The depressive episodes in manic depression follow the same diagnostic criteria as those of Clinical Depression or Major Depression.


Symptoms of a depressive episode include:

* Persistent sad, anxious, or “empty” mood

* Feelings of hopelessness, pessimism

* Feelings of guilt, worthlessness, helplessness

* Loss of interest or pleasure in hobbies and activities that were once enjoyable

* Loss of interest in sexual activity

* Decreased energy, fatigue, being “slowed down”

* Difficulty concentrating, remembering, making decisions

* Insomnia, early-morning awakening, or oversleeping

* Changes in appetite –decreased appetite causing weight loss or overeating and weight gain

* Thoughts of death or suicide; suicide attempts

* Restlessness, irritability

* Persistent physical symptoms that do not respond to treatment such as headaches, digestive disorders, and chronic pain


Description of less severe symptoms:

* Fluctuation mood throughout the day.

* Disruption of the usual sleep pattern

* A general slowing down of thinking, speech, and movement

* Feelings of Anxiety

* Tearfulness for no apparent reason

* Shortness of tolerance or short temper

* Lack of energy and/or exhaustion

* Inability to experience enjoyment

* Being forgetful

* Feelings of confusion in general

* Inability to concentrate

* Difficulty making decisions

* Negative thoughts about the future

* Being preoccupied with minor pain or illness

* Feeling lonely even in the presence of others

* Loss of identity

* Feelings of guilt

* An unrealistic sense of failure

* Negative feelings about the self


This phase of the disorder can be characterized by withdrawal from family, friends and social events and interaction. Individuals often complain that they are unable to cry and have difficulty finishing tasks. There are complaints of sadness, anxiety, pessimism, worthlessness, guilt, and absence of pleasurable experiences.

The manic phase of manic depression is characterized by excessively elevated euphoric mood, irritability, racing thoughts and inappropriate social behavior.


Other symptoms of mania are:

• Inflated self-esteem or grandiosity

• Decreased need for sleep

• More talkative than usual

• Flight of ideas or racing thoughts

• Distractibility

• Increase in goal directed activity

• Excessive involvement in pleasurable activities that have the potential for painful consequences. For example, activities having to do with finances, sexual activity, or foolish business decisions.

When the affected individual is experiencing the manic phase of bipolar depression disorder he or she might also experience the following:

• Feeling overly happy

• Feeling hyper

• Feeling grouchy

• Feeling restless

• Having difficulty concentrating

• Going days without needing sleep

• Thinking and talking fast

• Acting in an abrupt or rude manner


In the manic phase of bipolar disorder one can feel on top of the world and capable of anything. This feeling can lead to reckless behavior leading to problems in all areas of life. For example, spending sprees, drug and alcohol abuse, risky sexual activity, and behaviors that can cause problems with work.

Another less common phenomenon is a mixed episode where the individual experiences depression and mania simultaneously. In this case one might feel extremely happy but unable to concentrate, or having difficulty concentrating and focusing.

Manic Depressive disorder is a severe and serious form of depression for which there is no cure. But, in most cases the disordered individual responds well to medications for chemical balance and psychotherapy, namely cognitive therapy, approaches which helps determine the underlying causes of the depression and guides the individual in learning and developing coping techniques to deal with or change those underlying causes.