Depressive symptoms in bipolar patients also tend to be atypical, i.e., one sees an increase in sleep and appetite, a feeling of heaviness in the body, a tendency to feel rejected, and a preservation of volatile mood. One interesting study reported that many bipolar patients experienced dreams of death at the low point of their depression, and these dreams were soon followed by an upward mood change. Untreated pure mania can last three to six months. With hypomania the same symptoms appear in milder forms and are of shorter duration, so they do not affect social or work life as dramatically and hospitalization is not generally required. Irritability is most often the first noticeable change in behavior at the onset.
Some patients experience intense sexual energy or a marked increase in strength.
For true mania, the patient's behavior must also have caused significant social or work problems and the symptoms must have lasted at least a week or have caused hospitalization. The most common symptom. Easily distracted when confronted by unimportant or irrelevant stimuli and an inability to focus on tasks for any long period of time. Flight of ideas or racing thoughts. Increase in intensity in goal-directed activities related to social behavior, sexual activity, work, school, or combinations.