Bipolar Disorder from a Clinician’s Perspective

People with Bipolar Disorder spend the majority of their time feeling depressed. Credit: tiniroma/ freedigitalphotos.net

People with Bipolar Disorder spend the majority of their time feeling depressed.
Credit: tiniroma/ freedigitalphotos.net

Bipolar Disorder isn’t well understood.  Watch Silver Linings Playbook if you’d like to see a really good example of how it looks in real life.  It shows the chaos that can come with the Bipolar diagnosis.  It shows how it’s much more than “mood swings.”

 

Here are some common misconceptions about Bipolar Disorder:

  • It’s mood swings.
  • It’s feeling up and down about life.
  • It’s something someone can control on their own.
  • You don’t need to worry about suicide since it’s not depression.
  • Bipolar is an unusual diagnosis.
  • People who have Bipolar Disorder experience mania on a regular basis.
  • Mania means happy.
  • There is a test for a Bipolar Diagnosis.
  • Bipolar only exists in adults.

Here are some truths about Bipolar Disorder:

  • Moods are less relevant to the diagnosis than a full on affective state.  What this means is the person is wholly depressed or wholly manic.  This doesn’t just mean they feel sad or happy.  It means they have all the symptoms of depression (which often include sleep disturbance, lack of interest in life, suicidal thoughts, difficulty finding enough energy to complete routine tasks, and isolation among other symptoms) or all the symptoms of mania (mood lability, irritability, hyperverbal speech, flight of ideas, grandiose thinking, greatly decreased need for sleep, and psychomotor agitation).
  • People will use the phrase, “She’s bipolar,” for someone who changes their mind about something a lot.  That is not even close to what Bipolar Disorder is.  Someone thinking one way and then shifting their ideas is probably just that person changing their mind.  Some people change their minds a lot.  This does not make them Bipolar.
  • Bipolar Disorder can be managed to some extent with good mental health hygiene.  However, it usually requires medication and psychotherapy as well.  This doesn’t mean a diagnosis of Bipolar Disorder indicates a lifetime of therapy, but it does probably call for professional help at the outset to help regain stability.
  • Suicide is a VERY concerning threat for someone with the diagnosis of Bipolar Disorder.  The reason it is worrisome is because in a state of depression, someone with Bipolar Disorder may wish to commit suicide.  However, they might not have the energy to carry about the attempt.  If they move into a manic phase they might not be energized enough to complete the suicide attempt.  It is a definite risk with this diagnosis.
  • Bipolar Disorder isn’t the most common of mental health diagnoses, but it’s not all that rare either.  Chances are you know someone who has the diagnosis.  It is heritable, which means if you have it, your children have an increased likelihood of having it as well.
  • You only need to have 1 manic episode to be diagnosed Bipolar.  People incorrectly assume people are manic all the time.  This is patently false.  Someone with Bipolar Disorder spends the majority of their time in a state of depression in most cases.
  • Taking an online symptom check test or some other test doesn’t tell you if you suffer with Bipolar Disorder.  This diagnosis needs to be made by someone in the field of psychology or psychiatry.  There are other issues that mimic this diagnosis, such as methamphetamine abuse.  A professional can rule out other possibilities.
  • Bipolar Disorder does exist in children.  It is frequently first diagnosed in adolescence.

Bipolar Disorder is a very difficult diagnosis for family members and for the person who deals with it.  The depressive episodes can be ruthless in their pursuit of making someone completely miserable.  The manic episodes makes someone irrational, angry, and unreasonable.  In a state of mania someone usually has very questionable judgement as well.  There is hope for people who suffer with Bipolar Disorder, but the road isn’t easy.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

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