The Doctor Is In: Bipolar Disorder
I am so Over-The-Moon-Happy that two people asked me about Bipolar Disorder (formally known as Manic Depression). I believe this disorder is one of the hardest to diagnose AND is on my list of Top Ten Misdiagnosed. In a nutshell, persons who live with bipolar disorder experience a cycle (mania and depression) in their mood. This is not to be confused with moodiness. This is not to be confused with Seasonal Affective Disorder (triggered by winter months). This is not to be confused with a person with a “short fuse.” Here’s the thing, most of us have a baseline mood. The best analogy I’ve heard to capture mood is in regards to weather. Most places have a typical climate. Let’s use Texas…it has a warm climate. Now, based on wind and air pressure and a bunch of other stuff that I don’t fully understand but trust meteorologists to understand, some days are hot, some days are cold. But I know that most days are warm and sunny. Period. Now, on sunny days when a rain storm blows through…that is analogous to our affect. Affect? You know, when your happy mood is usurped by a distracted driver who almost runs you off the road, leaving you feeling . . . angry or shook up? That change in your feelings is your affect. It's temporary. (Hopefully.) Got it? I hope so. It is important that you understand mood, because when psychologists talk about bipolar they are referring to a person’s MOOD.
Before I get too far ahead of myself, let’s look at the symptoms. Look carefully. Most people assume they know ALL the symptoms and they do not.
Mania:
Impulsive (i.e., “I want to buy a new wardrobe…now.”)
Euphoria (i.e, “I’m wait to get to the mall and use my new credit card.”)
Irritability (i.e, At store: “What do you mean my card is declined? I have money. I want new clothes! Let me talk to your manager.”)
Excessive talking or Racing thoughts. (i.e. imagine the example above, without periods…sped up. )
Grandiosity: (i.e., I am brilliant. I’m going to write a brilliant novel…tonight.)
High energy. (i.e., starting new projects and working on it nonstop)
Risk taking: (i.e., driving fast, multiple sex partners in a short period of time, drug use, etc)
Depression:
Low mood (sad, depressed)
Low Self-Esteem (i.e, “I can’t do anything right.”)
Low energy (i.e., even the smallest movement feels effortful)
Slow speech (i.e., slurred speech, or like great effort is required to put words together.)
Insomnia (difficulty staying asleep or getting to sleep) or Hypersomnia (excessive sleeping: 10+ hours/day)
Loss of interest in hobbies or socializing or activities.
Poor concentration (i.e. Can’t follow a conversation, ideas trail off.)
Okay, look at those symptoms. A person with bipolar cycles between those two MOOD states. The cycle process last for a period of time. Remember what I said above…Mood is the climate. Climate is LONG standing. So, being happy one minute and sad the next is NOT bipolar. That person suffers from poor affect management or some other disorder.
There are two forms of Bipolar (I & II) I won’t get into the differences here. If you want to know, I’ll answer you below.
Persons with bipolar often self medicate. THIS complicates the diagnosis process. Drugs alter a person’s moods and behaviors. Depending on the level of drug use, the changes can be VERY drastic. Behaviors look like mood swings, but are really drug swings. (That is totally a Tracy phrase.) If drug use is present, another person is needed during the diagnostic interview to help separate out moods influenced by drug use and moods influenced by natural (atypical) cycles in the body.
For most people, symptoms appear in late adolescents, early adulthood. Persons with bipolar often recognize when their mania tips them into highly dangerous behaviors. They feel out of control and afraid. This fear underlies their aggression and combativeness. And although they hate this “out of control” feeling and the depression, they typically refuse help. Why, you ask? Manic states are a reprieve from paralyzing depression. During a manic episode, the sky is the limit. Who would want to give that up? Think about it. If you had a period of weeks in which you thought you were wonderful and capable of anything and everything, wouldn’t you turn away from someone who said, “I can fix the problem?”
Those who successfully live with the disorder typically have supportive family members, participate in therapy, and take medication regularly. It often takes many trials and errors to find the right combination of meds, therapy, and support. Thus, in my humble opinion, patience is the MOST important piece to the puzzle.
One of the best books I have read on the topic is An Unquiet Mind by Kay Jamison. I read it when it first came out, so my detailed memory is poor.