One textbook's answer to the question, "What is bipolar disorder?" says it is a major affective disorder in which an individual alternates between states of deep depression and extreme elation. This is misleading in that bipolar disorder - sometimes still known as manic depression or manic-depressive illness - is much more complicated than just alternating between depression and elation.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders says that bipolar I disorder is characterized by the occurrence of one or more manic episodes often accompanied by depressive episodes. So even if you're depressed 99 percent of the time, going through just one manic episode qualifies you for a diagnosis of bipolar I disorder according to this definition. Bipolar II disorder is defined as having one or more hypomanic episodes along with depressive episodes. But these cut-and-dried definitions leave out a lot of what manic depression really is.
Bipolar disorder in everyday language
Let's put it in terms everyone can understand. Bipolar disorder is an illness that affects thoughts, feelings, perceptions and behavior ... even how a person feels physically. It's probably caused by electrical and chemical elements in the brain not functioning properly (see What Causes Bipolar Disorder? for more information), and is usually (but not always) found in people whose families have a history of one or more mental illnesses.
While we're at it, let's be clear about something: a mental illness is one that affects the mind, not one that's all in the mind.
Most often, a person with bipolar experiences moods that shift from high to low and back again in varying degrees of severity, generally with more or less stable periods in between. The two poles of bipolar I disorder are mania and depression, and of bipolar II, hypomania and depression.
Mania, Hypomania and Depression
Mania might include:
- Feeling like you can do anything, even something unsafe or illegal
- Needing very little sleep, yet never feeling tired
- Dressing flamboyantly, spending money extravagantly, living recklessly
- Having increased sexual desires, perhaps even indulging in risky sexual behaviors
- Experiencing hallucinations or delusions
- Feeling filled with energy
Some people think that they are just "over their depression" when they become manic, and don't realize this exaggerated state is part of the illness - part of bipolar disorder.
Hypomania - a less extreme form of manic episode - could include:
- Having utter confidence in yourself
- Being able to focus well on projects
- Feeling extra creative or innovative
- Being able to brush off problems that would paralyze you during depression
- Feeling "on top of the world" but without going over the top.
Hypomania does not include hallucinations or delusions, but a hypomanic person still might exhibit some reckless or inappropriate behavior.
Depression might be identified by:
- Refusing to get out of bed for days on end
- Sleeping much more than usual
- Being tired all the time but unable to sleep
- Having bouts of uncontrollable crying
- Becoming entirely uninterested in things you once enjoyed
- Paying no attention to daily responsibilities
- Feeling hopeless, helpless or worthless for a sustained period of time
- Becoming unable to make simple decisions
- Wanting to die