What is bipolar disorder?

October 11, 2009

Cheesy old ad with a young woman saying - so simple

If experts don't understand bipolar, how can patients?

“Bipolar disorder” is a spectrum of disorders whose symptoms include periods of mania and depression; it is thought to be largely genetic, but research is not yet conclusive about the causes, neurology, or treatment. There is a 15% fatality rate, due to suicide.

Here’s a more eloquent definition, exerpted from my favorite resource, “Break the Bipolar Cycle” by doctors Elizabeth Brondolo & Xavier Amador:

Bipolar spectrum disorders (BSDs) are a group of disorders all of which involve cycling moods.  But BSDs are also accompanied by a wide range of other symptoms that affect not just your mood but also your energy, your memory and thinking, and your connection with other people. Because the symptoms change or cycle, it may feel like you are always losing ground, never gaining control over your life.

Then there’s the more clinical DSM-IV diagnostic criteria for each of the 4 types of bipolar it defines:

  • Bipolar I Disorder – at least one Manic or Mixed episode, but there may be episodes of Hypomania or Major Depression (this is what people typically think of when they think of Bipolar or Manic-Depression)
  • Bipolar II Disorder (here I’m quoting Wikipedia, which is quoting the DSM)
    1. Presence (or history) of one or more Major Depressive Episodes.
    2. Presence (or history) of at least one Hypomanic Episode.
    3. There has never been a Manic Episode or a Mixed Episode.
    4. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, delusional disorder, or Psychotic Disorder Not Otherwise Specified.
    5. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Cyclothymic Disorder – Highs and lows that impair functioning as with Bipolar II, but without meeting the criteria for a Major Depressive episode or a Manic episode
  • Bipolar Disorder NOS – “This designation abbreviated NOS can be used when the mental disorder appears to fall within the larger category but does not meet the criteria of any specific disorder within that category.”

The DSM-IV definitions immediately lead one to ask “what’s mania?  what’s depression?” — there are plenty of links here to lead you to the answers, but I think this is all more than enough for one post.

Hello, I hate you -- that's bipolar

 

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2 Responses to “What is bipolar disorder?”

  1. D said

    “This designation… can be used when the mental disorder appears to fall within the larger category but but does not meet the criteria of any specific disorder within that category.”

    So there’s an official way to diagnose someone who doesn’t actually meet the requirements to be officially diagnosed.

    Strange.

    Is the whole DSM that fuzzily-defined?

    • janusjana said

      Is the whole DSM that fuzzily-defined?

      Yes and no…. There’s all sort of fuzziness and loopholes, yet one of the critiques of the DSM is that it’s so overly specific. Mental disorders are not inherently easy to classify, especially given that patient testimony is a large part of diagnosing… even when that patient may be in a very fuzzy mental state.

      Are you now thoroughly confused? If so, you may be in a good position to understand the whole DSM.

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