Arlene Brewster, PhD
Arlene Brewster, PhD


What Does It Mean: Bipolar Disorder

I have recently been diagnosed with Bipolar Disorder. How is this different from Manic Depressive Disorder?

They are two names for the same condition. Bipolar Disorder is now the standard diagnostic term. This is a disease in which the patient has cycles of both depression and mania. The cycles may be severe, they may alternate, may be primarily depressive, or more rarely primarily manic. The cycles may alternate slowly or rapidly. For some patients, this cycle is tied to seasonal changes.

The cycles in Bipolar can be severe. Depressions can be so debilitating that people suffering from Bipolar Disorder cannot get out of bed. They are at increased risk of suicide and need to be monitored carefully. During the manic phase they may feel no need for sleep, show lack of judgment, and engage in risky behaviors such as gambling, excessive spending of money, sexual promiscuity, and other risk taking behaviors. They often feel invulnerable and display grandiose thinking. During the early phases of mania people often feel intensely  alive and happy. This euphoric feeling does not last and the manic phase progesses into paranoia, agitation, intense anger or sometimes psychosis.  In Bi Polar patients, the part of the nervous system that regulates emotionality does not work effectively. Bipolar patients often feel that are on a constant roller coaster. They often abuse drugs and alcohol to try to blunt the effects of the ups and downs. It is exhausting to suffer from Bipolar Disorder and very demanding and difficult to be in a relationship with someone who has Bipolar Disorder. 

Kay Redfield Jamison has promulgated the theory that Bipolar Disorder is linked to creativity. This does not mean that people with this disorders are necessarily more creative, but that creative people have a higher incidence of developing this disorder than other people. (See Jamison's An Unquiet Mind: A Memoir of Moods and Madness)

During my career as a therapist, I have seen a number diagnoses go in and out of fashion. I believe that the incidence of giving a Bipolar diagnosis, has significantly risen in the past few years. Bipolar Disorder can often be effectively treated with medication but these medications are often expensive and have potentially serious side effects. My caution is that not everyone who is moody, irritable, easily angered or impulsive is Bipolar. People can be irritable, difficult, and not have good coping skills without having the diagnosis of Bipolar disorder.

If you have diagnosed with Bipolar disorder, ask questions as to why this diagnosis was made. Be sure that the person you are seeing has experience with Bipolar patients and that they take a very thorough history. There is no medical   test that confirms the diagnosis of Bipolar disorder. It is diagnosed by taking a clinical history. It might be a good idea to get a second opinion before starting medications.



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