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My friend, Sarah, has always been a bit different than other ladies. She’s often been called unstable, manic, and unreliable by people in her social circle.
One word that people use to describe her is “moody.” But is she really, or is she different because her thought patterns are different from yours or mine?
Can we truly understand just how a person with bipolar thinks?
Sarah was recently diagnosed with bipolar I disorder. It hasn’t been an easy journey for her or her family. But understanding how her mind is unique and what influences her thought patterns has enabled her close family and friends to help her manage her mental health challenges.
For one, the idea that she’s only up or down is a stereotypical oversimplification. The bipolar mind’s inner workings are complex, and only by making the effort to understand how she thinks, can her friends support her.
How does the bipolar mind work? How does someone with bipolar think? Here’s what Sarah taught me.
What Is Bipolar Disorder?
In the early years when modern psychology was still developing, bipolar disorder was known as manic-depressive illness or manic depression, which only focused on the abysmal lows that people with the condition may suffer. Of course, it’s not that simple.
With bipolar disorder, the person experiences an unusual spectrum of mood swings and other characteristics like energy level changes, activeness turned to non-activity, and disrupted concentration abilities, which all affect their day-to-day living.
Bipolar disorder is disruptive to the person who has it and the people around them.
In the bipolar condition, several states are experienced, known as episodes. Energized or hyper behavior is called a manic episode, while the other end of the spectrum features lows and a lack of energy, which is called a depressive episode.
A bipolar person, like Sarah, doesn’t easily find a state of equilibrium or calm. They may have a slightly less severe manic episode, which is called a hypomanic episode, but this is still far from normal behavior.
Yet, it’s the disturbing way in which the bipolar sufferer shifts between the highs and lows that causes the most mental damage to their lives.
Five distinct types of bipolar disorder have been identified, and a diagnosis will indicate which type of bipolar disorder someone has.
Bipolar I Disorder
Characterized by severe manic episodes of 7 or more days, and depressive stints of 2 or more weeks.
Bipolar II Disorder
Characterized by depressive episodes that last 2 or more weeks, followed by hypomanic episodes, which are less severe than manic episodes.
Milder than bipolar II, cyclothymia has recurring episodes (hypomanic and depressive) that are mild and short-termed.
Medication-Induced Bipolar Disorder
Bipolar-like symptoms caused by chemical withdrawal symptoms or resulting from substance abuse and intoxication.
Medical Condition-Induced Bipolar Disorder
Certain illnesses such as Cushing’s Disease, multiple sclerosis, and traumatic brain injuries can cause similar symptoms to bipolar I and II.
Unspecified Bipolar Disorder
When you experience the same symptoms as bipolar disorder, but you don’t meet the usual criteria, you may be classified as having this condition.
Bipolar symptoms usually show up in your late teenage years or in early adulthood. To manage the effects of this condition, medical treatment (as well as counseling) is required for the rest of your life.
How Is Bipolar Disorder Diagnosed?
Bipolar disorder is diagnosed by a psychologist or psychiatrist when certain symptoms are present and for a specific period. These periods are called episodes.
Manic Episode Symptoms:
- Extreme elation or serious irritability
- Anxiety and jumpy behavior
- Less desire to sleep or rest
- Verbal vomiting about ideas
- Racing thoughts (not always able to articulate these)
- Excessive activity with no sign of fatigue
- Excessive indulgence in pleasure-related activities (food, drink, sex)
- Delusions of grandeur
Depressive Episode Symptoms:
- Lasting sorrow or anxiety
- Sluggish behavior and restlessness
- Insomnia or oversleeping
- Slurred speech or bouts of non-conversation
- Poor conversation skills and indecision
- Self-doubt over silly things
- Lack of interest
- Feelings of low worth, suicidal thoughts, obsession with death
The symptoms exist on a sliding scale, as all mental health states do.
So while a bipolar person may be absolutely intent on sleeping for days on end due to a depressive episode, they may also only yawn continuously and express feeling tired. It depends on the severity of the episode.
Sarah’s family noticed the dizzy highs and lows, which is how she got medical help and a diagnosis. She only knew she was tired but suddenly sparked with energy, and then she was tired again.
Someone with bipolar disorder rarely sees their own mood swings. Only with correct treatment can the symptoms be managed. Without treatment, symptoms can quickly worsen.
Treatment Options for Bipolar Disorder
There are a few ways to help someone with bipolar disorder. Your family doctor or counselor may recommend a specialist psychologist or psychiatrist or other resources to you and your family.
Medication helps alleviate the extreme symptoms and keep milder symptoms under control. A psychiatrist would prescribe mood stabilizers and atypical antipsychotics to help balance your mood.
