WHAT IS BIPOLAR DISORDER
I think Bipolar Disorder has become our de facto accusation for any person that displays any negative mood fluctuation. I can’t tell you how many people I’ve spoken with who have accused their ex-spouses of being “bipolar” because they struggled with anger or mood swings (although they conveniently leave out their own shortcomings or what they did to provoke their ex-spouse’s anger when describing their ex J). Thus, I want to make clear exactly what bipolar disorder is, and how it presents amongst adults.
First, bipolar disorder is not simply characterized by someone who becomes angry or experiences mood swings. Bipolar disorder is primarily characterized by a mood state called a “manic episode.” A manic episode is defined by the DSM-5 as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week, nearly every day (or any duration if hospitalization is necessary). There is also a constellation of symptoms present during this period of unusual mood and energy level. For example, the person exhibits a specific combination of the following symptoms (not necessarily all of these symptoms, but at least 3-4 depending on the specific mood state that is present): inflated self-esteem or feelings of grandiosity, decreased need for sleep (I used italics for the word need; there is a difference between not being able to sleep and not experiencing the need for sleep) or feeling rested after only a few hours of sleep, more talkative than usual or feeling a pressure to keep talking, racing thoughts and flight of ideas, distractibility where attention is often drawn to unimportant or situation-irrelevant stimuli, increase in goal-directed activity or psychomotor agitation (an experienced sense of agitation that leads to excessive motor movement, but that is not directed towards achieving a goal), and excessive involvement in activities that have a high potential for negative or painful consequences (e.g. spending sprees, sexual indiscretions, foolish investments, etc.). These symptoms cause impairment in one’s life and often lead to hospitalization. In addition, they are not caused by substance use or a medical disorder.
Let’s sum up the important points so far: abnormal mood disturbances, increased energy and activity level, 3-4 or more of the above-mentioned symptoms, and all occurring at the same time and lasting for at least one week. I want to emphasize, these symptoms occur as an “episode.” This means that there is a discrete period of time in which these symptoms occur together. It is not simply a person who has high energy one day, then one week later demonstrates impulsive spending. In contrast, these symptoms are part of a mood-state that occur at the same time and endure together for at least one week (or until the person is hospitalized). This is important to note in order to break the misconception of referring to people who exhibit mood swings or anger as being “bipolar.” Based on the criteria noted above, there is a clear difference between someone who becomes angry and upset during a fight with a friend or loved one and someone who experiences this enduring and impairing manic episode.
In terms of treatment, the best course of action is to seek out a psychiatric medical professional during the course (or preemptively) of a manic episode. Medications for bipolar disorder are generally considered the first line of treatment for a manic state. In addition, maintaining consistent sleep/wake patterns and developing effective tools to manage stress have been shown to decrease the occurrence of manic episodes. Charting one’s mood states on a daily basis is also an effective course of action in order to anticipate the occurrence of a manic state. For any additional questions or support regarding Bipolar Disorder, one can access the following website to learn more about the Depression and Bipolar Support Alliance. https://www.dbsalliance.org/