Wednesday, January 8, 2014

Lexicon of Madness -- Bipolar Disorder

Bipolar Disorder: Short for Bipolar I Disorder, formerly known as manic-depressive illness. As the older name implies, the course of the illness is marked by alternating episodes of mania and major depression, followed by periods of relatively unimpaired functioning. A manic episode can feature elevated mood, agitation, restlessness, decreased need for sleep, increased talkativeness ("pressured speech" -- as if the words are coming out of a fire hose), financial profligacy (e.g., spending sprees or extreme generosity), grandiosity (including delusions of having special powers or a divinely-ordained mission), increased goal-directed behavior, and psychosis. A person experiencing mania might act like a "maniac" -- abusing substances, being sexually promiscuous, driving 100 mph, and assaulting others if he feels that they are constraining him. He might spend his life savings on lumber and start building a ten-storey observation tower in his backyard. The symptoms of mania must persist for at least a week for the diagnostic criteria to be met. Following the law of "what goes up must come down," manic episodes are usually followed by a depressive episode of at least two weeks duration. This disorder is almost as rare as schizophrenia, and can be just as severe. (The U.S. Secret Service has more contacts with people who are bipolar than with people who are schizophrenic.) People suffering from bipolar disorder require medications such as lithium to stabilize their moods and usually have histories of psychiatric hospitalization, contacts with law enforcement, or suicidal behavior. Most people who describe themselves as "bipolar" are actually not. Usually, they are better described as moody, irritable, immature, and as having poor impulse control. Displaying a tendency to get disproportionately angry or upset over minor frustrations does not mean that someone is bipolar. Many people who have been diagnosed as bipolar actually have Borderline Personality Disorder, which is marked by extreme mood reactivity and instability of mood, but the mood states do not persist nearly as long as they do in bipolar disorder. Bipolar II Disorder features discrete episodes of depression and hypomania (which is essentially a shorter-duration, low-grade mania that won't land you in a psychiatric hospital or jail cell).

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