- Mental Health
The Many Evil Faces of Bipolar Disorder
The Statistics of Bipolar disorder
Approximately 3-4% of the population of the United States over the age of 18 is affected by Bipolar Disorder at any given time. To put this number in perspective for you, an estimated 5.7 million people in the US suffer from Bipolar Disorder, often times a debilitating disorder, and of the 35,000 people who commit suicide every year in the United States, over 90% of them were suffering with (either diagnosed or undetected but suspected) a major mental disorder, and Bipolar Disorder tops that list as one of the most prevalent disorders amongst suicide victims. The National Institute of Mental Health reports that of the 5.7 million bipolar sufferers in the United States, over 82% are considered severe cases. 48% of the people who suffer from bipolar disorder are receiving treatment; of those receiving treatment, a disturbingly low 39.2% are receiving minimally adequate care (21.8% of the total sufferers). In other words, the majority of bipolar disorder (BD) sufferers are walking around every day of their lives without any sort of medical treatment, and if left untreated, bipolar disorder continues to get worse. The median age of onset of Bipolar Disorder is 25 years old, although it can start as early as five years old and as late as 50 years old. An equal number of men and women suffer from Bipolar Disorder and it is prevalent in all races, ethnic groups, and socioeconomic statuses. Bipolar disorder is known to have a high hereditary factor; more than 2/3 of people with a diagnosis of Bipolar disorder have a close family member with the same diagnosis or a major depressive disorder. Furthermore, women are three times more likely to experience rapid cycling (going from mania to depression and back) whereas men are more likely to be manic rather than depressed, and their mania lasts longer.
What is Bipolar Disorder? According to the American Journal of Psychiatry, Bipolar disorder is a psychiatric disorder referred to as a mood disorder, though some publications and journals describe it as more of a personality disorder. Some believe they are the same thing; however, a mood disorder, such as Bipolar Disorder, is a different diagnosis out of the DSM-IV (Diagnostics and Statistics Manual) of mental disorders than a personality disorder. The most informative of all the educational resources that I found and read while attending Sonoma State University, is the American Journal of Psychiatry. The AJP described bipolar disorder as a mood disorder characterized by two distinct "mood swings" of sorts--the person is either in an extremely "manic" state--mania is an abnormally elevated or irritable mood, arousal and/or energy levels, or the opposite extreme is severe depression. Mania is the opposite of depression. I want to clarify something that many people make a mistake in thinking with bipolar disorder. Because mania is described as an elevated mood and is referred to as the opposite of depression, it's easy to make the mistake--and many people do--in thinking mania is always a positive state of mind. Some people think "euphoria" and wrongly assume that it's the kind of euphoria one gets when taking opiates. Mania can be, at times, a euphoric state, however the euphoria is not the same as a drug-induced euphoria, but can be described as more of an onset of intense happiness and excitement...here's what wikipedia.com says about the euphoria of bipolar disorder: "...While most people would consider euphoria to be purely benevolent, it can be problematic in individuals with bipolar disorder who experience phases of depression and mania. In a manic episode the patient acquires a state of euphoria, sometimes causing potentially dangerous actions to occur...." Mania has a small instance of being positive, but it can also be expressed with someone flying off the deep end and running around in a panicking state of mind or extremely irritable with everyone around them. The word mania comes from the Greek "μανία" which means "madness, frenzy"; and the Greek verb "μαίνομαι" which means "to be mad, to rage, or to be furious". The depression, on the other hand, is more of a withdrawn state of being; the bipolar sufferer who is in a depressed state will lock themselves in their room for days and cry uncontrollably and want to be left alone. There are times that each state--mania or depression--can last for weeks or even monthsat a time. The important thing to remember about bipolar disorder is the fact that the sufferer is rarely in a normal, even-tempered state of mind, or rather, what most people would consider an even-tempered state of mind; they spend the highest amount of time in either a manic or depressed state of mind. Many BD sufferers don't even know what a normal, even-tempered state of being is.
