Who is Bipolar? Learn the difference between mood swings and the disorder by Dr. Christina Villarreal

Bipolar disorder, also known as manic-depressive illness, has become a commonly used term by the public, with many of us becoming familiar with it as a result of celebrities such as Bobby Brown, Ben Stiller, Britney Spears, and Jim Carey exhibiting symptoms or identifying themselves as having been diagnosed with this disorder. But what exactly IS Bipolar disorder, and how can you tell the difference between someone who meets the criteria for the disorder from someone who is just 'moody' or chooses to live an extreme lifestyle?

Bipolar is a brain disorder, or chemical imbalance that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. The symptoms of bipolar disorder are severe, and the criteria for receiving a diagnosis are quite specific. They are different from the normal ups and downs that everyone goes through from time to time, as well as more extreme mood shifts you might observe in others.


The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies Bipolar Disorder by the occurrence of one or more manic or mixed episode (also known as agitated depression) often accompanied by depressive episodes. So even if you're depressed 99 percent of the time, experiencing just one manic episode qualifies you for a diagnosis of bipolar disorder according to this definition - but that still leaves most of us confused about who fits the criteria for a diagnosis, aside from the fact that the DSM-IV also differentiates between Bipolar I, Bipolar II, Hypomania, and Cyclothymia (all diagnoses that can be referred to as 'manic depressive'.)

This article aims to explain the differences amongst these disorders in the simplest terms. Bipolar disorder is an illness that impacts a person's thoughts, feelings, perceptions (both mental and physical), and behavior. It's likely caused by electrical and chemical elements in the brain that are not functioning properly, with research suggesting that people are genetically vulnerable to inheriting the disease when their families have a history of its occurrence.

Typically, a person with manic-depression experiences moods that shift from high to low and back again, with varying degrees of severity. To receive a diagnosis of bipolar, these symptoms CANNOT be a direct result of alcohol or drug use. The symptoms are severe enough to lead to impairment in work, social, or academic functioning, and may lead to involuntary hospitalization to prevent harm to self or others. Note: to receive a diagnosis of a manic or depressive episode, a specific type, duration and number of symptoms MUST be present; refer to a mental or medical health professional or the DSM-IV for more details on this.)

A depressive episode can be identified by:

Mood Changes:


A long period of feeling sad, hopeless, worried, guilty or tearful
Loss of interest in activities once enjoyed, including sex.

Behavioral Changes:

Feeling tired, or 'slowed down'
Having problems concentrating, remembering, and making decisions
Being restless or irritable
Changing eating, sleeping, or other habits
Thinking of death or suicide, or attempting suicide

May include psychotic or catatonic features as well.


A manic episode can be identified by:

Feeling like you can do anything, even something unsafe or illegal

extreme displays of emotion- including jubilant or euphoric expressions, rage, paranoia, agitation
Decreased need for sleep, yet never feeling tired

Inflated self esteem or grandiosity

highly talkative, or pressured speech

distractability, or being too easily drawn to unimportant or irrelevant stimuli
Dressing flamboyantly, spending money extravagantly, living recklessly
Having increased sexual desires, or indulging in risky sexual behaviors
Thoughts of suicide or other morbid/destructive behaviors

May include psychotic, or catatonic features

Bipolar I is defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, the person also has depressive episodes (typically lasting at least two weeks) but depression is NOT necessary for receiving a Bipolar I diagnosis, however the symptoms of mania or depression must be a major change from the person's normal behavior.

Bipolar Disorder II is differentiated from Bipolar 1 in that it involves symptoms of hypomania (less extreme symptoms and for shorter duration compared to full-blown mania), as well as the presence of a depressive episode. This diagnosis is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.

Cyclothymia is a "bipolar-like" illness. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.

Bipolar disorder, if left untreated, can wreak havoc on the personal lives of people with the disorder. Unstable moods frequently disrupt or even destroy personal and work relationships. People may have difficulty finding a life partner, instead moving through a series of passionate, short-lived romances. Impulsive behavior can be self-destructive and lead to serious legal problems. At it's worst, bipolar disorder can be lethal, leading to suicide or death of others. People with bipolar are also more likely to abuse drugs and alcohol. As many as 50% of people with bipolar may also have a problem with substance abuse, in an attempt to alleviate or enhance their symptoms. But bipolar disorder can be treated, and people with this illness can lead full and productive lives with the appropriate medical and emotional support. If you or someone you know is suspected of experiencing symptoms associated with Bipolar disorder, seek the help of a medical and/or mental health professional as soon as possible.



Sources: DSM-IV, webmd.com

For professional referrals, please contact Dr. Christina Villarreal @ christina.villarreal@gmail.com or visit her website at www.drchristinavillarreal.com