Mental Health Week in Canada is May 5 to 11.
There was a time when bipolar disorder (BPD) was considered a more uncommon mental health issue, relegated mostly to the domain of psychiatrists who would prescribe medications that came with debilitating side effects.
The term for bipolar was manic-depressive, and most people envisioned a roller coaster of highs and lows that meant days without sleep in the manic state, and weeks or months of sleep in the depressive state. Now, as with many mental health issues, we have a better understanding of bipolar disorder, including the fact that there is more to BPD than we once thought.
There are four types of bipolar disorder with varying levels of severity. I have often heard individuals state “I am bipolar” without specifying their diagnosis.
A diagnosis of BPDI will include episodes of mania and depression but it is not necessary to experience episodes of depression to have a diagnosis of BPDI. The focus for diagnosis is severe manic episodes that last a minimum of seven days. If depression is present it lasts approximately two weeks.
A diagnosis of BPDII is characterized by long debilitating episodes of depression. This can be more difficult to deal with, even considering that the mania is less severe and is described as hypomania. Both BPDI and II cannot be cured and they need to be managed with therapy and medication to improve quality of life.
A third type of BPD called cyclothymic disorder can be resolved with talk therapy and less potent medications due to less severe symptoms (hypomania and mild depression) that last for a two-year period. The fourth type of BPD is described in the DSM-5 as “unspecified” meaning that a diagnosis of either I or II does not meet the criteria but the individual is experiencing periods of abnormal mood elevation.
The frequency of episodes of mania and depression can vary greatly. Some individuals may have many episodes throughout their lives and others only rarely.
A further complication in diagnosing BPD is that it is very common to have co-occurring mental health issues such as anxiety, attention deficit hyperactivity disorder (ADHD), personality disorder, post traumatic stress disorder and substance abuse issues. These can be overlapping with BPD and that can interfere with a specific diagnosis. A thorough medical and mental health analysis is essential for diagnosis by a psychiatrist, although testing by a psychologist can provide relevant information for diagnosis.
Symptoms of BPD can include rapid mood swings, elevated happiness, racing thoughts, high energy, impulsivity and grandiosity, faulty judgement, distorted thinking and, at times, hallucinations and delusions. If you are concerned about your own state of mind or that of another, contact a mental health professional for assistance.
Questions for Deborah Joyce can be forwarded to her through the Peak.
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