Expansive Mood as a Symptom of Bipolar Disorder

Neuroscience helps explain extreme, impulsive behavior

Depressed Young Adult
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One of the criteria for diagnosing a manic or hypomanic episode of bipolar disorder is what we call an expansive mood. Individuals with expansive mood may behave brashly or lavishly, assume a superior or grandiose attitude, or dress and act flamboyantly. They exhibit larger-than-life behaviors that can often be accompanied by (or result in) extreme bursts of irritability.

Expansive Behavior in Bipolar Disorder

An expansive mood can reap unfortunate consequences for a person with bipolar disorder, ranging from interpersonal confrontations to financial loss.

Symptoms vary from person to person with some individuals believing themselves to be in a "creative cycle" while others are more disinhibited or recklessly impulsive.

In some cases, the person may become excessively friendly to the point where the behavior seems exaggerated and extreme. Boundaries can be ignored and even casual acquaintances or strangers may be pulled in as intimate confidantes.

Speech can often become inappropriate, such as making a crude joke at a church service or in a business meeting. Oftentimes, the person won't even understand why the behavior was wrong or how it offended others.

It is common for a bipolar person with expansive mood to spend excessively. Credit cards can be maxed out in a sudden burst of grandiosity, lavishing with friends, relatives, or even passing acquaintances with expensive gifts.

Much of these behaviors are centered around the need to garner attention.

This can translate to dressing outlandishly or standing out in a way that is inappropriate (such as wearing a bright dress to a funeral).

Expansive Mood and Other Manic Symptoms

Expansive mood is often coupled with other signs of a manic episode. Irritability is one of them. If the person believes that he is being ignored or dismissed, his exaggerated sense of importance may result in a sudden, angry outburst.

Over time, irritability and anger may displace the more flamboyant aspects of expansive mood as the manic episode progresses.

The bipolar individual may also exhibit a decreased need for sleep, spending three hours or less per night in bed. Conversations can often be frenetic and scattered. The individual may engage in more goal-oriented activities (the need to accomplish something big now) while easily being sidetracked or distracted.

More concerning, perhaps, is the sudden impulsiveness a person may exhibit during an expansive mood. It can lead to extreme risk-taking or the loss of restraint that can place the person directly in harm's way.

Causes of Expansive Mood in Bipolar Disorder

The association between disinhibition and bipolar disorder is well known and strong. It may be as obvious as driving recklessly through city streets or as subtle as intentionally avoiding condoms with someone you just met. At its core is an individual's need to seek reward without the ability to fully discern safe gambles versus unsafe gambles.

Neuroscience suggests that this behavior is driven, at least in part, by the overactivation of the nucleus accumbens, the brain's pleasure center. It is also shown that activity in the prefrontal cortex, which plays a role in decision making, is more often impaired in bipolar individuals than in healthy one.

Together, these factors appear to play a foundational role in the behaviors that are symptomatic of expansive mood.

A Word From Verywell

Extravagant or outlandish behavior is not in itself an indication of bipolar disorder nor does a person with bipolar disorder necessarily exhibit the scale of symptoms described.

However, if the cycling of moods, between extreme highs and extreme lows, is interfering with your or a loved one's ability to function, speak with your doctor and ask for a referral to a specialist experienced in the diagnosis of bipolar disorder. Treatment is available if needed.

Sources

  • Edge, M.; Miller, C.; Muhtadie, L.; et al. "People with bipolar I disorder report avoiding rewarding activities and dampening positive emotion." Journal of Affective Disorders. 2013; 146(3):407-13.
  • El-Deredy, W.; Sullivan, N.; Montaldi, D.; et al. "Decision-making and trait impulsivity in bipolar disorder are associated with reduced prefrontal regulation of striatal reward valuation. Brain. 2014; 137(8):2346-2355.
  • Muhtadie, L.; Johnson, S.; Carver, C.; et al. "A profile approach to impulsivity in bipolar disorder: the key role of strong emotions." Acta Psychiatrica Scandinavica. 2014; 129(2):100-8.

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