Personality disorder, on the other hand, refers to a class of "personality types and permanent behaviors" associated with powerful distress or defect, which cause the person to have great difficulty conforming to social expectations, particularly in their relationships with other people. Personality disorders have a separate diagnosis in the DSM-IV and include such disorders as Borderline Personality Disorder, Narcissistic Personality Disorder, and Antisocial Personality Disorder. People with personality disordersdo things in life differently than most people; for example, someone with an antisocial personality is likely to behave in a way that completely disregards and even violates the rights of others. Children with early signs of antisocial personality disorder are known to kill animals by doing such acts as putting a live animal in the microwave and turning it on, or beheading a pet. Wikipedia clearly explains that individuals with antisocial personality disorder have an "impoverished moral sense or conscience" and often have a lengthy history of legal problems, aggressive behavior and impulsivity that often dates back to adolescence or even childhood. On the other hand, someone withBorderline Personality disorder has the impulsive behavior like BD (Bipolar disorder) but also has intense and unstable interpersonal relationships, is fearful of abandonment, has an unstable sense of self--alternating between having an overly positive self-regard and being heavily disappointed in and not liking oneself to the point they display characteristics common to self loathing, which can lead to risky behaviors such as harming themselves by cutting, extreme abuse of both illegal and prescription narcotics and a high potential for attempting suicide. People report feeling like they are constantly "walking on eggshells" with someone who suffers from Borderline Personality Disorder, because you just never really know what to expect from one moment to the next with someone who has borderline personality, so you're conditioned to expect the worst. Based on the characteristics of Bipolar Disorder and Borderline Personality Disorder, what stands out most, based on my research into each of the two disorders' prominent features, is that borderline personality disorder appears more behavior-based while Bipolar Disorder appears more mental-based.
Polarity in Bipolar Disorder
Bipolar Disorder Types
There are two predominant, distinct forms of Bipolar Disorder: Bipolar II, a less severe form of bipolar, and Bipolar I, which is the form of bipolar disorder being discussed in this article. The DSM-IV was the first evidence of two separate yet distinct forms of Bipolar Disorder, though there are many contradictions apparent within the DSM-IV, making the DSM-V’s upcoming release a highly anticipated resource in the field of mental health, in which there will likely be a better distinction between BD I & II. However, until the DSM-V is released, the official distinction between Bipolar disorder I and II is as follows:
Bipolar I: A person with bipolar I has manic episodes, while in bipolar II there are hypomanic episodes. In mania, the elevated mood is abnormally different and it's important to note that the elevated mood interferes with the person's daily functioning, and the increased activity or energy that accompanies it is also abnormal.
Bipolar II: The hypomanic episodes, as opposed to the manic episodes of Bipolar I, are the difference between the two diagnoses. In the hypomania of bipolar 2, a person has a constant, uninterrupted mood that is elevated (heightened), expansive (grand, superior--even possibly euphoric) or irritable. The mood must be noticeably different from his or her normal mood when not depressed. For example, Mikayla is exceptionally cheerful, needs only a few hours of sleep rather than the eight hours she normally needs; she spends more money than she should and speaks far more rapidly than usual, along with other symptoms of hypomania. This behavior is noticeably different from her usual mood, yet there are cheerful people who normally well-functioning on minimal sleep; though there are those individuals who are impulsive and talk rapidly but do not display other symptoms of bipolar disorder, therefore, it's not necessarily abnormal in every case. What's important is each individual’s usual, typical state, because one's usual behavior is the only one to which a person can be compared.
Other differences between Bipolar I and II: One or more of the following symptoms must be present in mania but cannot be present in hypomania:
Feelings of grandiosity (believing that one's self is more important than actually is.These symptoms all fall under psychosis. Psychosis is never present in Bipolar Disorder II. Furthermore, the level of mania compared to hypomania is such that mania significantly interferes in daily life. A few more differences between mania and hypomania:
Someone with mania has to be hospitalized due to the severity of symptoms:
Hypomania doesn't last as long as mania and isn't as severe
More time is spent in depressed mood than hypomania with Bipolar II.
