Bipolar disorders are classically described as an alternating sequence of excited/agitated phases and depressed/inhibited phases. This description corresponds to a reconstruction of what happens over time and presents the various symptoms grouped into two categories that are opposites of one another: manic symptoms and depressive symptoms (for example, psychomotor slowing and agitation, euphoric or excited mood versus depressed and withdrawn mood, increased or reduced energy, and so on). However, the “bipolar” symptoms themselves are not usually described—that is, those symptoms that allow bipolar disorder to be recognized independently of the current phase. In other words: what do a person in a manic phase and the same person in a depressive phase have in common? Are there elements that can indicate bipolar disorder while the person is in a depressive phase, distinguishing it from simple (unipolar) depression or from depression occurring in the context of other illnesses?
Bipolar disorder usually retains one characteristic: mood instability, which is expressed through three “dynamic” parameters: switchity (the tendency to move, either suddenly or more gradually, from one phase to another), mixity (the simultaneous presence of elements belonging to both the depressive and manic states), and polarization.
All these characteristics belong to the “temperamental” or “personality” version of bipolar disorder, known as cyclothymia, and are particularly useful in describing milder bipolarity, that is, cases in which there are no phases with extreme symptoms (cyclothymic disorder), or in which only the depressive component reaches full intensity (bipolar II disorder). In cyclothymic personalities, rather than the individual mood “phases,” these elements of mood variability are particularly evident and can be described as follows.
Polarization
A “polarized” mood is not simply a mood located at a manic or depressive level; it is a mood that is “magnetized” in one direction, toward one pole. In practical terms, this means that a person with bipolar disorder is usually not simply euphoric or depressed, but is always “excited” in either a manic or depressive direction—that is, so to speak, “launched” or “tense” toward mania or depression.
A typical feature is blindness to the preceding or forthcoming phase: the current mood becomes the only key for interpreting reality. It becomes a kind of “illumination” (positive or negative) that colors reality with a series of meanings and provides a total explanation, like a revelation or an absolute and definitive point of view.
A person in a particular mood state does not perceive the possibility of change, even if their mood has changed dozens of times before. This means having no hope during depression, or failing to perceive the risk, superficiality, or lack of realism during mania.
For example, a person polarized in a manic direction is not simply “saturated” with good mood, but continually tends to seek an additional stimulus. Whereas simple happiness or contentment is a relatively stable state, manic or hypomanic excitement tends toward still greater excitement.
For this reason, people with a hyperthymic temperament and those with a cyclothymic temperament may be in a similar state of euphoria—the former continuously, the latter intermittently—but cyclothymic individuals tend to be more impulsive and more likely to become involved in new and risky activities. By contrast, hyperthymic individuals, at the same level of mood, are more constructive because they are more consistent.
People who enter a particular mood phase often experience it as a revelation or conversion, which they attribute to the circumstances and people of the moment. It may be a disappointment or abandonment during depression, or an illumination or awakening during a manic phase. In this perspective, they lose awareness of the fact that it is the mood that has changed, rather than reality itself.
Graphically, the idea could be represented by showing a non-bipolar mood as a small mark positioned high or low on a scale, whereas bipolar mood could be represented by an arrow “pointing” upward, downward, or—according to the concept of mixity—in lateral directions as well.
A non-bipolar mood can therefore be schematized on a scale, whereas bipolar mood requires a sphere, in which there is a tendency from the center toward the surface.
Polarization, as mentioned, occurs both in mild and severe forms. This is precisely what can help identify bipolarity within major depressive episodes or during periods of apparent equilibrium between major episodes.
Switchity (Mood Switching)
The tendency for mood to change manifests itself independently of the current phase.
Mania, for example, is typically unstable: mood may rapidly shift from euphoric to irritable, and an attitude may change from friendly to hostile. Mood can change rapidly in response to an external stimulus, from euphoric to desperate, or from indifferent to euphoric.
Alternatively, there may be smaller changes that nevertheless interrupt the continuity of a depressive or manic phase.
A depression may be interrupted by periods lasting several hours, usually in the evening, during which the person suddenly becomes capable of going out, meeting people, and engaging in relationships, only to return to complete isolation and inactivity the following day.
Alternatively, there may be “lethargic” periods interrupted by episodes in which the person writes, talks to themselves excitedly as if performing a kind of drama, conceives important ideas, eats voraciously, or uses substances.
During mania, or in people with a “euphoric” temperament, there may be brief interruptions, even lasting only a few hours, during which the mood becomes melancholic and pessimistic, with sad memories and demoralization over perceived wrongs, before eventually returning to its main course.
In other words, there may be incomplete mood switches that allow the other “pole” of mood to emerge even when it is not the predominant one: mania briefly appearing within depression, or depression briefly appearing within mania.
Mixity (Mixed State)
A proportion of the phases of bipolar disorder are “mixed,” meaning that they contain depressive and manic symptoms simultaneously, or in rapid and continuous alternation.
The phases are said to be “out of sync,” meaning that not all symptoms are depressive at the same time, nor manic at the same time.
For example, there may be motor agitation together with depressed mood; racing thoughts without the initiative to act; an elevated mood without the ability to conceive or develop thoughts and projects.
These are the classic mixed states.
Bipolar mood is often “mixed” in any case: a state of impulsivity or increased activation may be accompanied by a negative, worried, or furious mood. The person may describe this as “depression,” but it is actually also an agitated depression.
Alternatively, a person may be simultaneously melancholic and sad but creative, withdrawn and isolated in their own world while at the same time developing grandiose imaginary plans for a different life, and so on.
In cyclothymic temperament, this coexistence of depressive and excited elements is a frequent experience: being sad and excited at the same time, moving from laughter to tears, being attracted to or becoming exhilarated by negative or destructive aspects, finding “light in the darkness,” or, conversely, feeling sad in the middle of a party.
Many cultural and artistic movements or trends are based precisely on this kind of sensitivity and “mood aesthetic.”
Conclusion
When considering bipolar disorder, especially its milder or personality-related forms, it is useful to interpret it in more **dynamic terms—how mood moves—**rather than in terms of decomposition, that is, where the mood is located and when individual phases begin and end.
The phase-based view does not always clarify the picture.
Most people with bipolar II disorder will never identify their hypomanic phases and will instead identify themselves with anxiety or depressive disorders. In part, this is because there are often no true “phases”—long periods in which mood is fully and heavily oriented in one direction—but rather these persistent elements of instability, magnetization, and a “mixed” emotional tone that constitute the enduring feature of the disorder.