You know what mental illness appears to get misunderstood a lot? Bipolar Disorder. But never fear, here I am to sniff out the facts from the fiction for you. And because there’s so many fictions, this intrigue will be broken down into two parts.
Myth #1. A person with bipolar disorder has split personality.
Where did this idea originate? Is it from an awesome old movie that even my fascination with the retro and vintage has somehow missed?
Anyways, this is totally bogus. People living with bipolar disorder do not have a split personality. The ‘bi’ refers to the fact that those living with this condition can experience extreme mood swings commonly referred to as ‘mania’ and ‘depression’. The older term that was used for bipolar disorder is ‘manic depression’. I don’t quite understand how really super, dooper extreme (and I mean REALLY SUPER DOOPER EXTERME) shifts in mood has anything to do with a personality changing. But whateves. The other thing to add to this fiction, is that ‘split personality’ is actually not a real psychiatric thing anyway. So, let’s just save a lot of confusion and omit this myth from our bank of knowledge.
Myth #2. Bipolar disorder is just another name for mood swings.
If only it was. I am reasonably certain that a lot of people experiencing bipolar disorder would give their first child for the types of mood swings I might have over the course of the day – happy and energetic when I sniff my first coffee of the morning to down and sad when I think about how I had too many coffees (again) during the day.
When most people feel in the dumps or on top of the world, it's usually a short-term feeling that fades away along with the reasons that prompted the feeling, or as a result of a gradual adjustment to the new circumstances.
Bipolar mood swings are incredibly different, and they can last for weeks or months. Up mood swings or ‘manic episodes’ consist of really high energy levels, positive mood (confidence, optimistic), irritability (feeling impatient and angry), being easily distracted and heightened senses which can lead to dangerous lifestyle choices, racing thoughts that refuse to be corralled and out-of-ordinary behaviours that can damage careers and family lives. The down mood swings or ‘depressive episodes’ for a bipolar person can include flat or depressed mood, excessive sleep and lethargy, uncontrollable crying, marked physical slowing, suicidal ideation and even delusions or hallucinations. These are not normal mood swings.
So when we're talking about bipolar disorder, we're not talking about good moods and bad moods. There's no "snapping out of it" when it comes this condition.
Myth #3. Experiencing mania would be awesome!
Mania is a condition of a euphoric, elevated mood, feeling on the top of the world, with a marked increase in activity. In mild forms, this can allow the person to be more productive and experience significantly more feelings of pleasure. But as the mania progresses, people tend to become irritable where they are at risk of making decisions they normally wouldn’t and may not have the judgment they usually do. Lack of sleep is a common symptom of a manic episode and the person, over time can slowly lose control over their thoughts and actions. At the extreme end it can also cause psychosis. Sound awesome?
When I have seen clients experiencing manic symptoms, or being hospitalised as a result of a manic episode, they do feel pretty great. But the energy they have is really excessive and their thoughts are racing – it can be really hard for them to finish any one thought, let alone an actual task. Whilst they often may have some really grand plans, the level of distraction is high, and it’s hard to get these plans off the ground. Disinhibition can also be really high and often risky behaviours might result – like promiscuous sex or telling their loved ones how they really feel about them or giving away all their possessions.
As such, the fallout from a manic episode can be so very devastating.
Myth #4. The switch from happy to sad is really quick.
How long the extreme moods of bipolar disorder last, and how intense they are can vary a lot from one person to another. For example, some people experience mainly manic episodes, others experience predominantly depressive episodes, and others experience both extremes. Some people may even experience both high and low moods together – they may be extremely energized, for instance, but also feel depressed and hopeless.
Most people who live with bipolar disorder don’t careen from high to low and back again, with nothing in between. Some people can go for months or years with bipolar disorder in regression, before an episode of mania or depression may hit. Some people cycle quickly between high and low, while others only experience a full-blown manic state once every few years.
Myth #5. There is only one type of bipolar disorder.
A common – but mistaken – belief is that there is only one type of bipolar disorder. For the purposes of diagnosis, there are a number of different types. The main ones are:
Bipolar I Disorder is the most common and prevalent of the bipolar mood disorders. It features the experience of full manic episodes and severe depressive episodes. The patterns of extreme mood states are varied and different individuals may experience a different course of the illness. It is well documented that this can be a relapsing and remitting illness, where symptoms come and go, and as such it is important to ensure that treatment continues even if symptoms are no longer present.
Bipolar II Disorder is characterised by severe episodes of depression and episodes of hypomania (i.e., mild forms of manic symptoms) that almost never develop into severe mania.
People with bipolar I or bipolar II may experience frequent mood cycling. Those who experience more than four episodes of hypomania, mania, and/or depression in a year are said to experience Rapid Cycling. These people tend to alternate between extreme mood stated separated by short periods of being well.
Cyclothymic Disorder. This disorder occurs when an individual experiences frequent short periods of mild depressive symptoms and hypomania, mixed in with short periods of normal mood. Though a person experiencing cyclothymic disorder does not experience major depression or mania, they are at increased risk of developing bipolar I or II disorder.
Tune in tomorrow for part two of myth busting!