Mental Health Home > Manic Depression Symptoms


Some people with symptoms of manic depression might experience psychosis (or psychotic symptoms) during severe episodes of mania or depression. Common psychotic symptoms include:
  • Hallucinations (hearing, seeing, or otherwise sensing things that are not actually there)
  • Delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts).
Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the president or has special powers or wealth, may occur during mania. Conversely, delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with manic depression who have these symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness.

A Spectrum of Manic Depression Symptoms

It may be helpful to think of the various mood states in bipolar disorder as a spectrum or continuous range. At one end is severe depression, above which is moderate depression, and then mild low mood. Many people call "the blues" when it is short-lived, but it is termed "dysthymia" when it is chronic. Then there is normal or balanced mood, above which comes hypomania (mild to moderate mania), and then severe mania.
In some people, however, symptoms of mania and depression may occur together in what is called a mixed bipolar state. Symptoms often include agitation, trouble sleeping, a significant change in appetite, psychosis, and suicidal thoughts. A person may have a sad, hopeless mood while at the same time feeling extremely energized.
Manic depression symptoms may appear to be problems other than mental illness. For example, alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships may not be recognized as stemming from bipolar disorder. But these types of problems may, in fact, be signs of an underlying mood disorder.
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
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