Three Lesser Known Symptoms of Bipolar

There are a multitude of symptoms which can be present when someone has a diagnosis of bipolar. The condition can look different from one person to the next. This oftentimes makes it hard to notice and harder, still, to get a proper diagnosis. For a lot of people, the condition goes unnoticed and untreated for quite some time. It can really fly under the radar.

Many people tend to think you will see either severe depression or over-the-top euphoric mania with its risky behaviors and choices. But, it is not always so neatly compartmentalized. Not everyone has an identical presentation. And, too, symptoms exist on a spectrum, meaning they might be mild or quite severe. The symptoms can be more subtle.

While certain symptoms are more well-known and recognized, there are a few which exist but which tend to be not as widely acknowledged. If you know someone who has bipolar, if you wonder if you might have it, or if you suspect a friend or loved one has this diagnosis, here are some lesser-known symptoms.

Irritability, Agitation, Anger, Aggressiveness

These symptoms are seen frequently when someone is an episode of what is termed ‘dysphoric mania’. So, say you know someone who has typically been loving, calm, gentle, and kind in the past. That was how you normally know them to be. Now, suddenly, they are angry and aggressive. They become the opposite of what you have seen before. Their words and behaviors are very out of character.

Rage normally will have a trigger. We could look and see clearly “that is what set this person off.” However, with bipolar rage, there may be no reason, or it could be something relatively minor which would otherwise not bother the person much. It is chaotic and without reason.

It might be continuous, but it also can show up in bursts. This means the person could still show up at mom’s house for a nice dinner and all seems well, they can contain the anger, but then later that night they erupt in uncharacteristic rage towards their spouse, whom they’ve always adored.

They can get along well at work and find success, but then, seemingly out of nowhere, they display dangerous anger towards the lawn service workers if they believe they missed cutting a section of grass and did it deliberately. Suddenly, they race outside and are on the front lawn screaming in a frightening eruption.

Or, the relatively mild-mannered person you have known becomes outraged and is chasing down another driver through the neighborhood because that person seemed to make a strange face at them.

In some cases, things can get deadly and dangerous. There are cases where people end up in jail. Or property can be damaged.

The individual might, too, begin having urges to act violently and can begin to notice violent thoughts. It can be rather upsetting as it’s out of the norm for them. The dysphoric mania is scary and these behaviors and the related thinking is entirely out of the ordinary for your loved one. The individual can begin to blame other people (usually the one they are closest to) and/or their environment. They blame everything and everyone else as the source of their problems.

If you are the target of the rage the end result can be substantial trauma. The verbal abuse can be cruel and illogical. It is easy for others to say “don’t take it personally, it’s the illness speaking,” but that is far from easy to do when its your loved one speaking the words and the attack is, actually, very personal.

Cognitive Impairment

Another symptom that might occur is memory impairment. Let’s consider the rage outburst during dysphoric mania. The individual might remain fully aware of what took place. They recall what they said or did. Sometimes, though, they don’t. You might remember it vividly. It was unusual and terrifying and confusing. They either completely forget or only recall bits and pieces.

Day to day, there can also be difficulty with remembering things. Perhaps an appointment is forgotten, for example.

Psychosis

Psychosis can occur in both bipolar I as well as bipolar II. One issue we see is that the individual has been living with hallucinations and/or paranoid delusions for most of their life. So, they think everyone is experiencing it and that it’s normal. It can take someone letting them know that most people are not encountering this before they realize the problem. They don’t know that others don’t go through the same things.

When thinking about psychosis, many people might presume it would be very obvious. It would be so extreme it could not be missed. Perhaps. But this isn’t always the case. It can be subtle. It can be hard to distinguish sometimes because the delusions could be argued to be true.

For instance, an individual might suspect their spouse is cheating. Sometimes that unfortunately is happening. But in the case of bipolar psychosis, the loving, faithful spouse is demonized and accused of things they are not doing. They are home and remaining devoted, but the person in psychosis is convinced that they are up to something. The reality is that the situation is not true. It’s a delusion. But it will become challenging to convince the person otherwise no matter what opposing evidence is presented.

Like the rage mentioned above, psychosis, too, can be masked. The person can hide it at certain times and in certain circumstances. This means the person, again, could be at mom’s house and might be able to suppress things. Mom thinks all is relatively okay. Nothing is noted to be amiss. However, once back in their own home, they are insisting that their spouse is planning ways to destroy them – yet there are truly no grounds for the belief. It’s delusion thinking and paranoid thoughts taking over their brain. Suddenly, they tell their partner “I can’t trust you” when there really is no clear reasoning for this belief.

A difficult aspect of delusions is that the person can continue to function and socialize as normal. They don’t seem to be behaving in ways that are obviously odd or extreme.

A person with a delusion accepts the false beliefs relatively unquestioningly, even if and when there is evidence to the contrary. An attempt to contradict the belief can arouse a strong emotional reaction. The individual can become irritable and hostile. They may cut the person who is attempting to reason with them out of their life, discarding them as if they mean nothing. They become angry towards the person who was merely trying to assist them.

Psychosis can manifest in a variety of ways. The person could think others are against them. Everyone is, perhaps, manipulating and working to harm them. Or they could even believe their own spouse is plotting to have them killed or harm them in some other way.

The Positive News

All of this sounds terrible. It absolutely can be heartbreaking for you to watch your loved one struggle with these issues. And yes, someone in this state can cause immense harm to themselves and others. Relationships can be destroyed. Jobs lost. Lives ruined.

But, in the case of bipolar, these things are only present during an episode. This means that you will not see these symptoms when the person is stable. It’s a big indication that “something is wrong!” All of what you seeing and hearing is entirely out of the norm for the person.

If the diagnosis is properly treated, everything listed above can potentially be eliminated. The important thing is that the symptoms get identified early and that proper care is sought. This is not the time to worry about “what will people think.” And it’s critical to not put your head in the sand and ignore what is happening – there can be an inclination to notice things seem off, but to want to pretend it isn’t taking place or isn’t all that bad. Ignoring things won’t make them go away! In fact, ignoring can make things worse over time. We are dealing with someone’s brain and we don’t want to risk further damage.

While it certainly is hard and all of this is unpleasant, we must be honest and proactive. It’s the only way to make these symptoms stop – and maybe end them forever.