Could You Be Bi-Polar?

By Dee

What is bipolar disorder? What are some symptoms?
Bipolar disorder is a psychological disorder in which a person experiences an abnormally elevated mood and behaviors for a period of time before unexpectedly shifting into a depressive state. Chemical imbalances in the brain are considered a cause of bipolar disorder, often with some sort of genetic inheritance. Anecdotal reports suggest that knowing someone with bipolar disorder is similar to riding a roller coaster: the person's mood changes irregularly and without much warning, and that in one moment the person seems charged, happy, and excited, and the next, unexplicably down. In more severe cases of bipolar, individuals might suffer from psychotic episodes -- breaks with reality, disorganized thoughts, delusions, and hallucinations.

Signs of the depressive component mimic other forms of clinical depression: persisting sadness and anxiety, hopelessness, guilt, fatigue, interruptions in sleep patterns, loss of appetite, a resistance to be around other people, and so forth. I'll talk about mania more in the next question, but basically it means that a person is really keyed up, hyperexcited, and elevated. Sometimes, clients present "mixed" episodes in which they experience signs of depression and manic behavior simultaneously.

As with any psychological disorders, the symptoms are severe enough to impair work, school, relationships, and practicing daily routines and self-care. For a person to be diagnosed with bipolar disorder, there needs to be enough evidence to suggest that the individual has experienced both manic and depressive symptoms over a period of time.

One of the symptoms of bipolar disorder is mania. Can you explain what exactly mania means?
"Mania" comes from a Greek word meaning "to enrage" or "to be furious." Imagine what your life would be like if you were hopped up on coffee all the time. You feel super-energized and jittery, are unable to concentrate, experience racing thoughts and actions. Maybe these sensations feel good to you; maybe you feel like Leonardo DiCaprio's Jack in Titanic -- "I'm King of the world!" This is what life is like in a manic episode: always on the edge, always on the go, rushing everywhere and feeling like you do it nonstop (unlike coffee would eventually cause you to crash).

Not all episodes of mania look the same. Sometimes, it appears as if the individual is in a particularly good mood. Other times, it looks very much like the theatrical behavior I told you about a moment ago. Clinicians differentiate between two types of mania: the balls-out, no-holds-barred manic behavior which features elevated mood and some kind of risky, compulsive behavior like overspending money, hypersexuality, or increased risk-taking; and the lower-level, feel good and super happy behavior (without the risky business) called hypomania.

Manic symptoms never appear by themselves. It wouldn't make sense, and it certainly wouldn't gel with reality. Everyone, psychologically healthy or otherwise, can't run on feeling good forever and ever. Emotional states fluctuate. However, persons with bipolar disorder can experience wild and unpredictable mood swings (this is called "cycling") and cannot control their feelings in either state.

I've read that there is sometimes a bit of confusion between being bipolar and manic depressive? Is there a difference? If so, what are they?
Bipolar disorder and manic depression refer to the same psychological disorder. Bipolar disorder is used today because people with the disorder transition from manic to depressive states and back -- thus, two "poles" of dysfunction. This is distinct from clinical depression, a "unipolar" disorder.

How does a doctor diagnose bipolar disorder? Can a medical doctor diagnose it or only a psychologist?
Medical doctors and psychologists can both detect bipolar disorder so long as they both have appropriate clinical, psychological training.

Bipolar disorder is very difficult to diagnose properly. At minimum, the professional needs enough evidence to conclude that the client has been cycling back and forth between manic and depressive states with each state lasting most of the time, daily, for at least one week. The ideal diagnosis would involve the professional meeting with members of the whole family and getting each person's point of view on the client's behavior over a period of time in addition to any client self-reporting. Diagnostics may be extended. Even in the cases of standard clinical depression, professionals need to ask about manic episodes to be sure of a correct diagnosis. If bipolar is treated with the same medicines as clinical depression, bipolar symptoms can actually worsen. Diagnosis may take as long as several months, even years, to complete.

Bipolar is classified as Bipolar I or Bipolar II, depending on the level of manic symptoms. As stated earlier, manic symptoms alert clinicians to the presence of bipolar disorder even without depressive symptoms attached. Think of it like this. The downer will come eventually; our bodies can't stay keyed up indefinitely. Bipolar I is more intense than II, since type II tracks hypomanic signs. There's another type of bipolar called Cyclothymia in which clients alternate between hypomanic behavior and depressive behavior that does not meet the full list of symptoms for major depression. There is also a diagnosis called Bipolar NOS (Not Otherwise Specified) to describe bipolar-like behavior that does not meet the full list of criteria.

Clinicians also try to rule out other competing disorders like schizophrenia, borderline personality, schizoaffective disorders, and substance intoxication.

What are some treatment options for bipolar disorder?
Bipolar disorder requires medication for treatment, usually in the form of mood stabilizing medications and anti-psychotic medications to calm manic episodes. Antidepressants are not recommended because they trigger and exacerbate manic behaviors and may cause suicidal thoughts and ideation, while mood stabilizers tend to relieve both manic and depressive symptoms equally well. Clients should be urged to resume medical treatment even in the absence of symptoms in order to prevent relapse. Side effects include mood blunting (that is, difficulties in feeling or interpreting moods). Psychotherapy and counseling are effective in helping clients recognize mood changes and shifts and managing relationships. It is also recommended for friends and family to seek counseling of their own to learn more about the disorder and how to address changes in behavior, whether or not the client is treating bipolar with medication.

**Again if you have any questions about Bi-Polar, Depression or any other mental disorder feel free to ask in a comment and I will have Dee answer them for you!