Bipolar disorder is alternating high and low moods that are significant enough to produce negative consequences. Not every case of bipolar disorder is as extreme as what you hear about or see on television. In fact bipolar disorder is a spectrum. The typical case is someone who has a job and a family, who thinks they suffer from depression, but who occasionally has unexplained and high, energetic moods. The disorder is also sometimes called manic depression.
Approximately 1 percent of the population has bipolar disorder. However, if you consider the whole bipolar spectrum, then approximately 5 percent of the population has the disorder.
The diagnosis of bipolar disorder depends on whether you've had at least one episode of mania or hypomania. Hypomania is less extreme than mania. With hypomania, your mood is elevated and your functioning may be slightly altered, but generally you can carry on with your normal routine. These are the criteria for hypomania.
Has your mood been elevated or irritable to a degree that is definitely abnormal for you? If so, did you have any of these symptoms at the same time?
Answer these 7 yes or no questions. Most questions have more than one part, because everyone is slightly different. You need to answer yes to only one part per question in order for that question to count.
1) Elevated self-esteem. Did you feel on top of the world? Did you have unsubstantiated self-confidence or unwarranted optimism? Did you start or make plans for multiple new creative or business ventures? Did you feel you had all the answers?
2) Increased activity. Did you have an abnormally high drive to be active and to achieve goals? For example, did you take on multiple new jobs, clean your house much more than usual, or have longer work outs? Did you have increased restlessness or pacing?
3) Decreased need for sleep. Were you able to get by on just a few hours sleep and be full of energy the next day?
4) More talkative than usual. Did you talk faster or louder that normal? Did people comment on you unusual talkativeness?
5) More distractible. Did you have difficulty concentrating? Were you easily distracted, or jumping from one idea to another? Did you feel like you had racing thoughts? Did you have rapid changes in conversation? Did others find it exhausting, annoying, or hard to keep up?
6) Reckless behavior. Did you engage in reckless spending, driving, or relationships? Did you have spending sprees? Did you buy things you didn't need, or that you regretted or felt guilty about later? Did you engage in foolish business investments? Did you engage in more sexually risky talk or behavior? Were you more aggressive?
7) More social than usual. Were you more flamboyant, overly familiar, or flirtatious? Were you more friendly to friends and to strangers? Did you have increased sexual energy?
If you answered yes to at least 3 of these questions, then you meet the medical criteria for hypomania. These are the combined criteria of the American Psychiatric Association (DSM-IV) and the World Health Organization (ICD-10).
If you have had at least one hypomanic episode and one depressive episode, then you meet the criteria for Bipolar Disorder II. If you have had at least one manic episode, then you meet the criteria of Bipolar Disorder I.
For your convenience, I've included a printable version of the bipolar test.
Bipolar disorder often goes unrecognized because most people don't complain about the hypomanic symptoms. Why would you complain? You feel great when you're in a hypomanic state.
Most people complain about the depressive symptoms, and the depressed periods usually last longer than the periods of elevated mood. Therefore cases of bipolar disorder are sometimes mistreated as depression. The danger of treating bipolar disorder as depression is that antidepressants can bring on a hypomanic phase. The antidepressant will treat the depression phase of bipolar disorder. Your mood will lift, but then the antidepressant will continue to push your mood higher and you can become hypomanic.
This is why it's important to correctly diagnose bipolar disorder. The medications usually used to treat bipolar disorder are mood stabilizers like lithium, tegretol, and lamotrigine. I won't discuss them, because they fall outside the realm of this website.
Genetics explain approximately 70% of bipolar disorder. One study concluded that if one parent has bipolar disorder, the child is approximately 10 times more likely to develop bipolar disorder.
Almost all drugs of abuse can produce hypomanic symptoms. Even depressant drugs can trigger hypomania.
Marijuana almost triples the chance of developing psychotic symptoms and bipolar disorder. Marijuana which is normally considered a depressant can cause manic symptoms. A 3-year study followed 4,045 psychosis-free people. It came to the conclusion that marijuana smokers are three times more likely to develop psychotic symptoms (including manic-depression) than non-smokers.
1) J. Edvardsen, S. Torgersen, E. Røysamb, S. Lygren, I. Skre, S. Onstad, P.A. Oien. "Heritability of bipolar spectrum disorders. Unity or heterogeneity?" J Affect Disorders 2008 Mar;106(3):229-40. Epub 2007 Aug 9.
2) N. Craddock; I. Jones, "Genetics of bipolar disorder." J Med Genetics 1999; 36(8):585-94.
3) J van Os, M Bak, M Hanssen, RV Bijl, R de Graaf, H Verdoux, "Cannabis use and psychosis: a longitudinal population-based study," American Journal Epidemiology. 2002 Aug 15;156(4):319-27.