What is Bipolar Disorder? Facts and Myths Explained.

By: Bonnie Brown, PsyD

Mental health is a popular topic at the moment, thanks to stay-at-home
and safer-at-home orders. Plenty of people are having their first
encounters with intentional focus on their own mental health. While
depression and anxiety are primarily discussed, there are other mental
health issues that may be more common than people think. Bipolar
disorder, once known as manic-depressive disorder, is a diagnosis that
has often been thought of as mysterious. If you’ve been diagnosed
recently, or are just generally curious, keep reading. You are not alone
in either scenario.

Okay so here’s the technical bit…

Bipolar disorder is categorized in the Diagnostic and Statistical Manual
of Mental Disorders Fifth Edition (DSM 5) as two types of diagnoses.
Bipolar I Disorder requires the individual to have experienced a manic
episode. Symptoms of mania must include: elevated or irritable mood for
at least one week, and increased energy or activity during this time.
The increased energy or activity may include: inflated self-esteem,
decreased need for sleep, more talkative than usual or pressure to keep
talking, racing thoughts or ideas, distractibility, increase in
goal-directed activity, and/or involvement in activities that have a
high potential for painful consequences. A majority of those who have
experienced a manic episode have also experienced major depressive
episodes during their lives.

A major depressive episode requires five or more of these symptoms that
have been present during a two-week period: depressed mood, decreased
interest or pleasure in activities, weight fluctuations not attributable
to dieting, sleep disturbances, physical agitation or slowing, fatigue,
feelings of worthlessness, difficulties concentrating, and/or thoughts
of death or suicide.

Bipolar II Disorder consists of experiencing both a hypomanic episode
and major depressive episode. A hypomanic episode consists of the same
symptoms as a manic episode, however the symptoms are only present for
four to six days, and are not severe enough to cause marked impairment
or necessitate hospitalization. For this last reason, bipolar II
disorder has often been thought of as the “milder” of the bipolar
disorders.

Bipolar disorders have a genetic component that increases the risk of
development among individuals who have another family member diagnosed
with bipolar disorder. This is not to say that having a parent or
grandparent with a history of bipolar disorder means you should be
concerned that you will develop the disorder. The prevalence rate for
the general population is quite low, and having a family history only
increases that number very slightly.

De-mystifying Bipolar Disorders

There are myths about bipolar disorders that can perpetuate fear and
unease. One of these myths is that someone who is excited and happy one
day and then depressed the next day is bipolar. Remember the time
requirement for these moods. Depression requires two weeks, mania
requires one week, and hypomania must be at least four days. There is a
subtype called “rapid cycling” which is given if the person cycles
between one of these swings four or more times in a twelve month period.
Someone cycling daily would not be considered bipolar on that basis
alone.

Another related myth is that people who are diagnosed with bipolar
disorder do not experience a “normal” mood. In fact, people can spend a
great deal of their time in that in-between mood, also known as feeling
euthymic. As a result, it is not uncommon to effectively manage bipolar
and live a functioning life. This leads to the next myth, which is that
a bipolar disorder diagnosis equals disability and an inability to
function in life. This is far from the truth. If managed appropriately
to the individual, they have just as good of a shot at being healthy,
happy, and successful in whatever way that means to them.

Some people think that medication is the only form of treatment. While
it is true that medication is quite effective, the research shows that a
combination of medication and therapy is the most effective way to treat
bipolar disorder long-term. Therapy is incredibly useful in terms of
education, keeping sleep hygiene a priority, learning personal warning
signs and triggers, learning appropriate and individualized coping
skills, and maintaining social support.

A final, big, common myth is that mania is fun. Initially, people may
report that a manic episode feels good and productive. Part of the
symptom list includes getting more things done and possibly feeling very
confident. Think of an artist who spends days painting and producing
amazing artwork. Those feelings sound great, don’t they? Not to this
extreme. Mania can quickly become exhausting, painful, and even
dangerous. Examples of this include impulsively buying an expensive car,
and while driving that car for the first time, stopping at the mall and
buying a whole new wardrobe. Or, the need to experience something
thrilling takes the person to a club where they impulsively engage in an
intimate act while their spouse is at home. Mania can be destructive.

What to do if you want to know more…

Bipolar disorders have been confusing, vague, and plagued with
misconceptions throughout the years. This information is definitely not
everything there is to know about bipolar disorders, and should also not
be used to diagnose someone or yourself. If you suspect you might be
struggling with bipolar, or worry about someone close to you, it’s
important to let a professional figure that out. Contact a psychologist
or psychiatrist in your area with whom you can sit and give a detailed
history. It is their job to ask the questions and formulate the
appropriate diagnosis. And know that you are not alone, and it is not a
life-ending outcome.