What People Get Wrong About Bipolar

Yahoo! Health published an article entitled “What People Get Wrong About Bipolar Disorder”. Unfortunately, the article gets quite a few things wrong. The damage is done – Yahoo! Health has a much, much bigger audience than my little blog – but I’ll try to explain the inaccuracies anyway.

It’s strange to see Amelia Davis, MD, the medical director at Rosewood Ranch in Wickenburg, Arizona, get things wrong. But then, during my hospital stint I met a psychiatric nurse, a man around 60 who looked like he’s been working there for a while, who explained to me that “sometimes he gets depressed too, but then he just pulls himself up by the bootstraps and all is well again”. You’d think he’d know what depression is. You’d be wrong. Also, I have a strong suspicion that it’s mostly not Dr Davis that gets things wrong, but the journalist.

Now, without further ado, let’s look at the article.

Myth: People with bipolar disorder experience several mood swings in the course of a few hours.

[…] Bipolar disorder also does not cause moods to switch back and forth rapidly, going from manic to depressive within a few hours. Instead, individuals with bipolar disorder typically have two to four mood cycles a year, according to Davis.

When my doctor told me four mood cycles a year constitute rapid cycling, I could only laugh. I have ultra-ultra-rapid cycling bipolar disorder. The highest number of mood swings I have recorded in my mood chart was eight in the course of one day (during the hospital stay, while my meds were rapidly re-adjusted, but still). This month alone I had three depressive stints that lasted a few days, and three days where I cycled baseline > depression > baseline within hours. I also had hypomanias lasting from half an hour to half a day. Davis’ assumption is correct in case of patients with either “regular” or at best rapid cycling bipolar, although I think it’s important to consider the word “typically” and the idea that it’s not Davis who got it wrong, but the journalist, Ms. Bykofsky.

Myth: When people are in the manic phase, they are often happy.

Manic episodes can actually make people angry, irritable, and aggressive, Davis says. “People experiencing a manic episode often sleep very little, have increased energy, are talking very rapidly, and may appear hyperactive or involved in a lot of different activities, she explains. “Some people can even become psychotic and have delusions or start hear voices that are not there.”

This is not a myth. I’ve been happy with manic. I’ve also been irritable and aggressive – towards myself and others – at the same time. It is actually possible to feel happy and aggressive at the same time. I slept very little, my energy was increased, I was involved in a lot of different activities and I was so happy that once I cried out of sheer happiness because there was so much of it. I also became psychotic and heard voices, but what I heard was positive. I’m lucky in this aspect – my voices never told me to kill or harm myself, in fact, one of them told me NOT to do it multiple times.

Myth: Bipolar disorder is easy to diagnose.

Prolonged periods of misdiagnosis are actually common, Natasha Tracy, the award-winning writer behind the blog Bipolar Burble, tells Yahoo Health. “I sought treatment at the age of 20 and, at that time, I knew that I had bipolar disorder from the extensive research I had done,” Tracy says. “It took a change in doctors and about a year to be properly diagnosed — though a diagnosis is really only the tip of the iceberg in terms of gaining any real sense of wellness.”

This is completely true for a change. Bipolar is a condition that starts quite innocently at first and develops over time. I was receiving treatment for depression in the years 2004-2006 and again in 2011 until I was finally correctly diagnosed with BP, because my hypomanias never really got out of the “everything is wonderful” stage until end of 2011. You don’t go to the doctor to complain that you have too much energy, too much fun and that you are just too happy and can we do something about this. Therefore bipolar is very often misdiagnosed as depression. It is also important to note that there are many other illnesses that are similar to bipolar but aren’t, to only list thyroid problems, schizoaffective and schizophrenia.

Myth: You can take a quick test to diagnose bipolar disorder.

I don’t know if anybody ever thought this was true, therefore I don’t know if it’s a myth or is it Ms. Bykofsky trying to fill the page. I have never heard anyone assert that BP diagnose is easily made through a quick test. If anything, I heard people say (correctly) that BP is notoriously difficult to diagnose – see previous paragraph! My original diagnosis took two one-hour meetings with a psychiatrist, who then referred me to a hospital, where I was assessed again for 2.5 hours, filled questionnaires and got cross-examined by a panel of three psychiatrists and psychologist.

Myth: It’s impossible for people with bipolar disorder to lead normal, healthy lives.

This is not always a myth. It’s enough to watch Stephen Fry’s documentary “The Secret Life Of The Manic-Depressive” to see examples of people whose lives are totally ruined by bipolar. Most of us manage to recover and lead “normal” lives, whatever that is. Many of us, however, don’t. I have been on disability for three years now, and my longest period of stability since 2011 was 3 months. I suppose Dr Davis gets it right here:

“individuals with bipolar disorder can help control their symptoms by getting enough sleep, having a regular sleeping schedule, exercising regularly, eating right, keeping stress low, and having supportive people in his or her life,” Davis says.

Help control. Not control. It is indeed impossible for SOME people with bipolar disorder to lead “normal, healthy” lives. Many of us have found the right med regimes, coupled with all the things Dr Davis lists, have indeed allowed them to take control of their lives again. But not all of us.

I do not have any problems with the rest of the article. But I just wanted to straighten those inaccuracies. Perhaps one or two readers of Yahoo! Health will stumble upon my musings.

Photo: “Bipolar” by Jon Jordan. (CC 2.0)

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