Bipolar Disorder: More Than a Mood Swing

Continuing in the series of looking at various mental illnesses, today the topic is Bipolar Disorder.

Individuals who have bipolar disorder can have psychotic features such as hearing voices or seeing things that are not there in reality. Yet, this is not the primary feature. This disorder used to be called “Manic Depressive Disorder.” A basic understanding of this disorder requires individuals to understand the difference between mania (or manic) and depression.

Last week, this author shared an article that discussed the illness of depression. It is more than just a down mood. It has symptoms, and can be tracked as far as improving and decompensating. Generally, these symptoms include sleep disturbance (too much or too little), decreased interest in enjoyable activities, excessive guilt over which there is not a direct connection of guilt, fatigue, decreased concentration, decreased or increased appetite, symptoms of psychosis, similar to those associated with schizophrenia, and sometimes thoughts of suicide.

Bipolar disorder includes all of that. However, if you imagine a pendulum that swings between two extremes, that describes bipolar disorder. The other side of the pendulum is called mania or manic. A person who is manic will experience symptoms like these: Excessive involvement in pleasurable activities with potential for significant consequences, (unrestrained shopping, sexual indiscretion, or foolish financial investments etc.), decreased need for sleep, inflated sense of self-importance, more talkative than usual or a pressure to keep talking, racing thoughts, easily distracted, increased goal directed activity, even if the goal changes frequently.

When one compares these lists of symptoms, you notice a pattern on each side of the proverbial pendulum swing: the symptoms on each side are opposite. A depressed person will not sleep due to excessive worry, or will sleep many more hours than needed. A manic person will not sleep, and continue to have more than enough energy. A depressed person does not want to do anything fun, and a manic person will do things that are pleasurable without regard to any consequences. A depressed person often feels worthless, where as a manic person can have such an inflated sense of self-importance, that they can believe they can accomplish things which are completely impossible. Depressed individuals are usually withdrawn, and manic individuals will talk without hardly taking a breath. A depressed person can feel like they are running on empty, and the manic person has racing thoughts and is easily distracted. A depressed person often will not have any goals or not focus on goals which were previously set and a manic person will be very goal directed in very short segments of time.

All of these symptoms are managed in a person’s brain. When a person has bipolar disorder, they are consistently moving between these two extremes. Often times, individuals may say that a loved one has bipolar just because the person is moody or has mood swings. That is not bipolar. It takes much more than just mood swings to justify the diagnosis. Yet, if someone has the above symptoms, there is significant cause for concern. This article is not designed to teach the audience how to diagnose any mental health disorder. It is designed to know enough to determine when professional help is needed.

If you interact with someone that has these symptoms, you must recognize that the individual may not be able to make decisions in their own best interest. For example, this author once interacted with a person that was very manic. He thought he could jump off of a bridge and bounce back up to the height from which he took his leap of faith. Regardless of how much he believed this, it was not ever going to be true. He required hospitalization for his own safety. Not everyone that may have these symptoms will require hospitalization. There are lots of treatment options. The important thing for the general population is to know enough to recognize the symptoms and seek professional medical attention when it is necessary. If you are one of the first individuals from whom a struggling person or their family member seek care and advice. Be ready to offer assistance, and have the names of a good therapist or psychiatrist at your fingertips. Think about the potential danger to that individual and all others and make a decision about what is the best next step. Always err on the side of safety.

Depression and bipolar disorder are both mood disorders or illness in which the primary symptom is a change in the person’s mood. These individuals are not “crazy” or unintelligent. They deserve to be treated with respect, affirming care, and with friendship. When a person does not understand another person’s struggle, this is not justification for disrespect. When an individual has a depressive disorder, bipolar disorder, or some other form of mental illness, their behaviors can sometimes be difficult to tolerate. Just remember a wonderful quote from the 16th President of the United States, Abraham Lincoln: “I do not like that man. I must get to know him better.”