Let’s Talk About Bipolar Disorder


Let’s Talk About Bipolar Disorder

People increasingly seem to think they know about bipolar disorder. But do they really?

Many people seem to use the term “bipolar” to describe someone who is very moody or dramatic. In truth, bipolar disorders exist along a spectrum and vary widely. They are essentially disorders of energy regulation. People with bipolar disorders experience ups and downs, not like the regular ups and downs life brings, but far more distressing and impairing. In some cases the energy shifts so drastically that the person’s behavior is completely out of character compared with their baseline personality. People with the diagnosis may have long periods of normal energy, and only suffer with symptoms occasionally. Or, the symptoms may be present most days.

Bipolar illnesses are different than personality traits. Normal people with good judgment and healthy coping skills can have the diagnosis.

Why is there such misconception around this particular psychiatric diagnosis?

Psychiatric diagnostic criteria consist as checklists of symptoms, and the criteria are meant for use by trained professionals already familiar with the clinical features of the illnesses, not for use by untrained lay people. The written criteria sound vague, and often include things like “a change in energy level” or “irritable mood.” But what’s not obvious is, ”How big a change?” or “How irritable?”

Bipolar disorder involves changes in energy, mood, sleep patterns, and often behavior. A manic episode might involve no sleep (at all) for several consecutive days, followed by difficulty determining what is real from what is not real. A depressive episode might render a person incapable of mustering the energy to shower, get dressed, leave the house, or even deprive them of the desire to go on living. Symptoms may last weeks or months, with long stretches or normal in between. Or symptoms may shift more rapidly.

There has been a growing trend of patients coming in talking about bipolar disorder: how they have friends and family members with the diagnosis, or just as commonly, how friends and family members have hurled the label at them. But do they understand the diagnosis? Are they using the terminology correctly? Are you and your friends?

Misunderstanding and misusing psychiatric diagnostic language can have serious negative consequences. Here are just a few examples:

  • A specific diagnosis is used an an insult, and persons with that diagnosis overhear

  • Not understanding the diagnosis accurately, loved ones encourage someone with the illness to stop taking medication

  • Believing that “bipolar” is a way of saying someone is a difficult person, an individual with new symptoms refuses treatment

  • Seeing common personality traits defined as illness criteria, a person decides that mental illness is not real

People have been talking about bipolar disorder, yet many of the common understandings and assumptions are incorrect. Bipolar doesn’t mean what people think it means. Educate yourself and your loved ones, and be part of a better conversation.

Posted on December 17, 2018 .