negativity or a pessimistic point of view is clearly warranted. The disappointment of a rainy forecast for a picnic you'd planned would likely spur some negative feelings—or at the very least, palpable disappointment.

When to be concerned: With depressive pessimism, the negativity a person experiences is exaggerated compared to the reality of the situation. In fact, pessimistic thinking often precedes any specific event. A person may simply think: It's going to be another bad day.

The negative viewpoint may not be limited to a person's external perception of the world; it can also be turned inward onto themselves. Someone who is depressed might think thoughts like, No one likes me.

This negativity may also pervade a person's self-concept or sense of their abilities. For instance, they may look at a Help Wanted ad and think: There's no point in applying for that job—I would never get it.

When someone is depressed their perspective on how the world is, as well as who they are, is impaired by negative, often critical, patterns of thought. They may not be able to see (let alone feel) that they have good things in life to look forward to, that people who know them like and care about them, and that they are a capable person who has much to offer.

Self-Criticism

Being able to honestly recognize and address your flaws is an important aspect of growth, but you don't necessarily need to be hard on yourself to be effective. You can be critical of your own behaviors while at the same time practicing compassion for yourself.

All humans have flaws. Every person you know has their own old habits or unhelpful patterns of thinking that affect their ability to form healthy relationships, succeed in their career, or take care of their health.

Recognizing how you might be getting in your own way is key to clearing the path so you can move forward.

When to be concerned: If you view the areas where you need to work on yourself in an overly critical, even cruel, way rather than with compassion, it may be a sign that you're depressed. It's not uncommon for people with depression, anxiety, and other mental illnesses to focus on their flaws, which often become magnified. They may begin to find flaws that aren't really there.

The critical self-talk someone with depression uses can reflect this internal critic: the thought I look tired today becomes I'm ugly. The realization I made a slight miscalculation in my budget becomes I'm an idiot with numbers. A simple (and easily corrected) mistake may propel someone into a deluge of self-destructive thoughts. I forgot to feed the cat becomes I'm a bad pet owner, irresponsible, and a worthless person.

If you frequently berate yourself this way, it may be depression talking rather than realistic self-criticism. Likewise, if you're grappling with deep feelings of guilt (taking the blame for situations that aren't your fault—or anyone else's for that matter) it may be a sign of underlying, perhaps even severe, depression.

Indifference

Simply put, indifference is not caring one way or the other. By that definition alone, indifference may not sound like a good feeling to have. Indifference certainly can cause problems, both in personal and professional relationships, as well as our relationship to the world around us.

For example, being indifferent to the suffering of others compromises empathy. Not caring about the outcome of a certain situation, or being apathetic, is often an indication that we've lost motivation.

However, it can be very useful in situations when it's necessary to push through without getting caught up in what others think or becoming distracted by your own feelings. Sometimes being indifferent is fairly benign: for instance, when a friend asks you where you want to have lunch, you may find you don't have a preference and would be content with any of the options.

When to be concerned: When indifference leads to inaction, it could indicate you're dealing with depression. If you notice that the laundry has piled up, you haven't paid the bills —but you just don't care, this can be a sign that your level of indifference is creating problems in your life.

It's important for you and your loved ones to know that in these instances, it's not that you don't care—you can't care because of the shell of indifference created by depression.

You may notice your indifference affecting your relationships. For example, a friend may come to you with a problem and rather than feeling engaged and compassionate toward them, you might find yourself sitting there silently or perhaps offering polite noises of agreement. Mostly, you just feel detached.

The various symptoms of bipolar depression can be challenging to identify, but the more you understand them the easier for you (and those around you) to recognize your patterns. Having an accurate diagnosis, support from a team of medical and mental health care professionals, and treatment that's effective for you will help you effectively manage your symptoms.

Learning to cope with any mental illness, including bipolar disorder, takes time. Keep in mind that it's a process–and one that you don't have to go through alone.

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