February 5, 2013

Is Everyone Bipolar?

Bipolar has entered the common lexicon as in, “he’s so bipolar!” When people use the expression in a casual way they are usually referring to some one who is moody or temperamental, who gets upset easily. The part that they have right is that Bipolar Disorder, a serious mental health condition, is related to extremes of mood and behavior. The disorder has gotten much more public attention in recent years and many people feel it is being vastly over diagnosed.


Bipolar Disorder (BPD) used to be called Manic-Depression and the change is still a source of confusion.  Bipolar Disorder IS a form of depression and depressive episodes are always a part of the picture.  At it’s core Bipolar Disorder means the person experiences shifts in their mood disorder.  Someone may be suffering from depression for months and then, usually fairly suddenly, they wake up and the mood seems to have lifted. Now they are able to get things done, they feel a greater interest in life and they are no longer overwhelmed with somber and negative thinking.  For many people it may feel like they are just back to normal again and the relatively sudden shift in mood goes unnoticed.  The tip-off is that the the improvement doesn’t last very long and the depression returns.

People who suffer from this type of Bipolar Disorder, now called Bipolar II Disorder  often go undiagnosed for many years as they primarily experience depression. If they are treated for depression only they are likely to be unsuccessful at obtaining relief as the BPD diagnosis is missed.


The more dramatic but not necessarily more severe disorder is Bipolar I Disorder. In this mood disorder the person exhibits true mania-and there is nothing subtle or easy to miss about mania. Symptoms of mania include: a very elevated, expansive or hostile mood, great impulsivity, reckless behavior (often financial or sexual), poor judgement, dramatically decreased sleep, exaggerated self esteem or grandiosity sometimes accompanied by paranoia,  racing thoughts, pressured speech and increasing disorganization and ability to function normally at work or at home or in social situations. Irritability or hostility and aggression can all be part of the picture. A person experiencing mania is a person with whom it is impossible to get along.

At it’s most extreme mania evolves into true psychosis with delusions, hallucinations and/or paranoia.In the past, many people were improperly diagnosed with schizophrenia because at it’s most extreme mania is indistinguishable. The difference is that the person with mania can cycle into more normal functioning with absence of psychotic symptoms. For many people who are manic there is also a co-existing and disturbing depression. Suicide attempts are made by people who are manic as their thinking can become so distorted that death becomes a realistic solution to a perceived problem.

I can’t consider Bipolar I more severe because people with Bipolar II can suffer severe and lengthy depression and be at risk of suicide, especially if the Bipolar Disorder remains undiagnosed and treatment is insufficient.


I think not! I believe it is still under-diagnosed as many professionals continue to look for the dramatic and more obvious symptoms apparent in mania and overlook the more subtle but recurring shifts of mood in Bipolar II Disorder. If you suffer from depression and have not found success despite efforts at treatment, do discuss with your clinician the possibility of a hidden Bipolar Disorder. Take an online Mood Disorder Questionnaire and bring it in to your psychologist or psychiatrist. Do you have nights when suddenly you don’t feel you need to sleep and you are up all night, full of energy and ideas? Does your depression seem to magically lift at times and then come crashing back after only a few days of relief? Maybe the reason is because of Bipolar Disorder.


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