Have your moods been really up and down lately?
Have you been feeling like you don’t know how to control your emotions?
Has your sleep been a problem lately?
Have people been commenting that they think you have “Bipolar”, or maybe you yourself have been questioning whether you have Bipolar?
I get asked quite frequently by my clients whether they have Bipolar Disorder or not, or they come to me because they think they have Bipolar. I ask them why they think they have Bipolar disorder and they usually state they think they do because of the above questions.
I’ve come to realise that it is a common perception among the community that to have Bipolar Disorder is to have moods that are up and down or hard to control. Oftentimes my clients will have completed some online quiz testing if they have Bipolar or not coming back stating that there are chances that they do because their moods are up and down.
Because of this, I thought it would be a really good opportunity for me to write a blog article about what Bipolar Disorder actually is, and indicators that you may have it, just to clear up the confusion that is out there as it is a pretty big deal for someone to be worrying that they do have Bipolar Disorder when in actual fact they really do not.
So what exactly is Bipolar Disorder? It is a condition where a person has experienced at least one manic or hypomanic episode in their life. It is not uncommon for people to experience more than one of these episodes in their lifetime, and it is also not uncommon for people to also experience one or more episodes of a clinical depression (Major Depressive Episode) at some point in their lifetime also. So now you are probably wondering what is a “manic” and “hypomanic” episode and what is the difference between the two. These two types are quite similar, though one is quite a bit more intense than the other and last for a longer duration. Let us discuss the signs and symptoms of Bipolar Disorder first, and then we’ll get back to what is the difference between a manic and a hypomanic episode.
Signs and symptoms of Bipolar Disorder include:
- Elevated mood where you may feel like you are on “Cloud 9”, otherwise the mood is an irritable mood
- Lack of need for sleep usually getting between 1-3 hours of sleep a night and not feeling tired
- Rapid speech where the person is talking quite fast, often where it is difficult for the person’s speech to be understood by others
- High levels of energy, much more than normal for the person
- Starting projects without any plan and not finishing them, may also not have the knowledge or skill in how to carry out these projects before starting them
- Inflated sense of self-esteem/confidence or grandiosity, which may be delusional in nature (Delusions of Grandeur)
- Flight of ideas where the person has many ideas coming to their mind quickly
- More easily distractible than usual
- Psychomotor agitation
- Engaging in reckless behaviour; acting on impulse without any thought to the consequences e.g., shopping sprees, not obeying road rules when driving, increased sexual activity which may also be unsafe sexual activity
- Impairment in functioning including may not be engaging in daily hygiene, difficulties being able to go to work, not keeping up with house tasks
- Lack of insight into being unwell i.e., they think they are fine/not unwell while in the episode, even if someone tries to point this out to them
- Not wanting to participate in psychological treatment for the manic/hypomanic episode, in part because the elevated moods can feel so good at the time
While in one of these manic or hypomanic episodes, this is significant change in the person’s usual level of psychological wellbeing and functioning. These episodes are episodic meaning that the person is displaying these symptoms for a brief period of time, and then they come back to their baseline or usual level of psychological wellbeing and functioning.
What’s the difference between a manic episode and a hypomanic episode? Basically it is the number of and duration of the symptoms, and the level of impairment. With a manic episode a majority of these symptoms must be present for at least 7 days causing marked impairment is required. When this is present to a level that meets diagnostic criteria, this is classified as “Bipolar I Disorder”. There are times when a person may not reach a full blown manic episode, but may have a hypomanic episode, This is many of these symptoms are present for at least 4 days causing a change in functioning, though not as severe marked impairment as in a manic episode, and the person has also experienced a Major Depressive Episode at least once in their lifetime also. When this is the case, this is what we call “Bipolar II Disorder”.
There is also another type of Bipolar Disorder called “Cyclothymia”. This is where for at least a two year period, the person has experienced numerous periods of hypomanic symptoms that do not reach a full-blown hypomanic episode, and numerous periods of depressive symptoms that do not reach a full-blown major depressive episode, as per diagnostic criteria. There are other things that are also required, including that these symptoms ust be present for at least half of the time and the person not been without the symptoms for more than two months at a time.
There are also several other types and sub-types of Bipolar Disorders, which I will not go into further detail here as it is quite extensive.
As I was explaining above, it is pretty common for a person whom has experienced a manic or hypomanic episode to have also experienced at least one depressive episode also, as most of the time people get diagnosed as having depression first before the mania/hypomania episodes are picked up. This is usually because people do not tend to present to treatment when they are in a manic/hypomanic episode because this episode usually feels pretty good to them. When they’re depressed on the other hand, this often feels pretty terrible and they more often seek treatment at this point. To learn more about a Major Depressive Episode, click here.
So as you can see now, true Bipolar Disorder is much more than just having moods up and down. Indeed, Bipolar Disorder can have this, however when moods are up and down, this is typically referred to as Emotional Dysregulation.
With Emotional Dysregulation, it is where, as the name implies, the person has difficulty regulating their emotions. These emotions can include depression/sadness, anxiety, anger/rage, irritability, self-hate, embarrassment and other unpleasant emotions. When a person experiences a situation e.g., someone treating them in a certain way, this can trigger an emotional response, an unless the person knows how to healthily regulate their emotions, the emotions triggered can become:
- Intense and overwhelming
- Irrational or be a stronger reaction than what the situation generally warrants
- Long lasting for hours or days
- Make the person feel like they’re going “crazy”
- Be hard to control
Often the person with emotional dysregulation will use unhealthy coping strategies for dealing with these intense emotions such as with: alcohol, drugs, self-harm (cutting, hitting, burning), become angry at others.
Emotional regulation can also be part of another psychological disorder such as Borderline Personality Disorder (BPD), Post-Traumatic Stress Disorder (PTSD), and substance use issues/addiction.
If you think you could have a type of Bipolar Disorder, or if you’re struggling with Emotional Dysregulation, or dealing with other negative emotional states, talk to us today about a psychological evaluation or diagnostic assessment by our highly trained and fully qualified Clinical Psychologist Gold Coast, Ashley Gilmour. Ashley can help you to understand what the issues are with your mental health and develop a best psychological treatment plan for you. Contact us today to discuss how we can help you return to wellbeing.
Is Bipolar disorder overwhelm you? or have a question or query? Contact Ashley your Gold Coast Psychologist via email firstname.lastname@example.org or on 07 55743888. We are more than happy to help you!