Bipolar affective disorder or manic-depressive illness is a mood disorder characterized by periods of profound depression that alternate with periods of excessive elation and irritable mood known as mania. Bipolar depression is not just a disorder characterized by mood swings; for example, the highs and lows do not happen in regular cycles but sometimes a period of mania will show up once or twice a year or sometimes individuals will experience both mania and depression at the same time; a pattern known as a mixed episode. There are many different clinical presentations for bipolar disorder and as a result, many common myths and misconceptions that must be debunked in order to reduce the stigma and raise awareness for bipolar affective disorder.
Myth: Bipolar disorder is defined by cycles of highs and lows
Fact: Bipolar disorder is characterized by episodes of mania and depression that do not show up in any regular pattern
Many believe that mania and depression are cyclical in bipolar affective disorder; however, there are multiple types of bipolar disorder, including bipolar type 1, bipolar type 2, and mixed episodes. Each of these subtypes is characterized by mania and depression, but none of these subtypes are characterized by regular patterns of highs and lows.
Myth: You can get a test to diagnose bipolar disorder
Fact: Like many other mental health disorders, bipolar disorder is diagnosed through a thorough clinical history.
Bipolar disorder is diagnosed based on signs and symptoms, and although it is common for a physician to run lab tests to rule out other disorders, there is no test to diagnose bipolar disorder.
Myth: Bipolar disorder is only seen in adulthood
Fact: Bipolar disorder can be diagnosed in children and teenagers and is often confused with ADHD, oppositional defiant disorder and anxiety disorders in these age groups.
Bipolar disorder in children is possible. It’s most often diagnosed in older children and teenagers, but bipolar disorder can occur in children of any age. As in adults, bipolar disorder in children can cause mood swings from the highs of hyperactivity or euphoria (mania) to the lows of serious depression.
Myth: Mania is enjoyable, productive and fun
Fact: Manic episodes can be uncomfortable, anxiety-ridden, and unpleasant and often times can lead to erratic and illegal behavior.
When individuals experience mania, they often feel really good, have lots of energy and go without sleep for hours on end but they also can take big risks or do things they would not ordinarily do which can have damaging negative effects on their career, finances, relationships and reputation. Sometimes, mania can be accompanied by psychotic symptoms, which can be extremely frightening and distressing.
Myth: There is no treatment for bipolar disorder
Fact: Bipolar disorder can be maintained with a combination of medications and psychotherapy.
Bipolar disorder is best treated with a combination of medications, which can include mood stabilizers and antipsychotics used in combination with psychotherapy, specifically cognitive behavioral therapy.
Myth: Individuals with bipolar disorder are attention-seeking and trying to manipulate others.
Fact: A prominent part of bipolar disorder is lack of insight. Individuals with bipolar disorder, particularly during a manic state, are unable to see and understand their symptoms.
Individuals with bipolar disorder are unable to control their thoughts, impulses or actions during manic or depressive states and therefore suicidal thoughts or impulsive actions are not meant to seek attention. When others assume that these individuals are acting out for the sake of attention, it can worsen the stigma associated with bipolar disorder and result in more restricted access to treatment. The risk of not listening and not responding to those who are struggling with bipolar disorder is too great. Too often, individuals are afraid to speak out, and when they do, we need to validate that and support them.
Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases including mental health disorders and the stigma associated with them. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.