There are people who tend to write other beings off by thinking that they are not mentally fit to be within the community based on their acts and behaviours. Bipolar disorder, sometimes referred to as manic-depression, is a genetically based psychiatric disorder, which involves poorly regulated changes in brain chemistry resulting in extreme mood swings. With a proper diagnosis and treatment plan (usually a combination of mood-stabilizing medication and therapy), a person with bipolar can have a long, happy and successful life.
Signs of Bipolar Disorder include episodes of mania or hypomania, which can involve euphoric and expansive mood; or dysphoric mood, which is marked by high levels of irritability and agitation. These episodes also typically include grandiose self-image, decreased need of sleep, rapid thoughts, pressured speech, distractibility, increased energy and creative desires, and severe impulsivity that lead to high-risk behaviours.
Mania lasts at least seven days in a row, and can lead to severe consequences to health, finances and relationships. Hypomania has the same symptoms, but usually of shorter duration—at least four days—and often with fewer consequences per episode.
In bipolar depressive episodes, the mood can become severely reduced, dark, and demoralizing. Often in this mood zone, a person becomes very sad, restless, low on energy, hopeless, and even suicidal. While manic or hypomanic, a person can feel terrific, charged with energy and a sense of great creativity, and a strong desire to get several things done at once. However, bipolar depression will make the same person lose energy and interest in anything important or pleasurable, potentially causing a severe crash in his or her emotional or physical well-being.
Cycles of manic, hypomanic, and depressive episodes can last from several days to several weeks, and often come with periods of feeling “in-between,” known as the baseline mood zone. In the most severe instances of bipolar, psychotic features including hallucinations or delusions may be present during extreme mood episodes.
Types of Bipolar Disorder
There are three basic types of bipolar disorder, known as bipolar I disorder, bipolar II disorder, and cyclothymic disorder, which some people casually refer to as bipolar III. The distinction among these three types is important when it comes to understanding the overall course of the disorder and the various treatments that can be used.
Bipolar I Disorder
All that is needed to be diagnosed with bipolar I disorder is a history of at least one manic episode in the person’s lifetime. While depression is common in bipolar I disorder, it is not necessary for the diagnosis. A person with bipolar I may have had hypomanic episodes, but a single manic episode forever defines this type of the disorder.
When psychotic features of hallucinations, such as hearing voices that are not actually present, or delusional thinking are evident in bipolar disorder, only the bipolar I diagnosis applies. The seven-day minimum of a manic episode helps define the diagnosis, unless treatment interrupts the episode, as we would see in a psychiatric hospitalization.
People in a manic episode can become very excited, flush with energy and extravagance. They can exhibit rapid thoughts and become accelerated in their speech making it difficult to interrupt them. They also purposely avoid sleep due to the increased energy and need to get many things completed. They often engage in high-risk behaviours, such as spending sprees, sexual indiscretions, alcohol or drug binges, driving too fast, etc.
Not only can these behaviours’ lead to financial and relationship problems, but legal troubles may also eventually result. In any case, people with bipolar I disorder will often deny the consequences of mania, or justify the need to protect their manic behaviour as a means to maintain creative output in their lives, despite the extensive threat bipolar I can have on their overall health and functioning.
When manic, a person with bipolar I can be mistaken as having another disorder, such as ADHD, OCD, panic disorder, or narcissistic personality disorder. If they have psychotic symptoms, they can be thought of as having schizophrenia. But the intense change in mood drives all the symptoms of this particular psychiatric disorder. When mania subsides, they often return to a more typical, or baseline, mood zone. The confusion now is about whether or not they have any psychiatric disorder at all.
Bipolar II Disorder
Bipolar II disorder has traditionally been thought of as a lesser form of the condition compared to bipolar I. The reason for this difference is how a manic episode, which defines bipolar I, can be longer in duration and have more severe consequences within a particular episode. A hypomanic episode, which is characteristic of bipolar II, has the same symptoms but tends to be shorter in duration and generally less consequential in its effects. However, the impression that bipolar II is a lesser form of the overall condition of bipolar disorder is misleading.
First of all, simply looking at a manic episode and a hypomanic episode in a side-by-side comparison does not tell the full story of how devastating an overall bipolar II disorder can be. Unlike bipolar I, a bipolar II diagnosis fits if there is a history of one hypomanic episode and one episode of major depression. And the effects of the bipolar II condition should essentially change how that person is perceived by others around him or her.
In other words, at least one person close to that individual would agree that there is a noticeable change in their typical characteristics during hypomania. Often, because of the more objective input from family or associates around that person, the full effects of hypomania are uncovered. And in those instances, a clearer picture of hypomanic consequences can reveal impairments to occupational and social functioning.
Without a history of major depression, a person cannot be considered as having bipolar II. Someone having occasional hypomania by itself is not a bipolar disorder. But because the depressive episodes in bipolar II can be very severe—even suicidal—it’s mistaken to think of bipolar II as the lighter form of the overall condition.