Bipolar disorder can begin with a bout of either depression or mania, but about two-thirds of cases start with a manic episode, and mania tends to predominate. Just as there are many forms of depression, there are several types of bipolar disorder. The two main subtypes are bipolar type 1 and bipolar type 2. Both are characterized by one or more major depressive episodes, but the type and degree of mania differ.
Bipolar type 1
People with bipolar type 1 experience mania consisting of distinct periods of persistently elevated, expansive or irritable mood. The mania may involve delusional ideas and impaired judgment. A manic episode is diagnosed if elevated mood occurs with three or more other symptoms for most of the day, nearly every day, for one week or longer.
Bipolar type 2
People with bipolar type 2 experience what's called hypomania, a mild to moderate level of mania that is generally a less destructive state than mania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Impaired judgment is rare. Symptoms of bipolar type 2 can be so mild that patients -- and their doctors --mistake these periods of good mood for recovery between depressive episodes. Therefore, even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can turn into severe mania in some people or can switch into depression.
Manic Episode
By definition, a manic episode may include psychotic symptoms such as hallucinations or paranoia during euphoria. About one-half to two-thirds of people with mania have psychotic symptoms. In hypomania, no psychotic symptoms are present.
Getting the correct diagnosis is crucial. Certain medications and health conditions can cause significant mood swings that mimic the symptoms of bipolar disorder. These include corticosteroids, antidepressant or anti anxiety drugs, drugs for Parkinson's disease such as tolcapone (Tasmar), abuse of alcohol or other drugs, an under active or overactive thyroid gland, a neurological or adrenal disorder, vitamin B12 deficiency and other mental health conditions such as schizophrenia. These potential causes of mood swings should be taken into account when a person is suspected of having bipolar disorder or is not responding to treatment.
Hi Steve,
ReplyDeleteI have been following your blog and it has been helpful. I haven't commented on it because I don't know how?
My son has just been diagnosed with borderline bipolar disorder. We are in need of a good Christian counselor to help him. Who do you know up here in GR to recommend who might be able to help. Dr. Verle Bell diagnosed him but has a 4 month waiting list and he needs help now. Any help you can give me would be great. I know God has a purpose in all of this but it is so hard to watch him suffer!
Thank you
Hi Kathy,
ReplyDeleteThank you for being part of the blog. The problem of getting into a psychiatrist in a timely fashion is a common one in the U.S.A. I would be interested to know what the situation is in the many countries who read our blog.
More than one psychiatrist has told me that psychiatrists are becoming a rare breed.
They are over booked and insurance companies give little reimbursement for the needed "long sessions." We beed more Christan psychiatrists. Of course that is a different subject all together.
I have sent you information about psychiatric referrals for your son. Robyn and I have been praying for him and your family. We know the agony of having a child try to deal with such an awful disease. I am sure many others will pray as a result of reading this blog.
Please pray for me as I have thirty days to find a new psychiatrist in West Palm Beach, Florida.
I was with my old psychiatrist for over sixteen years. He was and is a great psychiatrist.
I will keep in touch and try to get back to your emails as soon as I can.