What is bipolar?

What is Bipolar Disorder?

Bipolar Disorder is the short term for Bipolar Affective Disorder. The name used in the past was Manic Depressive Disease. Bipolar Disorder involves cycles of depressed and euphoric, manic moods, which exceed the normal level.

The Bipolar Disorder runs through four possible episodes:

  1. (Major) Depressive Episode

  2. Manic Episode

  3. Hypomanic Episode

  4. Mixed Episode

 

  1. (Major) Depressive Episode

During a major depressive Episode five or more of the following symptoms appear, lasting about two weeks:

  • Persistant sad, anxious or empty mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness or helplessness
  • Loss of interest or pleasure in ordinary activities, including sex
  • Decreased energy, a feeling of fatigue or being “slowed down”
  • Difficulty concentrating, remembering, making decisions
  • Restlessness or irritability
  • Sleep disturbances
  • Loss of appetite and weight, or weight gain
  • Chronic pain or other persisting bodily symptoms that are not caused by physical disease
  • Thougts of death or suicide – suicide attempt

 

2. Manic Episode

During a manic episode mood is permanent raised, exuberant or nervous and this episode lasts about a week (or hospitalisation).

Three or more of the following symptoms persistent go on:

  • Increased energy, aktivity, restlessness, racing thoughts and rapid talking
  • Excessive “high” or euphoric feelings
  • Extreme irritability and distractibility
  • Decreased need for sleep
  • Unrealistic beliefs in ones’ abilities and powers
  • Uncharacteristically poor judgement
  • A sustained period of behaviour that is different from usual
  • Increased sexual drive
  • Abuse of drugs, particularly cocaine, alcohol and sleeping medications
  • Provocative, intrusive and aggressive behaviour

 

3. Hypomanic Episode

Hypomania is a milder form of mania. It has similar but less severe symptoms and causes less impairment. During a hypomanic episode, the person may have an elevated mood, feel better than usual and be more productive. These episodes often feel good and the quest for hypomania may even cause some individuals with bipolar disorder to stop their medication. Hypomania is often followed by an escalation to mania or a crash to depression.

 

4. Mixed Episode

Symptoms of both mania and depression at the same time for at least a week. For example, the person may experience rapid mood swings (happy, sad and irritable), be restless, irritable, unable to sleep and feel guilty and suicidal. Symptoms cause significant disruption to the person’s daily life and hospitalisation may be necessary.

Bipolar I and II and more

Bipolar I

Bipolar I disorder is also known as bipolar I or bipolar type I. Bipolar I is the most severe form of manic depression; it is characterized by one ore more manic episodes, usually accompanied by major depressive episodes. There is just one qualifying event in your life a doctor looks for in diagnosing bipolar I disorder: whether you’ve had, or are having, a manic episode. You don’t evenhave to have a depressive episode to be diagnosed with bipolar I disorder (although the vast majority of people who experience mania also have episodes of major depression). This explanation probably seems far too simple, given the severity and complexity of bipolar disorders. But as far as a diagnosis goes, a single manic episode that isn’t caused by a substance (could be an illegal drug or a medication, for example) is officially all it takes to diagnose bipolar I disorder.

Bipolar II

If you have bipolar II disorder, you will experience severe depression and a less severe form of mania known as hypomania. Therefore, your doctor will review you history and current concerns to determine if:

  1. You are having an episode of hypomania or if you’ve had one in the past.
  2. You are having an episode of depression or if you’ve had one in the past.
  3. You are not having a manic episode or if you’ve previously had one of these.
  4. Your mood symptoms are not primiarly part of a psychotic illness such as schizoaffective disorder or happening at the same time as symptoms of schizophrenia.
  5. Your symptoms are causing significant problems in any part of your life such as your family life, your social life, work, etc.

If your doctor, with your input, determines that your symptoms meet all the above points, you will most likely be diagnosed with bipolar II disorder.

As noted above, these criteria have been established through the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. It is the primary system used to classify and diagnose all mental disorders.

Cyclothymia

There are six checkpoints a doctor will review with you for diagnosing cyclothymic disorder as per the criteria in the DSM.

What sets cyclothymic disorder apart from the other types of bipolar disorder is that your symptoms last for months or even years without letting up. And yet, these symptoms aren’t quite severe enough (though still very troubling and painful for you) to be called a manic or a major depressive episode.

Therefore, diagnosing you with cyclothymic disorder is mor a process of ruling out these two distinct types of episodes. In making this diagnosis, your doctor will review your history and current concerns to determine if:

  1. You are frequently experiencing symptoms of hypomania and depression and that you’ve had these problems for at least two years.
  2. Your symptoms have gone away for more than two months during this two-year period.
  3. You have had a manic episode, a depressive episode or mixed episode during this two-year period.
  4. Your mood symptoms are not more likely caused by schizoaffective disorder or they are happening at the same time as symptoms of schizophrenia.
  5. Your symptoms are not caused by a drug (legal or otherwise) or another medical problem.
  6. Your symptoms are causing significant problems in any part of your life such as your family life, your social life, work, etc.

If your doctor, with your intput, determines that points one and six are yes while points two through five are no, you will most likely be diagnosed with cyclothymic disorder.

It should be noted that if, after being diagnosed with cyclothymic disorder, you develop symptoms of mania or major depression you may also be diagnosed with bipolar I disorder or bipolar II disorder.

 

Rapid Cycling

Rapid Cycling, according to the American Psychiatric Association’s Diagnostic and Statistical Manual, occurs when a person experiences four or more mood swings or episodes in an twelve-month period. An episode can consist of depression, mania, hypomania or even a mixed state. Rapid Cycling bipolar disorder is consideres to be a mor severe form of bipolar disorder. In some “rapid cyclers” the mood swings ca come even more quickly – weekly, daily or even hourly (called Ultra Rapid Cycling and Ultra-ultra Rapid Cycling).

Rapid Cycling bipolar disorder can feel like an out-of-control, mood-driven roller coaster for someone who has it. People who have rapid cycling bipolar disorder are more likely to attempt suicide than those with bipolar who don’t cycle through moods so rapidly.

Those with rapid cycling bipolar disorder may be particularly impulsive, irritable and angry. They may have outbursts that aren’t easily controlled.

 

The health information contained herein is provided for general education purposes only. This site should not be seen as a substitute for an official diagnosis or for professional health care.

 

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