With medication like lithium, anxiety is managed, which helps to stop a manic episode leading to suicide.
Talking about your mental health and the symptoms you experience is vital to help create a management plan and also to help the person with bipolar disorder to become more self-aware and regain some power over their lives.
Cognitive behavior therapy (CBT) is another type of psychotherapy which helps treat depression, and it can also help people like Sarah sleep better.
Electroconvulsive Therapy (ECT)
In extreme cases where medication has not alleviated symptoms, a psychiatrist may prescribe ECT, which is when the brain is shocked in an attempt to reset brain function and chemical balance.
If ECT is too risky, repetitive transcranial magnetic stimulation (rTMS) may work, which is when magnetic therapy is used on the brain.
How Mental Health Conditions Affect Your Thoughts
Your mood affects everything about your life and your perception of the world around you. Your mental health condition, such as bipolar disorder, affects your thoughts as you swing between manic, hypomanic, and depressive states.
A depressed state is not just about being sad. When you are manic, you are not merely happy. The thinking behind each is unique, and this thinking creates changes in behavior and reasoning.
Only with sustained medical treatment, therapy, and by working closely with your psychologist, can bipolar disorders be managed. This is not something you outgrow.
How a Person with Bipolar Thinks: 16 Thought Patterns
Sarah’s family told me that the symptoms were only visible manifestations of what is going on in her mind. Her thoughts work quite differently from the average Jane’s mind.
What may seem normal to her is considered abnormal to us, which is where conflict and misunderstandings happen. So to help Sarah, understand her, and better manage her condition, her family had to learn about the type of thinking that she might experience.
Here are the thought patterns a bipolar person may have during manic and depressive episodes (and also during hypomanic episodes – to a lesser extent).
Of course, this is only to give you an indication and help you understand, not to say this is exactly how a bipolar person thinks because, ultimately, we are all unique.
A Bipolar Person’s Thought Patterns During Manic Episodes
1. Rambling Speech
A bipolar person may experience an irrepressible urge to talk, to have a monologue, and to ramble. Even when the person they are talking to has stopped paying attention, they keep on prattling away.
They become as impulsive and exuberant as a child.
Example: Michelle Pfeiffer performs a rambling scene in the movie, The Story of Us, which approximates this type of rambling.
2. Rally Brain
In this heightened state, the bipolar person will experience a dizzy rush of racing thoughts, all jumbled together. Distraction often features as they seem unable to focus on one topic at a time. This can also be called flights of ideas.
Example: “I love eggs. Wow, that’s a cool tie you’re—. I missed the bus yesterday, but you drive faster, so I’ll go with you. They sent me a mail about a tax rebate, and I drank a cola.”
3. Divergent Behavior
When thoughts begin to snow-ball, it’s known as tangential thinking, which means ideas run through your brain faster than you can focus on them.
You start a discussion, based on what was being discussed around you, but the conversation runs off wildly, never answering the original question or idea.
Example: “I agree that coffee is better than … But I love orange juice, and ice cream is my favorite too.”
4. “I Am King”
Delusional thinking, feeling that you’re more important or capable than you really are and even thinking you’re the Messiah or a savior are all typical of these hallucination-type thoughts. Bipolar highs can lead to this type of thinking.
Example: “I was on the front page for the cake I baked for my daughter’s birthday. I must be the best baker in town or this state!
5. Random Associations
Mental health episodes such as manic bipolar events can prompt free-form association, where you identify something roughly related to your topic of discussion (but it’s actually unrelated), such as matching word sounds with odd rhymes.
Example: Mel Gibson’s character in Conspiracy Theory has several instances of this in rants, where he talks about how he’s feeling, then says, “the paint is peeling on the ceiling.”
When a bipolar person has a manic episode that causes psychosis, they may think they are both victim and villain.
One moment, they’ll tell you they were poorly treated or that someone attacked them, and suddenly, they are the most important person in the world.
In extreme cases, the hallucinations may become so severe that the person may lose all contact with reality, which usually requires medical intervention to alleviate.
Example: “I was chased down the road by the police, but they realized I had saved the kids from the burning bus, so they gave me a medal on the town hall steps.”
7. Long-Winded Discussions
It may sound like elaborate thinking or convoluted speech, but a manic episode may trigger an inability to think critically about what information is pertinent to a topic.
So the bipolar person ends up discussing everything even remotely related to a topic, usually all jumbled together with unnecessary information thrown in.
Example: “I love hotdogs. I had a hotdog in New York once, but I hated the mustard they put on with the onions. One day I want to own a hotdog stand, but I’m also gluten intolerant.”
