Bipolar Disorder

Bipolar disorder is a mental health condition that manifests in frequent, often sudden, changes of mood, impulsive behavior, unpredictability, and other emotional and behavioral symptoms.  Bipolar illness may appear in childhood,+ but more commonly becomes evident in the teen and young adult years.  Moods tend to fluctuate between depression and elation, but the manic portion of the illness may also appear as intense irritability and frequent outbursts of anger (which may be only verbal or both verbal and physical).  The fact that bipolar illness has a large component of depression often leads to missed diagnosis of the illness and treatments aimed at just the depression which may not help the fluctuations in mood and behavior.

The manic (high mood) portion of the illness may manifest as going for periods of time with little to no sleep and no loss of energy,  obsessive involvement in activities with a high potential for negative consequences, starting new projects but not carrying through, feelings of grandiosity, or feelings of irritability and anger that are out of proportion to situations.  The depression part of the cycle (low mood) can involve many different symptoms of depression: loss of energy, oversleeping, inability to concentrate or make decisions, and feeling down, blue or hopeless.  The main characteristic of bipolar illness is sudden fluctuations in mood, energy and behavior from one extreme to another which may or may not be broken up with periods of normal mood and behavior.

If you wonder if you might be suffering from bipolar disorder, contact psychologist, Dr. Firestein to schedule an assessment and begin counseling treatment.  Treatment usually includes a medication component and a therapy component.  Bipolar disorder is a very treatable illness once properly diagnosed.

Dr. Firestein wrote a monthly Q & A column for the Healthline magazine called Uncommon Sense for seven years.  Below are excerpts from previous columns.

Question: Dr. Beth,  I have a problem and people keep telling me that it is bigger than I think it is.  I have lost several jobs over the years, usually due to blowing up at my boss or a coworker. I tend to get angry and irritated easily at everyone from family members to complete strangers in grocery stores and gas stations. When I get into a project or hobby, nothing can stop me. I may work non-stop for days at a time, barely sleeping and sometimes I go on online buying binges.  I find that I tend to be either really happy and have a lot of energy or down in the dumps and unmotivated to get anything done. At those times, I feel really depressed. I’m seldom “in the middle”.  My family thinks I have bipolar illness, but I think I just have normal moods and typical life problems. How do I find out which of us is right?

Answer: I definitely think there is something important to sort out here.  While variations in mood and energy are certainly normal, the extremes you describe and your description of “almost never being in the middle” of the mood scale are definitely suspicious for a possible mood disorder.  Bipolar illness is characterized by repeatedly engaging in  impulsive behavior with a high probability of negative consequences, bursts of energy in which the person gets very little sleep and is obsessed with the activity, and excessive anger and irritability (and sometimes feelings of grandiosity and euphoria) among other symptoms.

Most people with bipolar illness cycle between highs and lows in mood and behavior and these cycles can occur closer together and happen more frequently as the individual gets older.  In addition, initial symptoms of euphoria when in a high energy phase often turn into more irritability and anger and less frequent euphoric feelings over time. In addition, the lows usually start to predominate over the highs with more and more depression happening over time.

Often the person does not realize how extreme their moods and behavior are although it is quite noticeable to family and friends.  I would take their feedback seriously and get a professional evaluation to determine whether or not you do have bipolar illness or some other kind of mood disorder. The diagnosis affects the treatment choices and it is important to get the diagnosis right the first time. It is important to note that bipolar depression requires a different form of medical treatment than more common types of depression.

Over time, an unidentified and untreated bipolar illness causes more and more problems in the person’s life with jobs, relationships, health, and money.  While it certainly feels scary and possibly shameful to find out you have such an illness, diagnosis and appropriate treatment can restore feelings of well-being and lead to more success in various areas of life functioning.

Bipolar illness can be tricky to identify and treat. Treatment usually consists of a combination of medication and psychotherapy.  Being diagnosed with a serious mood disorder isn’t something anyone wants to experience, but given the problems you are having with jobs and family relationships, it is definitely important to check it out.  You can read a bit about the illness online and see if the symptoms match your experience, but only a professional can really diagnose and treat the problem.

Be proactive and listen to the others in your life who care about you. Even if it turns out that you do not have bipolar illness, there is help available to assist you with your difficulties with anger and depressed moods. I strongly suggest that you give yourself the opportunity to make your life better.