1. Learn the Look-a-Likes
Manic Depression or Bipolar Disorder is difficult to diagnose because it can look like some other mental illnesses. For example, Major Depression exactly matches the depressive side of Bipolar Disorder. The mood swings of Borderline Personality Disorder (BPD) can also look very much like Bipolar Disorder. And, making the matter more confusing is the fact that a person can be diagnosed with both BPD and Bipolar Disorder. Further, knowledge of substance abuse is critical, since it can mimic Bipolar Disorder.
2. Get the Facts
According to the DSM-IV-TR, there are two types of Bipolar Disorder. The first is Bipolar I, characterized by a manic or mixed episode (in which both mania and depression are simultaneously present) that lasts at least a week; the second, Bipolar II, is characterized more by recurring Major Depression but with a history of at least one manic episode. Some people with Bipolar Disorder are "rapid cyclers." This means that their moods rapidly change, even in a given day, back and forth between depression and mania. Others cycle between moods over several months.
3. Get Clarity
It may be easier to determine when you are depressed than it is to determine when you are manic. We more easily recognize the fatigue, disinterest and sadness; the sleeping too much or not enough, or sudden changes in weight; the feelings of unworthiness, and the potential suicidality of depression. The often misused word "manic," however, has come to mean anything from a very busy day to a complete psychotic breakdown. But actually, when someone is in the manic phase of Bipolar Disorder they exhibit specific symptoms. The DSM-IV-TR tells us that mania shows up in several ways through such things as a drastic decrease in need for sleep, constant talking or pressure to keep talking, drastic distractibility, extreme inflation of self-image, excessive engagement in current goals, excessive involvement in dangerous activities such as shopping, drugs, alcohol or sex, and/or reports of racing thoughts.
4. Distinguish Between Normal and Abnormal
The words "excessive," "drastic" and "extreme" are used above so that you may distinguish between normal mood swings and the uncharacteristic signs of mania or hypomania (a manic episode of shorter duration). There is a difference, for example, between feeling good and celebratory after an achievement and the inflated self-image of a manic episode. The symptoms above result in an obvious impairment in normal functioning.
But as a lay person, you don't have to be able to diagnose it. You only need to know enough to get yourself or a loved one to a professional. So, if you or someone you know exhibits some of the above symptoms, a psychiatric intervention is essential. Untreated manic depression can deteriorate into psychosis. But also remember that some less excessive mood swings of shorter duration are to be expected in life, particularly during such phases as adolescence and pregnancy. Still, if you are in doubt, find out.
