To the layperson, what does that actually mean? Well, there are several types of "bipolar" that include bipolar 1 disorder, bipolar 2 disorder, and cyclothymic disorder. Some cases are more severe than others, even within these categories. Let's take a look at each one and I'll share my personal thoughts as well as the actual definitions and symptoms that can lead to a diagnosis.
Bipolar I disorder is a manic-depressive disorder that can exist both with and without psychotic episodes.
Bipolar II disorder consists of depressive and manic episodes which alternate and are typically less severe [than bipolar I] and do not inhibit function.
Cyclothymic disorder is a cyclic disorder that causes brief episodes of hypomania and depression.
In any type of bipolar you'll find discussion of hypomania, mania, or manic episodes as well as depression episodes. These aren't just your average up and down feelings that everyone gets from time to time in dealing with everyday life events and surroundings. For the sufferer of bipolar disorders, it is something that isn't necessarily related to life events or surroundings, but can appear and disappear at any time for no reason. So let's define these terms going forward, so we're all on the same page.
Mania - An elevated, expansive, or irritable mood that lasts for at least one week and is present most of the day, nearly every day. During this period, three or more of the following symptoms must be present and represent a significant change from usual behavior:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- Increased talkativeness
- Racing thoughts
- Distracted easily
- Increase in goal-directed activity or psychomotor agitation
- Engaging in activities that hold the potential for painful consequences, e.g., unrestrained buying sprees
Hypomania - An elevated, expansive, or irritable mood that lasts at least four consecutive days and is present most of the day, almost every day. Same symptom requirements as mania.
Depression - A major depressive episode resulting in depressed mood or loss of interest or pleasure in life. The DSM-5 states that a person must experience five or more of the following symptoms in two weeks to be diagnosed with a major depressive episode:
- Depressed mood most of the day, nearly every day
- Loss of interest or pleasure in all, or almost all, activities
- Significant weight loss or decrease or increase in appetite
- Engaging in purposeless movements, such as pacing the room
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt
Initially, I was diagnosed with manilla vanilla depression. I was put on Wellbutrin and Celexa. It seemed to improve a little and I continued this regimen for a year or so. After going on and off again, my primary physician finally referred me to a psychiatric professional for further evaluation. It was during this evaluation that I was diagnosed with Bipolar II. It seemed apparent after reviewing my history that I had more than one manic (hypomanic?) episode in my lifetime up to that point (this was 5+ years ago).
Then, at some point either last fall or early this year (2019), my latest psychiatric nurse practitioner changed my diagnosis to bipolar I, apparently based on the severity of my manic and depressive episodes. He also used a term recently that I had never heard before, calling me a "brittle bipolar." I'll leave that one for discussion on a later blog post.
So, suffice it to say that psychiatry professionals don't always get the diagnosis right on the first try (is it right now?). Regular medical doctors should be given all the facts about your situation to see if they feel like a referral for a psychiatric evaluation would be beneficial. If you're new to mental health issues and you're really looking for help, then don't leave anything out. You might be surprised how some seemingly insignificant detail could be the trigger for further evaluation or a diagnosis.
Mental health gets demonized a lot in our society. Bipolar comes out pretty much toward the top of the list, along with only a few others, such as schizophrenia and multiple personality disorders. For example, I love the show, "X-Files." It's one of my favorite sci-fi shows. However, after my diagnosis, I began to see a trend I had not really noticed before. In many episodes, people with suspected aberrant behavior are stated to be taking anti-psychotic medications and / or being stated as having bipolar disorder. In all of these cases, the character is described as "crazy," "unpredictable," "violent," etc. You get the point. It was a little disheartening to see in one of my favorite shows (granted this was from the 1990s), but it made me realize just how the public in general views bipolar disorders.
Well, there you have it in a nutshell. What bipolar disorder is all about. Definitions and symptoms straight from the big book of psychiatry, along with my personal journey through the diagnosis and observations along the way. I hope this has been of some help to you in your own journey. If it has, drop me a comment below and let me know!
(NOTE: I am NOT a psychiatrist or doctor of any kind. The information provided here is NOT meant to help diagnose or treat any disease or mental illness. I'm only sharing information for informational purposes only. Any concerns you might have should be addressed with your own doctor or psychiatric professional.)
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