What is Bipolar? Some tips to understand if this is the appropriate diagnosis for yourself or a loved one.

When describing someone who is moody, we often hear people describe that person as Bipolar. We use it loosely like, “They must have Bipolar.” But the truth is, Bipolar can be more severe than mood swings. Mood swings can be a result of multiple things, depression, anxiety, anger, and/or someone does not have the communication skills to express moods- so it presents itself as a temper tantrum. Bipolar is not characterized by rapid mood swings- I will explain Bipolar more in a second.

I am inspired to write this blog as I think about two previous clients. One client, experienced lifelong and ongoing trauma. This client would have mood swings and panic attacks. She was diagnosed as Bipolar- She was not. The other client, had real reasons to dislike his father and explained to providers that he heard “voices” telling him to hurt his father. Because of his temper tantrums and reported voices telling him to harm his father, he was diagnosed with Bipolar- He was not.

What is Bipolar?

Bipolar is characterized by having mania. Mania means that someone is having elevated, irritable mood, increased goal-directed activity, and energy lasting at least one week. Symptoms can include:

1. During this time, someone may have an inflated self-esteem. For example, I had a client who believed that he was the architect for the city.

2. Decreased need for sleep. i.e. The person may go days with little/no sleep.

3. More talkative than usual or pressure to keep talking. i.e. in my experience, clients are not even able to be redirected to slow down or listen. They can speak at a fast pace for long periods of time.

4. Flight of ideas. i.e. The person can’t seem to keep “on track” with thoughts. The person rapidly changes topics- much of it probably feels incoherent and doesn’t make sense.

5. Distractibility (i.e. attention too easily drawn to unimportant things)

6. Increase in goal-directed activity- On paper, this never seemed that bad to me. But when seeing this, it can have some severe consequences. Some client’s have described feeling a “high” and wanted to compete multiple tasks. Such as, go out and have multiple sex partners, spend all of their savings to start a new business plan, start a project but then immediately go to another project without finishing anything.

7. Excessive involvement in activities with high consequences. I.e. buying sprees, sexual indiscretions, or foolish business investments.

With Bipolar, someone may experience depression within the same time period of a manic episode, meaning the person experiences depression or loss of interest in things they used to enjoy.

There is also Bipolar II, which has the manic symptoms listed above, but it is considered a lower grade version. Bipolar I is characterized as a manic episode and Bipolar II is characterized by a hypomanic episode. Also, depression is common for Bipolar I but not required for Bipolar II.

When first being diagnosed, someone may experience depression first and it is not known that the person may have Bipolar until a manic or hypomanic arises.

What I am happy about is that in the DSM-5 (which is the book for all of the mental health disorders), there is an addition of a new diagnosis: Disruptive Mood Dysregulation Disorder. This diagnosis was created to “address concerns about the potential for the over-diagnosis of and treatment for Bipolar in children.” Children who may not have the words to express their experiences may display irritability and temper outbursts. If you have a child or know a child between ages 7-18, please research this diagnosis first before agreeing and accepting treatment for a Bipolar diagnosis.

Many disorders can have similar characteristics. I believe it is especially important for Black and Brown people that trauma be considered as a possible diagnosis. In my experience, there are times when trauma gets missed.  A person may lack the communication skills to express themselves and may not be able to identify that trauma is effecting their moods, which might take the form of depression and outbursts of anxiety.  Please be informed about the basis of a diagnosis that you or a loved one is receiving and please do your own research. I hope this information helps.