Bipolar Disorder Decoded

As a physician, I have heard the term “bipolar” applied quite loosely to behavior outside of the disease, so I would like to clarify when the diagnosis of bipolar disorder can be correctly applied to someone with mood fluctuations.

The major misconception about the term “bipolar” is that an individual with rapid mood fluctuations in a short time frame is suffering from a form or temporary episode of this potentially devastating mental illness. In actuality, the criteria for diagnosis of type 1 bipolar disorder are quite specific and require a manic episode lasting at least one week. These episodes consist of heightened activity, restlessness, inability to sleep, increased self-esteem and occasionally risk seeking behavior. They are generally associated with a loss of functionality; job performance will decline.

The attenuated (slightly weaker) form type 2 bipolar disorder,  also has very specific diagnosis and requires at least one hypomanic episode (a less extreme form of a manic episode) and a corresponding episode of depression.

To simplify, I like to describe the manic episode in type 1 bipolar as frantically flipping through a book without retaining anything and its counterpart hypomanic episode found in type 2 bipolar as rapidly flipping through the same book but being able to maintain focus and retain information despite high energy levels. Those who experience hypomanic episodes often find that their job performance remains normal or even improves.

With these definitions in mind, I urge everyone to be cautious about labeling someone or their mood as “bipolar.”. The actual disease requires a specific diagnosis and the time course is actually fairly lengthy.

dr. uruj kamal

dr. uruj kamal

Dr. Uruj Kamal is Chief Resident of Adult Outpatient Psychiatry at Baystate Medical Center-University of Massachusetts Medical School. A Stony Brook native, she enjoys combining her knowledge of mental health with healthy living. Dr. Kamal has a special interest in outpatient adult psychiatry.