Could You Be Suffering From Bipolar Disorder and Not Know It?

We all have moods that can go up and down, depending on what is happening in our lives.  Some days we’re happy and other days we’re sad.  But some of us have mood patterns that can be recurrent and severe.  Although my father (and many other members of our family) suffered from what was called “Manic-Depressive” illness, I was sure that I was immune.  I had gone to school, gotten my degree, and was a practicing psychotherapist.  I had tried to make myself believe that my knowledge would protect me.  It didn’t.  I’m one of millions of people who has bipolar disorder (some still call it manic-depression).  Could you be suffering and not know it?

When I was first attempting to deal with my own mood fluctuations it was confusing.  Some days I would feel wonderful.  Everything seemed to be going my way.  I loved my work and I loved my life and I couldn’t wait to get up and get going.  It seemed I had endless energy and could work for hours without getting tired.  I would often wake up at 4:00 in the morning because there were so many things I wanted to do. 

My friends and family were amazed at how much I could get done and how “up” I was.  It was like I could juggle 6 balls in the air and keep them all going at once.  The problem would be that I’d often see another ball I just had to juggle.  It would come in the form of a new idea or another way to make money.  When I was on a “manic” roll, I never seemed to know when to stop.  Eventually, I would be juggling too many balls.   Life was no longer fun and easy and my love of life often turned into irritability and frustration.  Eventually the balls would come tumbling down and I’d become depressed. 

Why couldn’t I stay high, I wondered?  It never occurred to me that I had a “mental” problem.  I just needed to figure out how to keep all the balls in the air. 

As is often the case, those closest to us see the problem before we do.  My wife kept telling me I needed to see someone, but of course I refused.  However, eventually I began to listen.  It was clear that if I didn’t do something, my marriage was going to come apart. 

Being a died-and-gone-to-heaven reader, my philosophy has always been, when in doubt, buy a book.  I was lucky to find An Unquiet Mind by Dr. Kay Redfield Jamison.  I knew Jamison was one of the world’s experts on bipolar illness.  I was moved to read this personal memoir of her own struggles with the illness.  It struck home in so many ways:

“During this period of increasingly feverish behavior at work, my marriage was falling apart.  I separated from my husband, ostensibly because I wanted children and he didn’t—which was true and important—but it was far more complicated than that.  I was increasingly restless, irritable, and I craved excitement; all of a sudden, I found myself rebelling against the very things I most loved about my husband:  his kindness, stability, warmth, and love.”

That struck home for me.  It seemed that everything Carlin did annoyed me, even the things that were meant to be kind and loving.

One final paragraph by Jamison resonated so well I knew I needed help.  She was talking about herself, but it struck home for me.  She said, “You’re irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough.  You’re frightened, and you’re frightening, and ‘you’re not at all like yourself but will be soon,’ but you know you won’t.” 

So, what exactly is this problem that affects millions of us?  Bipolar illness is classified as a mood disorder, a condition whereby the prevailing emotional mood is distorted or inappropriate to the circumstances.  Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder.  Mood disorders are often classified either depression or bipolar (though recent research indicates that things are a bit more complicated). 

Most people who have mood disorders are never properly diagnosed and treated.  Many others are misdiagnosed.  Depression has become more widely understood and treated in recent years.  Studies show that 60% to 70% of patients with depression improve.  However, that leaves another 30-40% who do not get better.  One reason for poor or incomplete response may be undiagnosed bipolar disorder. 

This is no small matter.  If you’ve ever suffered from a mood disorder you know how miserable your life can be and how miserable the lives of those around us can be.  Getting proper treatment can be lifesaving. 

As a practicing psychotherapist for the last 40 years, I have found that many times trying to split hairs to get an exact diagnosis is not worthwhile.  Often the treatment is the same, regardless of the illness.  However, in the case of depression and bipolar disorder, proper diagnosis may be the difference between full recovery and recurrent illness. 

Put simply.  If a person is bipolar and is given a medication for depression, their condition can get worse rather than better.  An antidepressant can actually trigger greater mood swings in someone who is bipolar. 

Other problems that can mistaken for bipolar illness include alcohol and substance abuse, attention deficit disorder (ADD), Irritable Male (and Female) Syndrome, sexual acting out, money-problems due to “manic” schemes to get rich. 

So how do you know if you are suffering from bipolar illness?  The only way to know for sure (and even for doctors trained in the field, the diagnosis can be tricky) is to talk to a psychiatrist (a medical doctor specifically trained to diagnose and treatment mental disorders).

I’m writing this to alert you to the possibility that you (or someone close to you) may have bipolar illness and to get you to see a doctor.

Here is a questionnaire developed by Robert M.A. Hirschfeld, M.D. which can help you recognize possible bipolar illness and encourage you to see a doctor if you think you might have this problem:

 Has there ever been a period when you were not your usual self and

1. You felt so good or so hyper that other people thought you were not your normal self
      or so hyper that you got into trouble?

2. You were so irritable that you shouted at people or started fights or arguments?

3. You felt much more self-confident than usual?

4. You got much less sleep than usual and found you didn’t really miss it?

5. You were much more talkative or spoke much faster than usual?

6. Thoughts raced through your head or you couldn’t slow your mind down?

7. You were so easily distracted by things around you that you had trouble concentrating or staying on track?

8. You had much more energy than usual?

9. You were much more active or did many more things than usual?

10. You were much more social or outgoing than usual?

11. You were much more interested in sex than usual?

12. You did things that were unusual for you or that other people might have thought were excessive, foolish, or risk?

13. Spending money got you or your family in trouble?

 If you answered “yes” to more than 1 of the above, have several of these ever happened during the same period of time?

How much of a problem did any of these cause you—like being unable to work; having family, money, or legal troubles; getting into arguments or fights?  No problem, minor problem, moderate problem, or serious problem?

What do you think?  Could you be suffering from bipolar illness?  Could someone you care about be suffering?  Have you tried to get help?