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What Type of Bipolar Disorder Is It?

Each bipolar disorder illness is unique!

Uniqueness of Bipolar DisorderWhen nearly anyone thinks about bipolar disorder, they think of the symptoms of “regular” bipolar disorder.  Not that any person with bipolar disorder is “regular” (and most would not want to be), but there are several different subtypes of bipolar disorder.

One big problem with bipolar disorder is that each illness is unique.  Psychiatrists may classify them into categories – but they don’t always fit.  Here are some case scenarios: (bipolar episodesbipolar groups)

•    Jennifer has episodes where she is extremely agitated and unhappy and never seems to sleep very much.  These periods seem to last for a long period of time – but can alternate with months where she is simply unhappy and doesn’t feel like doing anything.
•    Max has had periods of depression before.  A lot of times, they go away after a couple of months and then he seems normal but recently he “disappeared” for a couple of weeks after some really bizarre behavior.  His friends never knew that he was any kind of bipolar until he told them he had been at the hospital.
•    Ben has periods of depression that can last for several months but when he is not depressed, he is productive and seems quite outgoing.
•    Sandra’s mood state can switch erratically.  One day she is all about shopping and the next time you call her, she is still in bed at noon.   This is a constant issue – and you never know what you are going to get.

These are three examples of bipolar disorder that don’t seem to fit the “normal” pattern.  None of these patients seems to be “regular” bipolar.

Bipolar disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as:

Bipolar Disorder TypeBipolar I Disorder: manic or mixed episodes that last at least 7 days – or if manic symptoms are severe enough to need hospitalization.  This, usually, includes periods of depression that last at least two weeks.
Jennifer and Max both fit into this category.  Even though Max never had a severe manic episode, having a bipolar episode that warrants medical attention, he qualifies for the Bipolar I category.  Jennifer has mixed episodes – rather than euphoria or traditional mania – she has periods of “dysphoria” where she is agitated, irritable and irrational but with an excess of energy.

Bipolar II Disorder: depressive and hypomanic episodes in a pattern – but manic episodes are not severe.
Ben has Bipolar II disorder.  He has periods of depression that are debilitating, but his non-depressed periods are quite productive, and he doesn’t exhibit manic behavior.

Bipolar Disorder Not Otherwise Specified: (Bipolar Disorder NOS) symptoms of illness don’t meet any other group, but the symptoms are clearly not within the standard range.
Sandra has BP-NOS.  She is what is commonly called a “rapid cycler,” meaning that she switches back and forth from mania to depression much faster than other people with bipolar disorder.

There is also a very mild form of bipolar disorder known as cyclothymia.  It is a cyclical pattern of hypomania alternating with periods of mild depression.  Many people would not even realize this is a problem.

Bipolar disorder is hard to classify.  It may be easy to determine that someone has a problem – but the uniqueness of each bipolar case makes it more difficult for even a patient to identify with the diagnosis.  Each type of bipolar disorder is, usually, treated the same medically. With an anti-manic agent (Lithium), anti-epileptic (Lamictal, Depakote) or atypical antipsychotic (Abilify, Zyprexa) – and sometimes with an antidepressant.

Melissa Lind

What One Should Ask a Mental Health Expert

Mental health symptoms

Amnesia LizzardIf a person, a family member, or friend of someone who is in therapy, questions should be asked to avoid problems. All therapist expertise levels various and not all is qualified to diagnose mental illness. If one suspect that a person has a disorder, one should do the best to be extremely accurate on the symptoms, research them and describe them.

Go to a therapist. Then you will know what the issue is, and by researching your symptoms, you will be ahead of the game. If you describe your symptoms thoroughly, you will be better able to prevent incorrect diagnosis.

If you visit a therapist, the therapist will talk to you and listen to your opinion. They will search for signs and disturbances in your thinking patterns.

Therapists will check for symptoms like:

  • Blocking thoughts
  • Peripheral thought patterns
  • Fleeting ideas
  • Paranoia
  • Vague thoughts
  • Break in reality
  • Disassociation

If the patient displays a disturbance in their thinking patterns, the therapist may find psychosis. Counselors will consider schizophrenia or psychosis if the patient shows a change in reality. Paranoia and psychosis may be misconstrued if the mental health expert doesn’t have a good understanding between the two conditions.

Mental Health TherapistSchizophrenics are often paranoid and may suffer from post-traumatic stress in the early stages. If a patient provides answers to questions that are unrelated, the therapist may consider a potential mental illness.

Another area of concern is if the patient speaks in fragments of thoughts and don’t provide complete sentences or ideas. This is known as a fleeting thought process. If a patient is illustrating thoughts that are off the subject, the therapist may also express concern.

Other areas that are considered include language. Some patients may just have a lack of education, but they should be able to speak in a comprehensible manner. It is essential that the patient is not misdiagnosed simply because they have poor communication skills.

Because everyone is different, and they all may have different levels of education, it is essential that the psychological therapist pay attention to symptoms that are linked to mental health.

Be sure to ask the therapist questions any time there is a diagnosis, and on what the diagnosis is based.

For example, if the patient is telling the therapist about a dream and all of a sudden can’t remember what they are talking about, this can be a proof that the patient has suffered trauma. The symptoms are in front of the therapist, but it is wise to continue treatment to confirm the diagnosis.

Many therapists are not trained sufficiently in certain conditions, such as Multiple Personality Disorder. These conditions require that all therapists carefully examine the person because they may only be suffering from dementia.

However, if they are suffering from Multiple Personality Disorder it is usually because they are trying to block traumatic memories to avoid pain.

It is always wise to ask questions when you are visiting a therapist, and this can also help them to avoid any mistakes.

A healthy mind is vital, and mental health should not be taken lightly. Therapists are constantly studying the mind, and often use the guinea pig method until they figure out what the issue is.

Mental health symptoms are serious and should not be taken lightly!