There can also be symptoms such as hallucinations and delusions in Bipolar II only when in a depressed mood, rather than during a manic episode with Bipolar I, and it does not change the diagnosis from Bipolar II to I.
In addition to the two main types of Bipolar Disorder, Bipolar I and Bipolar II, there are two less severe, much more mild forms of Bipolar Disorder. Wikipedia states that “there are three main types as well as one which is considered "unspecified". I contacted Wikipedia in an attempt to get that information changed. Wikipedia does not claim to be 100% accurate with their information but in this case it's clearly inaccurate. Bipolar I and II are the main types of Bipolar disorder; the other two types are not as common nor are they even acknowledged by some health practitioners, they are sometimes just lumped together with Bipolar Disorders I and II.
Cyclothymia: A history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes. There is a low-grade cycling between moods which seems to family, friends, acquaintances, or anyone who talks at length to the individual as though he or she has a personality flaw, and interferes with functioning.
Bipolar Disorder NOS (Not Otherwise Specified): This is a form of bipolar which is very difficult to diagnose and categorize, but there are symptoms apparent which mirror both mania and depression, the symptoms are not as severe, but rather are milder and still interfere with normal, daily functioning.
Bipolar Disorder Spectrum
Please take a moment to participate in this poll before reading on
Have you ever had any of the following symptoms? (Make one selection by looking over the list of symptoms, and selecting the number that corresponds to the total # of symptoms) **SEE NEXT PARAGRAPH**
To get your results, please read each symptom, then once you've read them all count the number of symptoms you have (if any) and choose the letter that has the total number of symptoms you have. For example, if you have a total of 8 symptoms, choose the selection which says (+7). I did this mainly to give you an idea how, #1--Bipolar Disorder can be misdiagnosed since there are other mental illnesses which cause some of the same symptoms as Bipolar Disorder, and #2, to get you really thinking about each and every symptom and to force you to decide (honestly, I hope!) if you have any of these symptoms and/or if you possibly could be suffering from Bipolar Disorder or know someone who is...
In order to get a diagnosis of Bipolar Disorder, you would have to show unmistakeable and obvious signs of having both mania and depression (number 1 & 2), both which must have been present for more than six months; both have to be significantly impairing your ability to function in day-to-day life; it has to be affecting your interpersonal relationships and/or preventing you from having relationships at all; in order to have mania, and you have to have at least six of the major symptoms of mania in order for a firm diagnosis of Bipolar to be made. Furthermore, you must have at least one of the symptoms of Psychosis (the last one, I lumped all three symptoms together). Also, for a diagnosis of mania, there has to have been a prolonged period of a mood that is very unusual for the individual person. Bipolar disorder is very confusing!
The Rapid Cycling (Mania to Depression) in Bipolar Disorder
Art Depicting Bipolar Disorder
Altman Self-Rating Mania Scale
- Altman Self-Rating Mania Scale - Wikipedia, the free encyclopedia
This is a widely used method for Psychiatrists and other Health Practitioners to find out how patients rate themselves in the mania department. It's very important to be completely honest throughout...
Knowledge and Experience in Abnormal Behavior
In addition to the knowledge I possess in regard to Bipolar Disorder and other abnormal behaviors, I have work experience consisting of working one on one with children and adolescents between the ages of five and seventeen years of age, who had been formally diagnosed with and were being treated for a variety of abnormal behaviors, including both Bipolar Disorder and a variety of personality disorders. Thanks to my wonderful education at Sonoma State University in Rohnert Park California, I have extensive understanding of Psychology and mental disorders. While attending American River College in Sacramento, California, I worked in group foster homes for several years. These group foster homes were Level 6, a moderate-level of security in a regular residential home, as opposed to a hospital or institutional-type of setting. All of the six girls in the three individual homes, had a minimum of one mood disorder or personality disorder; more than one had multiple mental issues. Working with children and adolescents who were the labeled early on as problem children, or who had been in and out of foster homes a large percentage of their childhood years, I quickly recognized the feelings of having been abandoned and given up on, which led to my determination to one day open a state of the art residential foster home in which the children would be given the love, attention and acceptance they had so cruelly been denied. I care very much for these children, they experience more adversity and pain and dysfunction as children than most people do their whole lives. My plan after graduating with my Bachelor of Art in Psychology, was to dedicate my life to helping foster kids through nurturing and stability.
