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How Does a Person With Bipolar Disorder Think?

If someone in your life has bipolar disorder, there’s a good chance that their behaviors have sometimes been sources of confusion, frustration, or even fear. One way to address these concerns is to learn how a person with bipolar disorder thinks. Empathy alone won’t make their problems magically disappear – but the more you understand about their thought processes, the better prepared you will be to keep your loved one safe and help them find effective treatment.

Understanding Bipolar Disorder

Bipolar disorder is a complex mental health condition that is characterized by dramatic swings in mood, attitude, and energy. 

To understand how a person with bipolar disorder thinks, it is important to first review a few basic facts about the condition, including the three main symptom types and the three most common versions of the disorder itself.

Types of Symptoms

As established in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptoms of bipolar disorder often occur as episodes:

  • Manic episode: A manic episode is a period of at least one week during which an individual exhibits elevated mood as well as a significant increase in motivation, confidence, and energy. The symptoms that a person experiences during a manic episode can be intense enough to impair their ability to function in one or more important areas of life.
  • Hypomanic episode: A hypomanic episode is similar to a manic episode, except the symptoms are a bit less intense and don’t last as long. The DSM-5 criteria for the duration of a hypomanic episode is four days.
  • Major depressive episode: During a major depressive episode, a person will struggle with low mood, diminished energy and motivation, persistent fatigue, and similar symptoms. To qualify as a major depressive episode as defined in the DSM-5, these symptoms must be present most days, for most of the day, for a period of at least two weeks.

Types of Bipolar Disorder

There are three primary types of bipolar disorder, which are differentiated by the nature, intensity, and duration of symptoms:

  • Bipolar I disorder: To be accurately diagnosed with bipolar I disorder, a person must have at least one manic episode. People who have bipolar I disorder often also have major depressive episodes, but those are not a requirement for this diagnosis.
  • Bipolar II disorder: Someone who has bipolar II disorder will have at least one hypomanic episode and at least one major depressive episode, but they cannot have had a manic episode. (The presence of a manic episode would qualify the individual for a bipolar I disorder diagnosis.)
  • Cyclothymic disorder: People who have cyclothymic disorder will have periods of hypomanic symptoms and periods of major depressive symptoms, but neither will rise to the level of a full hypomanic or major depressive episode. These symptoms will persist for at least two years, with no asymptomatic periods longer than two months.

How a Person With Bipolar Disorder Thinks

The only way to understand exactly how a person with bipolar disorder thinks is to be a person with bipolar disorder. The many factors that can influence a person’s thought process include:

  • Which version of bipolar disorder they have
  • How long they have been living with bipolar disorder
  • The type of episode or symptoms they are currently experiencing
  • If they are taking medication for bipolar disorder
  • If they have participated in therapy to help them manage their symptoms
  • The quality of their personal support system
  • If they have any co-occurring medical or mental health concerns

Given all of these variables, the following two subsections include examples of how (or what) a person with bipolar disorder may be thinking.

During a Manic or Hypomanic Episode

While experiencing manic or hypomanic symptoms, someone with bipolar disorder may have the following types of thoughts:

  • Their mind races from one thought to the next, and they feel like they can’t keep up.
  • They feel compelled to launch new projects or take on new tasks, often adding multiple projects to their schedule.
  • They are extremely confident in their skills and abilities, to the point that they are sure they could achieve success in areas where they have no training or experience.
  • They are so excited about their plans that they don’t want to go to sleep.
  • They become easily distracted when trying to express their ideas or hold a conversation, which often precludes them from sharing the information they had intended or learning from the person they are speaking with.
  • They have little to no capacity for self-censorship. If they have what they believe to be a great idea, they want everyone to know about it. If they are angry about something, they won’t be able to hold their tongue.
  • They lack the ability to constrain their urges, which often results in potentially harmful impulsive behaviors such as unsafe sex, reckless driving, shopping sprees, and gambling with large amounts of money.

On a superficial level, some manic or hypomanic symptoms (such as elevated confidence, energy, and motivation) can sound like positive attributes. But it is important to realize that the extreme nature of these symptoms can be sources of great harm. 

For example, while it is laudable for a person to be confident in their abilities, an unfounded belief in their own infallibility could cause them to engage in behaviors that damage their health, relationships, and financial well-being.

During a Major Depressive Episode

At the other end of the psychological spectrum, depressive symptoms can affect a person’s thoughts in the following ways:

  • They have little to no motivation, which can make it difficult to even get out of bed.
  • They struggle with low self-esteem and a profound lack of confidence in themselves.
  • They find it quite difficult to concentrate or focus.
  • They are easily irritated, frustrated, and discouraged, with even minor annoyances or setbacks capable of derailing their attempts to make progress.
  • They have little to no interest in sex.
  • They lose interest in sports, hobbies, or other activities that used to be important to them, which may be due to either low motivation or an inability to experience joy.
  • They have recurrent, intrusive thoughts about death and dying.
  • They think about harming themselves or attempting to end their own life.

The disruptiveness of these maladaptive thought patterns underscores the importance of finding effective comprehensive care for bipolar disorder. With proper treatment, a person can experience relief from some symptoms, learn to manage others, and exert greater control over their thoughts and behaviors.

Find Bipolar Disorder Treatment in Atlanta

Peachtree Wellness Solutions offers a full continuum of customized programming for adults who have been living with bipolar disorder and other mental health concerns.

Features of care at our mental health treatment center in Atlanta, Georgia, include individualized planning, evidence-based services, and close personal support, all provided by a team of skilled and compassionate professionals. We understand how disruptive untreated bipolar disorder can be, and we are here to help you find your path to a healthier and more hopeful future. 

To learn more or to schedule a free assessment, please visit our Admissions page or call us today.