6 Unusual Symptoms of Bipolar Depression

When Emotions Become Extreme

Woman making angry phone call in local coffee shop
asiseeit/Getty Images

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

Sadness and lack of pleasure (dysthymia) may be the most obvious ways in which depression shows up in bipolar disorder, but they aren't the only ones. There are other emotions that aren't often associated with depression but are most certainly potential symptoms when they reach extreme levels.

Here are six of the most common such symptoms and how to recognize when they cross the line from reasonable responses to circumstances or a current situation to over-the-top levels that should prompt concern.

Irritability in Bipolar Depression

Everyone gets cranky now and then, most of the time with good reason. The list of stressors that can cause a person's mood to take a nosedive is endless—a headache, a bad night's sleep, an upcoming dentist appointment, an unexpected bill.

When to be concerned: Garden-variety irritability can be a sign of bipolar depression when the least little thing explodes into a major annoyance for no apparent reason. In other words, the response is out of proportion to what appears to be the trigger. Depression also could be the cause of persistent irritability that lasts for days or weeks at a time.

Anger in Bipolar Depression

Anger is a natural and frequently reasonable response to many situations—someone else has been blatantly unfair or disrespectful, for example. Anger also can be viewed as irritability pushed to an extreme.

When to be concerned: When anger is symptomatic of bipolar depression, a person may explode over what might otherwise be a mild irritant or over nothing at all. It may be a brooding anger that comes to a head over something seemingly harmless. If anger lasts or becomes frightening or violent, get help as soon as possible.

Worry and Anxiety in Bipolar Depression

This pair of emotions may show up in a number of ways. As with anger, there are many scenarios in which it's natural to worry or feel anxious, but under normal circumstances, these emotions disappear once the cause for concern is resolved.

When to be concerned: When worry becomes incessant and out-of-control, it may be that depression is an underlying cause. For instance, a person may worry obsessively about common everyday issues. Do I have enough sleeping pills? What will we have for dinner? Did I put gas in the car? Another way a person with bipolar disorder may express depression is with extreme anxiety in response to everyday issues. I have to call the plumber—but what if he can't come today? I'd better leave early for my appointment in case the traffic is bad.

Or it could be a more generalized anxiety, perhaps accompanied by racing thoughts that are commonly associated with mania or hypomania. Anxiety is frequently associated with being indecisive.

Pessimism in Bipolar Depression

Not everyone can have a glass-is-half-full attitude all the time. There are times when negativity is just that—a pessimistic view of a situation that clearly warrants it. If the weather forecast calls for rain on the day of a picnic, then it may be hard not to expect that to happen.

When to be concerned: In the case of depressive pessimism, the negativity is exaggerated out of proportion with reality. It's going to be another bad day. Nobody likes me. There's no point in applying for that job. There's no reason for it to be a bad day, plenty of people like you, and whether you're depressed or not, you might have a good chance of landing the job.

Indifference in Bipolar Depression

Simply put, indifference is not caring. This could be a very useful emotion in situations in which it's necessary to be able to forge through without getting caught up in what other people think.

When to be concerned: You may rightly suspect that you're dealing with bipolar depression when indifference leads to inaction, the laundry piles up, the bills aren't paid, and you just don't care. Or a friend calls with a problem, and you can only make polite noises or sit and listen silently, the words not really penetrating your shell of indifference. In depression, it isn't even so much that you don't care as that you can't care.

Self-Criticism in Bipolar Depression

It can be healthy to recognize flaws you might have that are getting in the way of healthy relationships, career success, or other important aspects of life. Being able to see how we might be getting in our own way is often the key to clearing the path ahead.

When to be concerned: Your flaws seem magnified or you find flaws that aren't there. "I look tired today" becomes I'm ugly. "I've made a mistake in balancing the checkbook" becomes I'm an idiot with numbers. Forgot to feed the cat? I'm worthless. If you notice you're frequently berating yourself, it may be depression talking and not realistic self-criticism. The same may be true if you find yourself grappling with undeserved guilt—taking the blame for situations that clearly aren't the fault of anyone.