Bipolar Disorder

People with a bipolar disorder experience both the lows of depression and the highs of mania

• Many describe their lives as an emotional roller coaster

Diagnosing Bipolar Disorders

DSM-5 distinguishes two kinds of bipolar disorder:

• Bipolar I disorder
• Full manic and major depressive episodes
• Most experience an alternation of episodes
• Some have mixed episodes
• Bipolar II disorder
• Hypomanic episodes alternate with major depressive episodes

Unlike those experiencing depression, people in a state of mania typically experience dramatic and inappropriate rises in mood

• Five main areas of functioning may be affected:

• Behavioral symptoms
• Very active – move quickly; talk loudly or rapidly
• Flamboyance is not uncommon
• Cognitive symptoms
• Show poor judgment or planning
• May have trouble remaining coherent or in touch with reality
• Physical symptoms
• High energy level – often in the presence of little or no rest

People are considered to be in a full manic episode when, for at least one week, they display an abnormally high or irritable mood, increased activity or energy, and at least three other symptoms of mania

• In extreme cases, symptoms are psychotic
• When symptoms are less severe, the person is said to be experiencing a hypomanic episode

Without treatment, the mood episodes tend to recur for people with either type of bipolar disorder

• If people experience four or more episodes within a one-year period, their disorder is further classified as rapid cycling
• If their episodes vary with the seasons, their disorder is further classified as seasonal

Regardless of particular pattern, individuals with bipolar disorder tend to experience depression more than mania over the years

• In most cases, depressive episodes occur three times as often as manic ones, and last longer

Between 1% and 2.6% of all adults in the world suffer from a bipolar disorder at any given time, and as many as 4% over the course of their lives

• Bipolar I seems to be a bit more common than Bipolar II
• The disorders are equally common in women and men
• Women may experience more depressive episodes and fewer manic episodes than men and rapid cycling is more common in women
• The disorders are more common among people with low incomes than those with high incomes
• Onset usually occurs between the ages of 15 and 44 years
• In most cases, the manic and depressive episodes eventually subside, only to recur at a later time
• Generally, when episodes recur, the intervening periods of normality grow shorter and shorter

A final diagnostic option:

• When a person experiences numerous episodes of hypomania and mild depressive symptoms, a diagnosis of cyclothymic disorder is assigned
• Mild symptoms for two or more years, interrupted by periods of normal mood
• Affects at least 0.4% of the population
• May eventually blossom into bipolar I or II disorder

References:
Bernstein, D.A. & Nash, P.W. (2008). Essentials of psychology (4th ed.) Boston: Houghton Mifflin Company.
Comer, R.J. (2013). Abnormal Psychology (8th ed).  Worth Publishers
Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) American Psychiatric Publishing, 2013
Feldman, R. (2013). Essentials of understanding psychology (11th ed.). New York, NY: McGraw-Hill.
Friedman, H.S. & Schustack, M.W. (2012), Personality: classic theories and modern research (5th ed). Boston: Pearson Allyn & Bacon.
McGraw-Hill.McGraw Hill Higher Education (2013), The McGraw Hill Companies, Inc.
Ryckman, R. M. (2013). Theories of personality (10th ed.). Mason, OH: Cengage Learning.
Sue,Sue, and Sue (2014).  Understanding Abnormal Behavior (10th Ed), Cengage Learning