The Many Faces of Bipolar Disorder

Bipolar Disorder is a mood disorder, and it’s a diagnosis that is very easy to confuse with other conditions.  As a clinician, I often have the experience of meeting people who have been “diagnosed” with Bipolar Disorder, and, after a thorough evaluation, they do not meet full criteria for the diagnosis. This  means that the person probably has something else.  Misdiagnosing Bipolar Disorder is common because it overlaps with so many other conditions, such as Attention Deficit Hyperactivity Disorder, Borderline Personality Disorder, Anxiety, Depression and Substance Abuse (to name a few).

There are several problems with being misdiagnosed—first, someone has the wrong diagnosis, they are probably taking the wrong medication to manage it.  Also, the person is not getting the psychotherapeutic care that they need—treating anxiety, for example, is very different than treating Bipolar Disorder.

So what are the symptoms of Bipolar Disorder? First, one must have both mania and depression (not at the same time, necessarily, they just must have had at least one episode of each).  In order for one to meet criteria for having a manic episode, she must have at least three of the following symptoms lasting at least one week continuously:

-Inflated self-esteem or grandiosity

-Decreased need for sleep (note, a decreased need for sleep, not necessarily a decrease in the amount of quality of sleep)

-More talkative than usual

-Racing thoughts

-Easily distractible

-Increase in goal directed activity (such as projects)

-Becoming overly involved with high risk activities (e.g., gambling, risky sexual behaviors)

In order for one to meet criteria for an episode of depression, she must have five or more of the following symptosm for at least two weeks continuously:

-Pervasive low mood

-Decreased interest in things the person once found pleasurable or fun

-Significant weight loss or gain, or significant change in appetite

-Sleeping too much or too little

-Feeling very slowed down

-Loss of Energy

-Feelings of constant worthlessness or inappropriate guilt (e.g., “everything is my fault”)

-Difficulty concentrating and making decisions

-Recurrent thoughts of death or suicide

 

There are two types of bipolar disorder, Bipolar I and Bipolar II.  Bipolar I means the person has had both manic and depressed episodes, and Bipolar II means the person’s mania is less extreme, or that they have “hypomania.” This means the person’s mania is not as destructive, long lasting or impairing as mania, in that they are not hospitalized, yet it still creates problems.

In looking at these symptoms, it’s easy to see why many people are misdiagnosed with Bipolar Disorder—who hasn’t had difficulty sleeping or difficulty concentrating from time to time?  These symptoms overlap with many conditions.  It takes a trained and experienced professional to be able to properly diagnose someone so she can get the care she needs.

If you think yourself or a loved one struggles with these symptoms, whether or not they have the actual diagnosis, please know that help is there.  I have worked with Bipolar Disorder for many years in my profession, and I enjoy this kind of work.

Thank you for reading!

 

 

 

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