Most people who deal with depression typically exhibit prolonged symptoms of sadness, hopelessness or guilt. But this is not the case if you have bipolar disorder. Having unpredictable and severe episodes of high and low moods is probably the easiest way to describe this condition. Keep reading to learn more about bipolar disorder and find out why, of the many types of depression, it’s one of the most difficult to diagnose.
Basic Facts About Bipolar Disorder
Also known as manic depression, bipolar depression or manic depressive disorder, bipolar disorder is characterized by having up-and-down episodes of mania and depression.1 This condition causes unusual shifts in energy, mood and activity levels, and may hamper an individual’s ability to perform everyday tasks.2
Bipolar disorder is not an uncommon illness and, according to the National Institute of Mental Health (NIMH), it affects 2.6 percent of U.S. adults today.3 It typically develops during late adolescence or in early adulthood (the average age when this illness manifests, for both men and women, is 20 years old).4 There are four main types of bipolar disorder, namely:5
• Bipolar I: Extreme elation is the hallmark symptom, and the individual’s behavior escalates quickly and spirals out of control. This manic episode (which can be identified by having elevated, irritable or expansive mood) can last for as long as seven days.
• Bipolar II: This is four times more common than Bipolar I, and is identified by having hypomanic symptoms (less severe manic symptoms). If not addressed, hypomania can worsen, causing the individual to become severely manic or depressed.
• Cyclothymic disorder: This is when a person has mood swings and shifts that are similar to bipolar I and II, but the shifts are usually less dramatic. Over time, a person who suffers from these mood swings may be diagnosed with bipolar I or II.
• Bipolar disorder not otherwise specified (NOS): If a person shows bipolar tendencies and symptoms but does not fit into any of the three criteria above, he or she will be classified under this catchall category.
Hallmark Symptoms of Bipolar Depression
Bipolar disorder is very different from just having the usual “mood swings” — it’s a lot more severe than that, as the mood changes of someone with this disorder can last for days, weeks or even months. They are often so intense that they interfere with a person’s ability to function. Because the symptoms are so confusing and sometimes occur very subtly, this condition is very difficult to diagnose.6 Here are some of the warning signs of this disorder, which can be divided under depression and mania.7Depression:
Prolonged feelings of sadness or hopelessness
Fatigue and lack of energy
Loss or increase in appetite
Social withdrawal, even from family and friends
Loss of interest in once-enjoyable activities
Memory, concentration and decision-making problems
Suicidal thoughts or attempts to commit suicide
An overly happy feeling — being elated for long periods of time
Impulsiveness or extreme restlessness
Being twitchy or jumpy, or easily agitated
Unrealistic overconfidence in your own abilities
Having racing thoughts
Risky behavior (going on big spending sprees, having impulsive sex or gambling away your life savings)
How to Diagnose Manic Depressive Disorder
Although there are distinct symptoms that can manifest in someone with manic depressive disorder, there is actually no single bipolar test that can help confirm this condition. Usually, a combination of methods is needed to ensure a proper diagnosis. While bipolar depression does show distinct symptoms, there is no single bipolar depression test to confirm the condition. Often, a combination of methods is used to make a diagnosis, and can include:
• Physical exam and lab tests — Standard lab tests like urinalysis, blood tests and MRIs will help identify if you are suffering from medical problems that may be causing your symptoms.8
• Signs and symptoms — Your symptoms will be evaluated and compared with the criteria for bipolar and related disorders, as stated in the Diagnostic and Statistical Manual of Mental Disorders.9
• Psychological evaluation — Your physician will sit down with you and discuss your feelings, thoughts and behavior patterns. He or she may also give you a psychological self-assessment questionnaire. Family members may also be interviewed to ask about your symptoms.
• Mood charting — You will be asked to keep a daily record of your moods and activities, as well as other factors to help confirm your bipolar tendencies.10