What is Bipolar Disorder? Facts and Myths Explained.
By: Bonnie Brown, PsyD
While depression and anxiety are discussed most, there are other mental health issues that may be more common than people think. Bipolar disorder, once known as manic-depressive disorder, is a diagnosis that has often been thought of as mysterious. If you’ve been diagnosed recently, or are just generally curious, keep reading. You are not alone in either scenario.
Okay so here’s the technical bit…
Bipolar disorder is categorized in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) as two types of diagnoses. Bipolar I Disorder requires the individual to have experienced a manic episode. Symptoms of mania must include: elevated or irritable mood for at least one week, and increased energy or activity during this time. The increased energy or activity may include: inflated self-esteem, decreased need for sleep, more talkative than usual or pressure to keep talking, racing thoughts or ideas, distractibility, increase in goal-directed activity, and/or involvement in activities that have a high potential for painful consequences. A majority of those who have experienced a manic episode have also experienced major depressive episodes during their lives.
A major depressive episode requires five or more of these symptoms that have been present during a two-week period: depressed mood, decreased interest or pleasure in activities, weight fluctuations not attributable to dieting, sleep disturbances, physical agitation or slowing, fatigue, feelings of worthlessness, difficulties concentrating, and/or thoughts of death or suicide.
Bipolar II Disorder consists of experiencing both a hypomanic episode and major depressive episode. A hypomanic episode consists of the same symptoms as a manic episode, however the symptoms are only present for four to six days, and are not severe enough to cause marked impairment or necessitate hospitalization. For this last reason, bipolar II disorder has often been thought of as the “milder” of the bipolar disorders.
Bipolar disorders have a genetic component that increases the risk of development among individuals who have another family member diagnosed with bipolar disorder. This is not to say that having a parent or grandparent with a history of bipolar disorder means you should be concerned that you will develop the disorder. The prevalence rate for the general population is quite low, and having a family history only increases that number very slightly.
De-mystifying Bipolar Disorders
There are myths about bipolar disorders that can perpetuate fear and unease. One of these myths is that someone who is excited and happy one day and then depressed the next day is bipolar. Remember the time requirement for these moods. Depression requires two weeks, mania requires one week, and hypomania must be at least four days. There is a subtype called “rapid cycling” which is given if the person cycles between one of these swings four or more times in a twelve month period. Someone cycling daily would not be considered bipolar on that basis alone.
Another related myth is that people who are diagnosed with bipolar disorder do not experience a “normal” mood. In fact, people can spend a great deal of their time in that in-between mood, also known as feeling euthymic. As a result, it is not uncommon to effectively manage bipolar and live a functioning life. This leads to the next myth, which is that a bipolar disorder diagnosis equals disability and an inability to function in life. This is far from the truth. If managed appropriately to the individual, they have just as good of a shot at being healthy, happy, and successful in whatever way that means to them.
Some people think that medication is the only form of treatment. While it is true that medication is quite effective, the research shows that a combination of medication and therapy is the most effective way to treat bipolar disorder long-term. Therapy is incredibly useful in terms of education, keeping sleep hygiene a priority, learning personal warning signs and triggers, learning appropriate and individualized coping skills, and maintaining social support.
A final, big, common myth is that mania is fun. Initially, people may report that a manic episode feels good and productive. Part of the symptom list includes getting more things done and possibly feeling very confident. Think of an artist who spends days painting and producing amazing artwork. Those feelings sound great, don’t they? Not to this extreme. Mania can quickly become exhausting, painful, and even dangerous. Examples of this include impulsively buying an expensive car, and while driving that car for the first time, stopping at the mall and buying a whole new wardrobe. Or, the need to experience something thrilling takes the person to a club where they impulsively engage in an intimate act while their spouse is at home. Mania can be destructive.
What to do if you want to know more…
Bipolar disorders have been confusing, vague, and plagued with misconceptions throughout the years. This information is definitely not everything there is to know about bipolar disorders, and should also not be used to diagnose someone or yourself. If you suspect you might be struggling with bipolar, or worry about someone close to you, it’s important to let a professional figure that out. Contact a psychologist or psychiatrist in your area with whom you can sit and give a detailed history. It is their job to ask the questions and formulate the appropriate diagnosis. And know that you are not alone, and it is not a life-ending outcome.