A Little Insight Goes A Long Way
Understanding Bipolar Disorder, symptoms and treatments is the key to the management of the disorder. The myriad of emotions that a person suffering from bipolar experiences in twenty-four hour period is astonishing, to say the least. Imagine one minute that you are hyper, can not sit still, so many thoughts going through your head like bits and pieces that pass as you look out a window; the next moment you are inexplicably sad, lonely and depressed, feeling as if life has no meaning, no one cares about you and you just do not want to go on; and then in another short period it is as if nothing in the world matters, you are deliriously happy and laughing inappropriately at situations and people; next jumping to being severely agitated and angry for no reason and wanting to cause harm to those around you. As you move through each phase, never in the same order, its like your mind is wiped clean of any memory of the previous state of mind, as if a light switch is flipped on and off, causing the changes in moods. To a person on the outside looking in, that has no knowledge of Bipolar Disorder, it can be a very disconcerting thing to witness. It’s like witnessing a rapid metamorphosis of sorts.
Common Misdiagnosis
There are many reasons that someone can be misdiagnosed. A main cause of this being the mindset of the patient when they are diagnosed, in other words, the kind of mood they are in. Excessive talkativeness and decreased need for sleep could cause the person to be misdiagnosed as having ADHD; being sad or depressed can lead a psychiatrist to believe they suffer from clinical depression. Bipolars are commonly misdiagnosed as having other disorders such as borderline personality disorder, Schizophrenia, Clinical depression, antisocial personality disorder or Schizoaffective disorder, all of this is depending on their state of mind at the time. There are so many reasons that patients are given a misdiagnosis of bipolar disorder. The signs of bipolar disorder are not always recognized right away. It is because of this that it is so widely misdiagnosed. Treating someone with bipolar as if they only suffer from depression is not only a misdiagnosis, it can also be life threatening in so much as medications used to treat depression, such as antidepressants, for a bipolar in their depressive state are almost like sugar is to a type 2 diabetic when their glucose is at its highest. The key to a proper diagnosis, once again, is completely understanding the disorder and the stages in which it goes through.
Why More Than 50% Are Misdiagnosed
As unbelievable as it may seem, it is true that more than half of people who suffer from Bipolar Disorder receive a misdiagnosis of unipolar disorder or depression; the reason is most bipolar sufferers seek treatment while in the low moods or depressive state of the disorder. It is impossible for the doctor or therapist to know that just yesterday or a week ago they were in a manic state or a hyper elevated mood phase of the disorder. Most bipolar sufferers do not think to tell the doctor or therapist about the state of their mood before the depressive state. At that moment, all they can think about is feeling overwhelmingly depressed. That is why familiarity of the symptoms, knowing the different stages of the disorder and becoming comfortable with their doctor and having a friend or relative active in the care plan helps to bring more clarity when it comes time for a true diagnosis.
Family Can Play A Key Role
I am not a doctor, nor do I proclaim to be. I have received no medical training, nor do I suffer from the disorder. I am a parent with a child who suffers from Bipolar Disorder II. My daughter Krysta, who is now 18 years old, was not properly diagnosed until she was sixteen and I first began to notice her symptoms when she was about nine years old. Prior to receiving a correct diagnosis of bipolar disorder, she was misdiagnosed as having ADD (Attention Deficit Disorder), ADHD (Attention Deficit Hyper Disorder), Depression and Separation Anxiety from her father (due to divorce) and at one time a doctor felt that she was just having issues managing her anger and it was recommended that she attend Anger Management Therapy.
Family can play a key role in the correct diagnosis, perhaps the first time around. Family and friends are able to recall the rapid change in moods and offer a descriptive account on the mood and the actions the person displayed while in the various mood states. This can provide to be very beneficial to the doctor. Individuals that have bipolar disorder do not always recall the true facts of events when they are in the midst of what is called a bipolar mood. They live in a fantasy world for the most part, with feelings of delusion. The delusion may be in the form of accusing a spouse or partner of cheating, overwhelming feelings that they are not wanted, etc. Bipolar can be a very needy disorder which in turn can be exhaustive to their support system, causing family to eventually give up or to put it bluntly; thinking that they are just crazy. During a full blown manic state a person whom suffers from bipolar disorder has little to no control over their actions. In addition, this can be very dangerous to those around them. Once agitated, the situation will only escalate until either medication is given and they begin to level the moods back to a normal state, or in the worst scenarios they have to be hospitalized for their own and others safety.
Family will remember that when in the height of the mania the person threw something or kicked a hole in the wall, or even ran away. The sufferer will deny any of this happened.
