Bipolar Disorder: Preceded by Mood Changes and Sleep Problems

AngerIt is not uncommon for an unsteady mood and sleeping problems to occur before the onset of bipolar disorder.[1] In fact, the earliest signs to appear are often irritability, impatience, social isolation, weight gain, tiredness, and suspiciousness.1

According to Dr. Eike Zeschel of Ruhr University—Bochum, “These symptoms might be indicators for early recognition of bipolar disorder.”1 For example, patients with bipolar disorder often report mood changes and disturbed daily rhythm during the months that lead up to their first depressive or manic episode.1 Psychosis-like symptoms also occurred significantly more often before a depressive episode rather than before a manic episode.1

Zeschel and colleagues conducted a study in which participants were approximately 35 years old.1 Twenty-seven patients had bipolar disorder type I and 15 had bipolar disorder type II.1 Overall, every patient with type I bipolar disorder and all but one patient with type II reported having at least one pre-onset symptom.1

Pre-depressive symptoms lasted significantly longer—4.1 months—than pre-manic symptoms—1.3 months.1 The frequency and severity of the symptoms were similar between the two types of bipolar disorder, however.1

The most common symptoms that preceded the first depressive episode were depressed mood, reduced energy, physical exhaustion, tiredness, and social isolation.1 On the other hand, the most frequently reported symptoms before the first manic episode were feeling extremely energetic, physical agitation, talkativeness, racing thoughts, and low requirement for sleep.1

According to Zeschel, “In general, early symptoms showed a progressive, accelerating course toward a full-blown mood episode. Symptoms became more prevalent and more specific to the respective affective phase the closer the patients got to their mood episode.”1

General symptoms, such as unsteady mood and disrupted sleep patterns, also occurred frequently in both groups of participants.1 The first symptoms to appear in both patient groups were irritability, impatience, social isolation, weight gain, tiredness, and suspiciousness.1

Zeschel said, “These findings highlight the necessity to inquire about the patients’ entire psychopathological symptom ‘package’ and not only about specific affective symptoms when suspecting that they may be developing bipolar disorder.”1

[1] Pedersen, T. (2013). Bipolar Often Preceded by Mood Changes, Sleep Problems. Psych Central. Retrieved on December 27, 2013, from http://psychcentral.com/news/2013/12/21/bipolar-often-preceded-by-mood-changes-sleep-problems/63606.html

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