What is Bipolar 1 Disorder? Bipolar I Symptoms

Bipolar 1 disorder, once known as manic depression, is a mental illness that involves vast, out-of-control mood swings from depressed to elevated moods. There are four types of bipolar disorder:

  1. bipolar 1
  2. bipolar 2
  3. cyclothymia
  4. bipolar not otherwise specified

Bipolar 1 is the type most easily diagnosed as it contains the most pronounced elevated mood, called mania. A person with bipolar 1 (also noted as bipolar i) has episodes of both mania and depression. The presence of these episodes are the hallmark symptoms of bipolar I.

About 6 million people, or 2.5% of the U.S. population, suffers from bipolar disorder. About 1% of the people in the U.S. are thought to have bipolar 1 disorder.

Bipolar i symptoms consist of the symptoms for major depression and manic episodes. People with bipolar 1 swing between mania and depression.

Bipolar I Symptoms of Mania

A Bipolar I diagnosis requires at least one manic episode in the person's lifetime with a duration of one week or more. In order to be considered a manic episode, it must drastically impair a person's social or occupational functioning, or lead to hospitalization. It must not be attributable to another condition.

A manic episode is characterized by a profound mood disturbance of elation, irritability or expansiveness. According to the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), at least three of the following bipolar 1 symptoms of mania must also be present:1

  • Grandiosity
  • Diminished need for sleep
  • Excessive talking or pressured speech
  • Racing thoughts or flight of ideas
  • Clear evidence of distractibility
  • Increased level of goal-focused activity at home, at work, or sexually
  • Excessive pleasurable activities, often with painful consequences

People are most frequently diagnosed with bipolar type 1 when they have a manic episode that results in hospitalization. Bipolar psychosis can also be part of mania.

Detailed information on Bipolar Mania

Bipolar 1 Symptoms of Depression

Bipolar 1 disorder also requires the presence of major depressive episodes. According to the DSM-IV-TR, a major depressive episode must consist of either a marked depressed mood or loss of pleasure / interest for at least two weeks. Bipolar I symptoms of a major depressive episode must cause significant impairment or distress and must not be explained by another illness.

A depressed episode also must contain four or more of the following bipolar 1 symptoms of depression (three if the person shows both a depressed mood and lack of pleasure):

  • Significant weight loss or gain or significant loss or increase in appetite
  • Hypersomnia or insomnia – too much sleep or too little
  • Psychomotor retardation or agitation – lethargic or agitated movements and demeanor; can be seen by others
  • Loss of energy or fatigue
  • Decrease in self-worth or feelings of guilt
  • Decreased concentration ability or marked indecisiveness
  • Preoccupation with death or suicide; patient has a plan or has attempted suicide

Detailed information on Bipolar Depression

Bipolar I Symptoms of a Mixed-Episode

A bipolar 1 disorder episode may be diagnosable as both a manic and a depressed episode. This is known as a mixed episode and is quite common in bipolar disorder type 1. For a mixed episode diagnosis, the depression need only be present for one week.

article references

next: What is Bipolar 2 Disorder? Bipolar II Symptoms
~ all articles on types of bipolar disorder
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Last Updated: January 29, 2018

Reviewed by Harry Croft, MD