Bipolar Disorder is the New ADHD

Everyone's bipolar. 


Bet you didn't think that was possible, did you? Well, apparently it is. Your mother, your cousin, your neighbor's dog-walker...they're all bipolar. For this disorder, apparently all you need to qualify is a magazine article that sounds vaguely like you or a friend, and voila! There it is. No professional intervention required. The aunt of a client called to talk at me over the phone the other day. (While I can't acknowledge that certain people are or are not a client of mine, their relatives often feel comfortable calling and telling me in detail what is wrong with that person anyway.) Her words were, " And I know she is bipolar because I saw Dr. Phil talking about it the other day and she has what he says." 


Sometimes I hate Dr. Phil.


The thing is, most people don't understand what bipolar disorder is before they start labeling their relatives or diagnosing themselves. It is not when someone hates you one day and loves you the next. (That's closer to borderline personality disorder, another over-diagnosed problem.) It is not always when someone's mood changes rapidly. That's only part of it. 


For Bipolar I Disorder (This is straight from the DSM-IV, as of now the most current diagnostic bible for medical and mental health professionals) an individual MUST have had at least one Manic Episode to qualify for diagnosis. 


A Manic Episode is NOT being high on a drug or substance. It is not simply feeling excited or over-the-top. It is "sufficiently severe to cause marked impairment in occupational functioning...[social & relational]...or to necessitate hospitalization to prevent harm to self or others..." A manic state is so debilitating a person cannot participate in normal life. This is serious stuff.


At least three and sometimes four of the following have to be existing FOR AT LEAST A WEEK to qualify for a manic episode:


(1) "inflated self-esteem or grandiosity"
(2) need less sleep - i.e. 3 hours is suddenly enough
(3) "more talkative than usual or pressure to keep talking"
(4) thoughts running away with you to the point it cannot be controlled
(5) ADHD-like distractability
(6) "increase in goal-directed activity", for example deciding instantaneously to start a new business, stay up for three days to study for a test, etc., or "psychomotor agitation" Twitch, twitch, twitch...
(7) Risk-taking behavior like extreme promiscuity, high-stakes gambling, high-dollar shopping sprees, death-defying activities. 


There's more to the qualifications for this diagnosis but I believe this is the part that's most frequently misunderstood. There are not many people that have true Manic Episodes, therefore, not that many people have Bipolar I Disorder. Bipolar II Disorder includes Hypomanic (must only last for four days) and Mixed Episodes (one Manic Episode + One Major Depressive Episode), both also unlikely to be found in the majority of the population. 


True Bipolar Disorder is a serious diagnosis - it's not something you want to have for kicks! Misdiagnosis leads to the same problems as existed in the last "it" diagnosis: ADHD. Over-medication, ineffective treatment (it won't work if you don't actually have the disorder) and labels. So please think about it before diagnosing your friends and family, or especially yourself! 


Even if you see it on Dr. Phil. :) 


'Til Next Session,
Stephanie Ann Adams