Symptoms of Bipolar Disorder
There are six main symptoms associated with bipolar disorder. Most people would wonder how can that be misdiagnosed. In actuality, it is easy to see why, when there are another fifty-seven underlying symptoms that fall under the main six symptomatic categories:
- Mood swings
- Cycles of symptoms (rapid changes in moods between highs and lows)
- Mania – and its symptoms:
- Excessive talkativeness
- Inappropriate elevated mood
- Distractability
- Irritability
- Overly-inflated self-esteem
- Grandiosity
- Unrealistic ideas
- Hypersexuality (increased sex drive)
- Decreased need for sleep
- Feeling on top of the world
- Talking very fast
- Racing thoughts
- Rebelliousness
- Increased goal-directed activity – e.g. shopping
- Excessive shopping
- Reckless behavior
- Physical agitation
- Spending sprees
- Insecurity-e.g. false insecurity, convinced partner is cheating, constant need for attention, feeling as if no one wants them around
- Depression – and its various symptoms:
- Persistent sad mood
- Overeating
- Loss of interest in activities
- Appetite loss
- Weight loss
- Weight gain
- Sleep pattern changes
- Insomnia
- Difficulty sleeping
- Oversleeping
- Sluggishness
- Agitation
- Lack of energy
- Feelings of worthlessness
- Inappropriate guilt
- Difficulty thinking
- Difficulty concentrating
- Thoughts of death or suicide
- Suicide attempts
- Chronic pain
- Mixed manic and depressive symptoms
- Agitation
- Psychosis
- Appetite change
- Trouble sleeping
- Suicidal thinking
- Psychosis
Awareness of Mental Health Disorders
It is imperative that school counselors and teachers be trained in recognizing the signs that a child could be suffering from Bipolar Disorder. Teachers spend more time with our children during the school year than we do, unfortunately. If the Board of Education made training mandatory in Mental Health Awareness, perhaps these children could receive an earlier diagnosis, which would put them on the road to dealing with not only having the disorder, but to managing the disorder. Think of it in terms of being told you have cancer and you have six months to live. That would be pretty difficult to accept. That is a pretty final diagnosis. Being told that you are bipolar is final to the sufferer. Bipolars do not process things as we do. Their emotions are extremely dramatic; going from overly angry to a depressive low. Bipolar may not be curable, but it is very much manageable. Early detection and early treatment can speed them on to the road to not only managing the disorder, but accepting the fact that they have Bipolar Disorder.
I feel like I’m bipolar.. am I??? My dad is bipolar, and has been my whole life, He has gotten worse because of his heart attack in June. When he’s manic, I love it! He does funny, and risky stuff, and I take part. My younger brother (15) doesn’t like it as much as I do and I don’t know why. I feel like I also get manic sometimes. I feel like my thoughts are rushing, and I act crazy and obnoxious without thinking at all, it feels like an impulse. I have anxiey issues though, and I take anti-depressents for it. Why do I find it so fun when my dad is acting crazy when he’s manic, and other people around me hate it, or is embarassed? Am I bipolar too?
A. Bipolar disorder tends to runs in families. Your father has it and therefore you are at an increased risk for developing the disorder. I cannot diagnose you over the Internet and just because your father has it does not necessarily mean that you do, but you might. If you do have it, this may explain why you find it fun and entertaining when your father is manic (i.e. you can relate). Perhaps he’s more “fun” when he is manic because being manic is like being high on drugs. Everything seems and feels better than it actually is. People with bipolar disorder commonly say they like the feeling of mania. Tara Parker-Pope’s Well Blog in the The New York Times last year featured a number of individuals discussing their experience with mania. One interesting quote came from Carter Goodwin, a 42-year-old artist with bipolar disorder, who said “I miss the mania…I love the mania. It feels so good to feel like I can do anything and like there is something really special about me. But it’s all chemical. It’s not true.”
You mentioned feeling impulsive while manic. Mania and impulsivity go hand-and-hand. If you are manic then you are not thinking clearly. If you are not thinking clearly then you are less likely to make well-thought out decisions and more likely to engage in less calculated or reckless behavior (i.e. impulsivity).
As for your brother, perhaps he’s concerned or embarrassed because he knows that the manic behavior is abnormal and unhealthy. To be manic is to be unstable. Some aspects of your behavior are apparently disturbing to him. That could explain his reaction to you and the reaction of others.
When your father is manic and you join in with him, you make be inadvertently making his situation worse. You take antidepressants for depression but you are not currently treating the mania-like symptoms (i.e. rushing thoughts, impulsivity). My suggestions for you are to realize that you are at risk for bipolar disorder (because of a family history), to limit or eliminate the manic-like activities that you engage in with your father, and to consider being assessed and treated for bipolar disorder. It is important to seek treatment as soon as possible so that you can decrease the chances of developing full-blown bipolar disorder. You may also want to consider family therapy. Since your father experiences mania, he may benefit from treatment as well. In addition, if he were being treated, it might make it easier for you to stabilize your manic symptoms. If you’d like to find a therapist in your community, please search this directory. I wish you and your family the best of luck.