How Can I Help?
Everything I presented thus far shows the complexity of bipolar disorder and anyone going through it should have a large, trustworthy and reliable support network. You'll notice I didn't include treatment options in this article. The focus is on the disorder itself and anyone suffering should not do so alone. Anyone with BD should be encouraged, for as long as it takes until they realize that a support group would be an amazing and positive coping resource. There are many, many BD support groups available all over the country, find them...use them....make them your friend. Don't suffer alone, get into a group. This disorder is manageable, you just have to have a positive attitude and not give up....every day is a new opportunity to have a better attitude than yesterday. Its crucial to follow the advice of your physician as well. When you wake up tomorrow, tell yourself that LIFE IS GOOD! Don't give up, keep smiling and remember that each person with bipolar disorder is unique, special, and important. Always remember that.
Bipolar and Me...
There is more than one reason why Bipolar Disorder is such an interesting, important disorder for me and in my life. It is natural for someone with an education such as mine, in Psychology and Abnormal Behavior, to be completely fascinated by disorders like bipolar because it's very multi-faceted and there is such an enormous variety of different major and severe symptoms, some of which can differ from person to person (like halluncinations, delusions, and clang associations ) making each case of BD very unique to each person. And each person has unique, personal coping skills and abilities which definitely impact how they get through each day and what their attitude is. There are so many factors involved that it's very intriguing to hear each individual person's journey through the disorder, before being diagnosed and after. Bipolar disorder is also very personal to me because I have a few good friends (casual and close) as well as family members either who have BD or who have strong symptoms of it (there are also a handful to which I have expressed my suspicions, and not one of them will trust that I know a great deal about this disorder and feel comfortable in my insight into it, though I don't blame them, most people view BD in a very negative and harsh way. Plus, having a relationship with someone who has Bipolar Disorder is challenging, frustrating, and tiring but as long as you can keep reminding yourself that the person doesn't choose to be difficult, it makes it easier.
I'm no longer embarrassed to say this and for most of my life I was, but I believe and have for years, that I have bipolar disorder, I have symptoms which I believe show I have it but I have had two different Psychiatrists tell me that I DO NOT HAVE BIPOLAR DISORDER; I completed an online bipolar disorder test one time and printed it and took it to my Psychiatrist and he stated that "You do not have Bipolar Disorder, Jennifer". I don't know why they are adamant about me not having it while I feel I do, but to be quite honest, after conducting research for this article and typing it up and piecing everything together, I just can't believe how many symptoms I seem to have, but maybe for me it's difficult to self-diagnose. Maybe I'm being like I was in college when I first took an abnormal behavior class, every single disorder and condition I learned about I swore I had. Perhaps I just get so involved in my research of these things that are of great importance to me and in preparing my report and findings I start to feel like it's hitting home when really, I'm just doing a thorough job in conducting research and doing my reporting. There's certainly no shame in that.
By the author: This story that I tell is about my medical condition, bipolar disorder. From my teenage years until the present I have had to battle with the highs and lows of this illness but I also have had a struggle to discern the difference between reality and psychosis.
Over the years I have had bizarre experiences even when mentally well. Because of this I began to think that someone very powerful was playing a mind game with me and I was actually a victim not just a mental patient. However this is impossible to prove. None of my family or closest friends will entertain any other idea except that I am deceived by this illness. I think in the back of my mind that I may have stumbled on a Nazi conspiracy to rule the world. This is how I have lived for most of my adult life torn between two realities. However despite this dilemma I have learned to not only survive but also to triumph over this affliction.
© 2013 Jennifer Stockton