Bipolar Disorder Symptoms and Diagnosis 6 Unusual Symptoms of Bipolar Depression How to recognize extreme emotions common to the condition. By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on April 14, 2024 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print asiseeit/Getty Images Table of Contents View All Table of Contents Irritability Anger Worry and Anxiety Pessimism Self-Criticism Indifference Close Sadness and lack of pleasure (dysthymia) are two of the most common manifestations of depression in bipolar disorder, but they aren't the only ones. When bipolar disorder reaches extreme levels, six other emotions can emerge and can be intense. Learning to recognize them in yourself or someone you know is crucial. What is bipolar disorder? Bipolar disorder is a complex mental illness characterized by periods of depression alternating with mania or hypomania. Signs and symptoms in the manic phase typically include insomnia, overcommitment to work and other activities, rapid speech, and grandiosity). Irritability Everyone gets cranky occasionally and often with good reason: a bad headache, a sleepless night, or an unexpected bill, for example. However, this garden-variety irritability can signal bipolar depression if it is out of proportion to its trigger. Depression alone also can cause persistent irritability that lasts for days or weeks at a time. Can Depression Turn Into Bipolar Disorder? Anger Anger is a natural, often reasonable response to day-to-day frustrations—for example, when a coworker is blatantly unfair or disrespectful. Anger also can be viewed as irritability that's been pushed to the person's limit. When to Be Concerned When anger is a symptom of bipolar depression, the person may seem to explode over a situation or event that would otherwise be considered a mild irritation. They may even become angry in the absence of an external trigger. Someone exhibiting anger as a symptom of bipolar depression may seem (or even say that they feel) angry for no reason. Feelings of anger may seem to erupt out of nowhere, but the person may have been thinking about the issue for some time. The anger can reach a tipping point over a seemingly harmless trigger. If you or a loved one is experiencing anger that persists, is frightening, or escalates to violence, it's time to reach out to a doctor or therapist. How Anger Management Works Worry and Anxiety As with anger, anxiety is natural in many situations. Normally, these emotions disappear when the issue is resolved. When they persist or get worse, they can indicate a mental illness. When to Be Concerned Worry that feels unending or out of control or proportion can be a symptom of depression. Someone with depression or an anxiety disorder may worry excessively about common everyday issues. For example, someone might worry disproportionately about everyday concerns and routine aspects of daily life such as household tasks or their commute to work. Thoughts such as I have to call the plumber, but what if he can't come today? or I'd better leave early for my appointment in case the traffic is bad can stem from underlying anxiety and depression. Anxiety can also make someone indecisive. They may enter into a cycle of thinking about what they need to accomplish but having difficulty committing to a solution. Some people with bipolar depression experience generalized anxiety and racing thoughts. Press Play for Advice On Dealing With Indecision Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring psychologist William Miller, PhD, shares how to deal with indecisiveness. Click below to listen now. Subscribe Now: Apple Podcasts / Spotify / Google Podcasts Pessimism Sometimes, negativity or a pessimistic point of view is warranted. However, many people with bipolar depression turn this negativity inward, which chips away at their self-concept and sense of their abilities. For instance, they may look at a Help Wanted ad and think: There's no point in applying for that job—I would never get it. When to Be Concerned With depressive pessimism, the negativity a person experiences is outsized to the reality of the situation. In fact, pessimistic thinking doesn't require a specific event. A person simply might think: It's going to be another bad day. A person with depression is impaired by negative, often critical, patterns of thought. They may not be able to see (let alone feel) that people like and care about them and that they are competent. Low Self-Esteem and Depression Self-Criticism Being able to recognize and address flaws is an important aspect of growth, but taking this to an extreme can indicate a problem. Understanding that all humans have old habits and unhelpful patterns of thinking that affect their relationships, careers, and health is important—and recognizing how you might be getting in your own way is key to moving forward. When to Be Concerned If you view yourself in an overly critical, even cruel, way rather than with compassion, you may be depressed. People with depression, anxiety, and other mental illnesses commonly focus on their flaws, often magnifying or even imagining them. This critical self-talk comes from one's internal critic: The thought I look tired today becomes I'm ugly. The realization I made a slight miscalculation in my budget becomes I'm an idiot with numbers. A simple (and easily corrected) mistake may propel someone into a deluge of self-destructive thoughts. I forgot to feed the cat becomes I'm a bad pet owner, irresponsible, and a worthless person. If you frequently berate yourself this way, depression may be talking rather than realistic self-criticism. Likewise, grappling with feelings of guilt (taking the blame for situations that are not your fault) may be a sign of underlying, perhaps even severe, depression. Indifference Simply put, indifference is not caring one way or the other. By that definition alone, indifference may not sound like a good feeling to have. Indifference certainly can cause problems, both in personal and professional relationships, as well as our relationship to the world around us. For example, being indifferent to the suffering of others compromises empathy. Not caring about the outcome of a certain situation, or being apathetic, is often an indication that we've lost motivation. However, it can be very useful in situations when it's necessary to push through without getting caught up in what others think or becoming distracted by your own feelings. Sometimes being indifferent is fairly benign: for instance, when a friend asks you where you want to have lunch, you may find you don't have a preference and would be content with any of the options. When to Be Concerned When indifference leads to inaction, it could indicate you're dealing with depression. If you notice that the laundry has piled up, you haven't paid the bills —but you just don't care, this can be a sign that your level of indifference is creating problems in your life. It's important for you and your loved ones to know that in these instances, it's not that you don't care—you can't care because of the shell of indifference created by depression. You may notice your indifference affecting your relationships. For example, a friend may come to you with a problem and rather than feeling engaged and compassionate toward them, you might find yourself sitting there silently or perhaps offering polite noises of agreement. Mostly, you just feel detached. The various symptoms of bipolar depression can be challenging to identify, but the more you understand them the easier for you (and those around you) to recognize your patterns. Having an accurate diagnosis, support from a team of medical and mental health care professionals, and treatment that's effective for you will help you effectively manage your symptoms. If you or a loved one are struggling with bipolar disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Learning to cope with any mental illness, including bipolar disorder, takes time. Keep in mind that it's a process–and one that you don't have to go through alone. Coping With Bipolar Disorder 3 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Mental Health. Bipolar disorder. Updated January 2020. Ballester J, Goldstein T, Goldstein B, et al. Is bipolar disorder specifically associated with aggression?. Bipolar Disord. 2012;14(3):283-90. doi:10.1111/j.1399-5618.2012.01006.x Anxiety and Depression Association of America. Depression. Additional Reading Bipolar Disorder. National Institute of Mental Health. Nih.gov. Published October 2, 2019. American Psychiatric Association. What Are Bipolar Disorders? Psychiatry.org. Published 2017. By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit