Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However, recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused repetitive cognitive activity, in depressed as well as in manic states.
Maladaptive strategies include venting, denial, substance use, behavioral disengagement, self-distraction, and self-blame.
“People with bipolar disorder often report that there's an obsession of the day or the week, and as one problem gets resolved, it can easily be replaced by another problem,” Hubbard says. “There's something in the brain that needs to ruminate and worry and obsess about different topics.
Thoughts such as suicidal ideation, self-blame and others are common in bipolar disorder. So if we understand that thoughts can be dysregulated in bipolar disorder, it stands to reason that intrusive thoughts may be one of the types of dysregulated thoughts that we may have.
Overthinking, Rumination & Bipolar Disorder
Most people overthink decisions or second-guess choices they've made at one time or another but when you have bipolar disorder, it can feel like you're on a hamster wheel without any signs of a slow down or an end in sight.
For example, the belief, I am unlovable, may be driving the conditional rule, If I am thin, then I will be loved by others, which may drive obsessive thinking about one's appearance, excessive exercise, or disordered eating habits.
The causes of maladaptive behaviors vary significantly. They can include personal history, learned behaviors, problematic thinking patterns, and emotional dysregulation issues. Difficulties with anxiety often cause maladaptive behaviors, too.
Patients with bipolar disorder may experience an exacerbation in executive dysfunction when manic or depressed, which may lead to a tendency to ruminate because of a failure to inhibit self-focused thoughts of a positive or negative nature.
Importantly, however, rumination is not only related to depression, but is involved in the development and/or maintenance of a broad range of disorders, including post‐traumatic stress disorder (PTSD), anxiety disorders, insomnia, eating disorders, somatic symptom disorder, and substance use disorders2, 3.
Messiness as a sign of an episode of mania
Overspending may result in a lot of purchases that you may not have room for at home. In turn, this could lead to cluttering. All these behaviors during an episode of mania could make messiness more likely to occur for some people living with bipolar disorder.
Bipolar disorder can cause your mood to swing from an extreme high to an extreme low. Manic symptoms can include increased energy, excitement, impulsive behaviour, and agitation. Depressive symptoms can include lack of energy, feeling worthless, low self-esteem and suicidal thoughts.
It's common for someone with bipolar disorder to hurt and offend their partner. When someone is first diagnosed, there are often relationship issues that need to be addressed. Couples counseling can help you: Understand that there's an illness involved in the hurtful behavior.
1. Mariah Carey. Singer, songwriter, actress and producer Mariah Carey has won too many awards to list. The iconic artist opened up in 2018 about her 2001 diagnosis of bipolar disorder, in which she was hospitalized for a physical and mental breakdown.
People with bipolar disorder can work, but they may face challenges. Many mental health conditions can make it difficult for a person to carry out day-to-day responsibilities, especially in the workplace.
Hypersexuality can exist as a sign of bipolar disorder or on its own. Also referred to as compulsive sexual behavior or sexual addiction, hypersexuality is described as a dysfunctional preoccupation with sexual fantasies, urges, or behaviors that are difficult to control.
Bipolar disorder may make it more difficult for you to interpret people's emotions. Missed clues make it harder for you to empathize when others feel happy or sad. If someone is feeling troubled, you may lack enough empathy to be moved to help.
With symptoms such as depressed mood or swift mood changes, bone-deep fatigue, and dark thoughts, living with mood disorders like bipolar disorder can be difficult at times. On the days when your symptoms peak, you may feel especially frustrated and overwhelmed.