Bipolar disorder can start with either a depressive episode or a manic (or hypomanic) episode. The specific pattern of the first episode can vary from person to person.
Bipolar I Disorder: In some cases, the first episode of bipolar disorder is a manic episode. A manic episode is characterized by an abnormally elevated or irritable mood, increased energy levels, impulsivity, and possible psychotic features. After experiencing a manic episode, individuals may have periods of normal mood or depression.
Bipolar II Disorder: For others, the initial episode may be a depressive episode. Bipolar II disorder is characterized by at least one episode of major depression and at least one hypomanic episode (a less severe form of mania). Hypomania involves similar symptoms to mania but is not as severe and does not lead to significant impairment or psychosis.
It is essential to understand that bipolar disorder is a recurrent and chronic condition, meaning that individuals with the disorder will typically experience periods of both depression and mania or hypomania over time. The frequency and intensity of these episodes can vary among individuals, and some people may experience more depressive episodes than manic episodes or vice versa.
Moreover, some individuals may experience a mixed episode, where features of both depression and mania occur simultaneously. This can involve feeling sad and hopeless while also experiencing increased energy and agitation.
The diagnosis of bipolar disorder is based on a careful assessment of a person's history, symptoms, and mood patterns over time. It is crucial to seek professional help if someone is experiencing mood disturbances, as an accurate diagnosis and appropriate treatment are essential for managing the condition effectively. Bipolar disorder often requires a combination of medication, psychotherapy, and lifestyle adjustments to help stabilize mood and prevent relapses.