What does Bipolar Mean?
by Bradley T. Wajda, D.O.
Unfortunately the term “Bipolar” has become synonymous with the phrase “mood swings”. While people with “Bipolar” illness (also known as “Manic-Depression”) have mood swings, not all mood swings are “Bipolar”. No doubt this is one reason why the diagnosis of “Bipolar” is so popular today. It is a frequently used term from Hollywood to self-help books and magazines - a term used to describe almost any mental health condition. By learning about what “Bipolar” actually IS, we can more easily see those situations when it is NOT. Actual Bipolar illness can occur in both children and adults while affecting males and females equally.
There are different types of Bipolar illness but a description of classic “Manic-Depression” gives one a good idea of just what Bipolar illness is. It is just as the name implies - cycling between episodes of mania and depression. “Mania” is an overly happy, outgoing, and at times irritable mood lasting at least 1 week. Several behaviors accompany mania including: talking very fast, jumping from one idea to another, having racing thoughts, being easily distracted, taking on several new projects, requiring very little sleep, having an unrealistic belief in one’s abilities, and behaving impulsively by taking part in a lot of pleasurable and/or high-risk behaviors (such as spending sprees, impulsive sex, and impulsive business investments). Depressive episodes are episodes of Major Depression lasting at least 2 weeks (a description of major depression is a separate topic unto itself but a simple explanation is a sadness that causes a loss of interest in daily activities, affects appetite, lowers energy, affects sleep, and impairs concentration).
Bipolar illness is both over-diagnosed and misdiagnosed. Rapid mood swings (occurring faster than every 4 days) are NOT bipolar illness. Unfortunately, even some mental health professionals consider these as “rapid cycling” bipolar mood swings. Rapid mood swings are “affective instability” and are caused by personality disorders, substance abuse, medication side effects, or underlying medical issues. “Rapid cycling” as applied to a bipolar illness means that there are 4 or more cycles in a year. Cycles are defined by the duration of the mood - hypomanic episodes must last at least 4 days, mania must last at least 1 week, and depression must last at least 2 weeks to qualify for bipolar illness. Note that even one bonafide manic episode (absent underlying medical issues) means that the patient is bipolar.
If mood swings are a problem, don’t assume its “Bipolar”. Medical illnesses, substance abuse, personality disorders, and acute stress are just a few of the reasons for someone to exhibit mood swings. Seek the expertise of a professional to diagnosis and treat the problem.