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Agitation in Bipolar Depression

Bipolar depression comes with many symptoms like depressed mood which can involve feelings of hopelessness and worthlessness. There is loss of interest in activities or even people that you usually enjoy. People can have problems with sleeping and eating regularly. Thoughts of death or suicide are common. One symptom that’s often overlooked is agitation.

When people usually think of depression, it’s a slowed state in which a person may sleep a lot or have a severe lack of energy. There is also another type of depression called agitated depression. Agitation is a negative state of heightened arousal as opposed to feeling slowed down by depression. When a person is experiencing agitation in bipolar depression it might be due to a mixed state, which involves symptoms of both depression and mania.

There are actually two types of agitation that can be experienced.

Physical agitation, called psychomotor agitation, is an uncontrollable urge to move. It happens in about 40% of people with bipolar disorder. It’s possible this urge to move is the body’s way of coping with excess energy or anxiety. Some symptoms include:

  • Pacing
  • Picking at hair or clothing
  • Rocking motions
  • Bouncing your knee up and down
  • Hand wringing
  • Finger tapping
  • Figeting
  • Fast talking

In addition to physical agitation, there is also emotional agitation that can include symptoms like:

  • Extreme irritability
  • Anxiety
  • Anger
  • Racing thoughts
  • Emotional outbursts

Agitation can be mild, but it can also grow into a dangerous state if not resolved quickly. When agitation appears in mixed states, people can become more impulsive, aggressive and reckless. When this happens, the person experiencing agitation can become quick to anger. Violence is a possibility, especially in the most dire of circumstances, like those in which a person may need to be hospitalized. People experiencing agitation may also be more likely to self-harm or attempt suicide.

If you have bipolar disorder and are experiencing agitation, it’s important to speak with your doctor. You may be at the beginning or in the midst of a mood episode whether depressed, manic or mixed. Medication may need to be adjusted in order to ease the symptoms of agitation.



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Image credit: Janneke Cobb

Agitation in Bipolar Depression

LaRae LaBouff

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APA Reference
LaBouff, L. (2017). Agitation in Bipolar Depression. Psych Central. Retrieved on June 1, 2020, from


Last updated: 7 Nov 2017
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