A Bipolar Person’s Thought Patterns During Depressive Episodes
8. Highly Self-Critical Thinking
We all have some self-doubt, but the depressive episodes of a bipolar person can lead to severe and harsh negative self-talk.
It can become so severe that they believe they have no purpose and should rather end their lives – which is where suicidal thinking also begins.
The bipolar person may not necessarily know how to explain what they are thinking during this stage, which makes therapy less effective until their rush of thoughts has been calmed down with medication.
Example: “I am so pathetic. Nobody can possibly love someone like me; just look at how I mess everything up.”
9. Brain Blocking
A depressive episode may trigger incomplete thinking or thought blocking. When this happens, the bipolar person starts a sentence, then leaves out the rest of the information, with their brain having blocked that information.
Example: “I ordered the lobster at the restaurant, and Jane told me … (silence).”
The fragile state of a bipolar person’s mind during a depressive state means that they may think in circles. Like a dog chasing its tail, they keep rehashing negative thoughts.
If they face a problem, they keep picking at the problem, but they lack the ability to find a solution or think outside the problem to ask for help. Instead, they are stuck and grind their mental wheels. Soon, they feel hopeless, which may deepen the depressive episode.
Example: “I don’t know how I am going to get to work on Monday. I have to work on Monday, but there’s no way I will be on time. I have no transportation to work on Monday. I’m going to get fired for missing work on Monday.”
11. Lacking Words
When a depressive episode has hit hard, it may cause the bipolar person to lose the ability to form sentences or hold coherent conversations. Instead, they may grunt, mutter a few words repeatedly, or stick to “yes, no” answers, no matter what you ask them.
Example: “Where do you live?” – Yes
12. Black-and-White Thinking
Known as a common logical fallacy, someone with bipolar disorder will often see life in terms of black and white, with no shades of gray. Usually, this thinking is also negative in nature.
Instead of seeing that there are reasons why they couldn’t make it to their cousin’s baby shower, they keep fixating on how bad they are for not going.
Example: “I lost my wallet. I am such a terrible person for losing my wallet. I am going to be broke now, and I’ll never find the wallet. I suck as a person for losing my wallet.”
13. Emotional Overload
During a depressive episode, a bipolar person is exceptionally fragile in their ability to regulate emotions, and negative emotional thinking quickly takes over. They feel a black cloud of depression that overwhelms them.
They draw conclusions about themselves based on their feelings, not facts. As you can imagine, this can become very self-destructive.
Example: “I am so fat. People must hate me because I am so fat. Nobody will hire me or even talk to me at a job interview because I disgust them with my fat.”
14. Catastrophic Thinking
Another example of bipolar thinking when in the grips of a depressive episode is catastrophic thinking. It’s when you associate a small act with dire consequences, ignoring the illogical connection.
No matter what, you play out worst-case scenarios in your mind, which leads to anxiety and more trauma.
Example: “My boss frowned at me in the lobby. I’m sure he’s got my pink slip on his desk even now. I’m going to be fired, and I’ll lose my health insurance, which means I’ll go crazy and be locked up.”
15. Simplified Views
The bipolar person who starts thinking in simplified terms is trying to make generalized conclusions about their life. They take something small and see everything else in the same light. This makes them generalize and find excuses for lambasting themselves.
Example: “I don’t feel like my treatment is working since I’m not feeling better. No other treatment will work either. I won’t go back to see my psychiatrist or psychologist.”
Being depressed, feeling like it’s the end of the world, and lacking the ability to think outside the box, the bipolar person quickly starts to think that everything is their fault.
If they see someone looking at them, they assume that person is thinking ill of them or gossiping about them.
Example: “My partner didn’t speak to me at all during dinner. They must be mad at me. I did something to upset them.”
Final Thoughts About How a Person with Bipolar Thinks
Truly understanding how anyone with a mental illness, like being bipolar, thinks isn’t easy. But we can try to understand so we can be there for our friends and family who are going through this.
And if you suspect you may be bipolar or have been diagnosed, understanding these thought patterns may give you insight into how you think and process, and then you can work with a mental health professional to further guide you.
We often learn from movies, and these 21 best films that explore mental illness are must-see movies that will help you understand bipolar thinking better.
And if you're looking for more articles about mental health, be sure to check out these blog posts:
- 23 Best Fidget Toys for Adults With Anxiety
- What to Talk About in Therapy? 22 Topics to Consider
- Self-Gaslighting: 9 Signs & How to Stop Gaslighting Yourself
Finally, if you want to identify YOUR personality type, then take one of these 11 personality tests to better understand what makes you tick.