The two disorders are bipolar I and bipolar II, according to the Diagnostic and Statistical Manual of Mental Disorders, DSM. The National Institute of Mental Health estimates bipolar disorders affect approximately 5.7 million adults per year, with the median age of onset being 25 years. Either bipolar disorder is characterized by mood swings, ranging from major depression episodes to manic episodes. While some patients with a bipolar disorder do well with medication and therapy, some are extremely debilitated, and cannot function in employment.
Bipolar And Major Depression
For either bipolar disorder, a major depressive episode must occur at some point in order for a clinician to verify a diagnosis of bipolar I or bipolar II. Major depression is a state in which a person is in a depressed mood most of the time, loses interest in his usual activities, and generally is not functioning well at work, school, home or social activities.
Mania
Bipolar I may be diagnosed when a person is currently or last was in a highly elevated, euphoric, grandiose mood. The mood elevation is unlike her ordinary good mood. She may do dangerous and risky things, like jumping off a building, or charging up all her credit cards without regard to consequences. The manic state must severely interfere with her usual activities.
Hypomania
For bipolar II, the person's elevated mood state is called "hypomanic" and does not have to severely interfere with the person's life. Hypomania is an unusually elevated mood, lasting at least four days. Like the manic state, the person may need less sleep, be grandiose and do pleasurable things without regard for consequences. According to the DSM, hypomania may only be diagnosed when no psychosis is present.
Mood Cycles
In bipolar I and bipolar II disorders, the depressed and elevated moods cycle. How long the cycling period for each mood lasts is variable. These disorders may not be diagnosed when the person has only had a depressive episode.
Psychosis
In Bbipolar I, a person may experience psychotic episodes at either end of the mood spectrum. Often the nature of the psychotic themes is similar at both poles. When the person returns to his baseline ordinary mood, he may remember and be able to talk about his psychotic periods.
Mixed Mood
For bipolar I, a person may experience a depressive and manic state within one day, called a mixed episode. A mixed episode may only be diagnosed if the mixed state happens for at least one week.
Common Misconception
Sometimes people refer to something they call "Bipolar Schizophrenia." This term is incorrect. There is a form of schizophrenia called "Schizoaffective Disorder," which is a schizophrenia disorder with mood swings. The two disorders are easy to confuse, and sometimes cannot be distinguished without further health history, or more cycles.
References
- "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision"; American Psychiatric Association; 2000
- National Institute of Mental Health: Numbers Count: Mental Disorders in America
- National Institute of Mental Health: Bipolar Disorder
