We tend not to think of people with bipolar disorder as having any “hidden symptoms.” It may seem that individuals with bipolar are either engaged in their treatment — and therefore experience few extreme mood swings — or they are not. If not, they may seem very depressed and down, or the opposite: very full of energy, excitement, and ideas.

After all, how much can one really hide his or her mood swings from others? Can someone suffer from hidden or masked bipolar disorder without others knowing?

The surprising truth is that sometimes people with bipolar disorder can do a pretty good job in hiding or minimizing certain symptoms of their condition. On World Bipolar Day, we explore some signs that perhaps individuals are struggling with their bipolar more than they care to let on.

I spoke with our very own Psych Central blogger Gabe Howard, who lives with bipolar disorder, to get some of his insights. I also spoke to others who have bipolar disorder to get a better understanding of the ways people sometimes try to hide their bipolar symptoms.

“It was difficult during my initial treatment because sometimes I was intentionally misleading people around me and sometimes I didn’t know,” Gabe told me. “I was learning the difference between depression and sadness. I was learning the difference between excitement and mania and, most of all, I was trying to figure out what my life was going to look like “on the other side.””

“It took me 4 years to learn all the coping skills I needed. To adjust my medications, to figure out what I could handle and couldn’t handle in life. Sometimes, I would hide my symptoms because I just couldn’t stand letting my family down again. I didn’t want them to worry.”

1. They Try Hard To Keep The Manic Energy In Check

You can sometimes see acquaintances with bipolar disorder struggling to keep their manic energy in check. They downplay the flight of ideas as just being creative and “feeling free” to explore a lot of different ideas. Or they may try and hide the mania while not around others, expending a lot of energy to keep a serene face on the outside while their thoughts race on the inside. Sometimes those with bipolar disorder doesn’t realize they’re sick until it is too late and the symptoms have once again taken hold.

This could be a sign that the person’s current treatment is not working as well as it could. It may be because the person is either not taking his or her usual medications, the medications need adjusting, or some other aspect of treatment is not working.

2. They Pretend Everything’s Alright When It’s Not

“Sometimes I would hide my symptoms because I just couldn’t stand the idea of switching medications again,” Gabe tells me. “I’d think to myself, ‘Hey, this isn’t ideal, but maybe I can live with it.’”

He and other sufferers of bipolar disorder said they would sometimes try to “fake it until you make it” — pretending the treatment was working even when they weren’t feeling any different. Lots of people with hidden illnesses such as bipolar put on a happy face to the world while inside, inner turmoil still reigns.

3. They Beg Off From Being Around Friends Or Family

Those struggling with a mood swing — whether it be mania or depression — might do their best to keep it hidden by simply disconnecting from friends and family. They come up with a wealth of excuses to not go out, not to attend a family gathering or party, or say they’ll come only to cancel at the last minute. People with bipolar disorder going through the extremes of a mood swing may feel like they can keep it to themselves if only they cut off most communication with others, or keep it to the bare minimum.

This may also manifest itself in the opposite behavior during a manic episode — a person proposing a dozen different activities to do. And each day, the list is different, but the energy and enthusiasm is constant — and overwhelming.

4. They Have Problems With Sleeping Or Eating That Aren’t Common For Them

We all have a difficult night’s sleep from time to time. Someone in the depths of a depressive episode or the heights of a manic one individuals will go to extremes with either their sleep or eating — or both. Some folks with mania might turn to alcohol or drugs as well, which they may also take too far (even resulting in an accidental overdose). If you know someone with bipolar disorder and he or she suddenly starts calling you at 3 am, that may be a sign the individual is struggling with a mood swing.

5. They Simply Say, “I’m Sick.”

Sometimes people with bipolar hide their symptoms in plain sight when asking for time off work or when they miss a class. Gabe tells me, “I say ‘I am not feeling well, I’ve been sick all weekend/night/day,’ and just let the person on other end of the line assume it’s a physical illness.” This is more of a half-lie, since the person is indeed struggling with a condition, just not the physical condition most people assume.

Not all bipolar symptoms are hidden. For further information, check outthe symptoms of bipolar disorder.

Wondering if you have bipolar disorder? Take our bipolar test now.

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