For starters, she asks you to go shopping and spends an excessive amount of money. She doesn’t just buy one pair of boots, she buys five. And then she buys three pairs of the same designer jeans in different colors.
In addition, she seems to be talking faster than usual. She speaks so rapidly that keeping up with the banter is a challenge. It’s as if she feels euphoric.
Three weeks later, you notice a dramatic shift in her mood. She becomes depressed even though nothing out of the ordinary has happened. The depression is severe. She stays in bed until three in the afternoon. This behavior lasts for two weeks.
“Maybe she’s just moody,” you think. “But then again, this doesn’t seem normal. Could she be bipolar?”
If you haven’t heard of bipolar disorder, you’re definitely not alone. Many people are unaware of this chronic condition.
Bipolar disorder is a serious mental illness marked by distinct periods of both abnormally elevated and abnormally depressed mood. According to the Depression and Bipolar Support Alliance, bipolar disorder affects nearly six million Americans. That’s about 2.6 percent of the population.
In truth, it can be difficult to tell the difference between typical moodiness and bipolar disorder. That’s because both involve a shift in emotions. Moodiness is a simple expression of a range of emotions, whereas bipolar disorder is a chronic psychiatric condition that causes the mood to cycle through periods of mood elevation, known as mania, and episodes of depression.
“We all experience moodiness or changes in mood, which is very normal. But bipolar disorder is a very distinct condition,” says Dr. William R. Marchand, a psychiatrist and author of Depression and Bipolar Disorder: Your Guide to Recovery and Mindfulness for Bipolar Disorder. “Moodiness typically only lasts for hours or a day or two and then the mood gets back to normal. But bipolar disorder causes persistent and recurrent emotional symptoms that interfere with life.”
To differentiate between the two, it’s important to know the characteristics of both conditions.
“One way to think about it is that with normal moodiness, the person is just experiencing the emotional state of their mood. For example, they may be feeling irritable or depressed,” says Dr. Marchand. “But in an episode of bipolar mania or depression, there are many additional symptoms. If it’s a depressive episode, symptoms include difficulty experiencing pleasure, changes in weight or appetite, changes in sleep patterns, increased or decreased energy, negative thinking, hopelessness and a loss of sex-drive.
"Symptoms of manic episodes include euphoria, inflated self-esteem, decreased need for sleep, rapid speech, racing thoughts, increased goal-directed activity and excessive involvement in activities that can cause painful consequences, such as unrestrained buying sprees or sexual indiscretions. Milder manic episodes can also occur and these are known as hypomania.”
To diagnose bipolar disorder, doctors rely on a set of criteria published in The Diagnostic and Statistical Manual of Mental Disorders, commonly known as the DSM-5. This manual specifies three primary subtypes of bipolar disorder: bipolar I disorder, bipolar II disorder and cyclothymic disorder as well as several other forms of the illness.
Marchand says that there are distinct differences between each type of bipolar disorder.
“To have bipolar I, a person must have experienced at least one severe episode of elevated mood that meets diagnostic criteria of a manic episode at some time in their life,” says Dr. Marchand. “Unfortunately, most individuals have multiple manic and depressive episodes as well as hypomanic episodes.”
Bipolar II is different than bipolar I in that manic episodes are not as extreme. “To be diagnosed as bipolar II, a person must have one or more occurrences of major depression and at least one episode of hypomania. Most people experience multiple episodes of depression and hypomania,” says Marchand.
Yet another type of bipolar disorder is cyclothymia. “To be diagnosed with cyclothymia, a person must have experiences of both depressive episodes and mood elevations over at least two years,” says Marchand. ”This is a less extreme form of the illness and none of the episodes can meet criteria for major depression or hypomania.”
If you are concerned that someone you love is suffering from bipolar disorder, there are a number of things that you should look for. Dr. Marchand explains that this begins with suicidal thoughts.
“The most concerning symptom of bipolar depression is suicidal thinking,” says Dr. Marchand. “This is a medical emergency and requires immediate action.”
He says that people often avoid this topic out of fear. However, this is the last thing you should do.
“If someone you know or love is increasingly sad and down to the point that depression is interfering with daily activities, it’s always appropriate to ask if they’re having suicidal thoughts,” says Dr. Marchand. “Some people are afraid to ask because they think that it might cause the person to have those thoughts. But that’s absolutely not true. Asking about suicidal thinking is the best way to prevent suicide.”
If suicidal thoughts are present, then immediate medical or mental health intervention is required. Help can be obtained by taking the person to an emergency room, by calling 911, or by calling the national suicide prevention hotline at 1-800-273-8255. You can also visit their website at: www.suicidepreventionlifeline.org
If these symptoms sound like you or someone you know, talk to a professional as soon as possible. Though bipolar episodes may come and go, the condition is lifelong. And left untreated, it can become extremely dangerous.
Though bipolar symptoms may not fully disappear, one can live a happy and healthy life. A combination of medications, counseling, and mindfulness can help to manage the disorder.
And always remember that mental illness is nothing to be ashamed of. Millions of people suffer from mental illness. It’s no different than dealing with diabetes or high blood pressure in that it can be managed.