Someone very close to me suffers from Bipolar Disorder which went undiagnosed for years. In fact, he was consistently misdiagnosed as having depression. As the name of this disease implies, Bipolar Disorder is characterised by dramatic shifts in mood between being “up” and being “down”. Generally speaking, people with Bipolar Disorder experience way more episodes of depression than they do of mania or hypomania; therefore making a proper diagnosis challenging. Furthermore, medications used to treat depression can and often do make Bipolar Disorder worse. Being that the criteria for diagnosis in Bipolar I is having had “at least one” manic episode, and the rest of the time, the person suffers from depression only, it is easy to see why Bipolar Disorder is very easily misdiagnosed. Bipolar II Disorder is even more difficult to spot at times, because people suffering from a hypomanic episode may not see their symptoms as a problem; and in fact, feel more productive, creative and up during those times. Proper diagnosis often relies on self reports from patients; therefore, if they don’t report symptoms of hypomanic behaviour, this disorder be misdiagnosed for years.
As the name implies, Bipolar Disorder is a psychological disorder characterized by dramatic mood shifts between a manic or hypomanic state and a depressed state. These cycles can occur over the course of several months or several times in a week depending upon the individual sufferer, however there are two main subtypes of Bipolar Disorder: Bipolar I and Bipolar II. Patients in both of these subtypes experience depression – often this is the primary emotion associated with both types. It is in the type of mania experienced that distinguishes these two subtypes from one another. Bipolar I patients suffer from at least one full blown manic episode in their lives, whereas Bipolar II patients suffer from hypomanic episodes. Let’s look at the definitions of these terms:
Mania (as paraphrased from WebMD) is defined by elevated mood, or extreme irritability, pressured speech (the person sounds as though the ideas are piling up too quickly to be able to articulate them verbally), insomnia, delusions of grandeur (the patient irrationally thinks they are capable of superhuman feats), excessive spending (often landing them several thousands of dollars in debt), substance abuse, hypersexuality and inflated self image. Manic episodes can be extremely damaging to the patient’s health, pocketbook and relationships.
Hypomania is a less severe form of mania (the prefix “hypo” means lower than) and is characterized by an elevated mood, creativity, decreased need for sleep, lots of energy and a sense of confidence. Patients experiencing hypomania do not necessarily view it as a negative feeling and often experience increased productivity during these periods. Patients suffering from hypomania are still at risk for engaging in risky behaviours, although they may not be as severe as in full blown mania. It is important to note that in order to be diagnosed with Bipolar I, a person must have experienced at least one full blown manic episode in their life.