So you’ve been diagnosed with major depressive disorder. Putting an official name on what’s wrong may have been obvious, devastating or a total relief. In any case, it’s a big step in understanding oneself and getting proper help. What you may not know is that your depressive symptoms might not tell the whole story, and not knowing this can be incredibly dangerous. Depression is a big part of bipolar disorder, a different mood disorder with different realities.
Bipolar disorder causes shifts between deep emotional lows (major depression) and intense emotional highs (mania or hypomania). These mood episodes can cause significant changes in a person’s thinking, energy levels and behavior. They can last anywhere from hours to months. When not effectively treated, the disorder can take away one’s ability to function in everyday life. Studies show that approximately 20 percent of people with bipolar disorder attempt suicide. Yet, when effectively treated, people with bipolar disorder can gain stability, diminish the frequency and severity of mood shifts, and lead successful lives.
According to a survey taken by the National Depressive and Manic-Depressive Association, a staggering 69 percent of patients with bipolar disorder are initially misdiagnosed and remain so for upwards of 10 years. The most common misdiagnosis is unipolar depression, with 40 percent of bipolar disorder patients initially receiving this incorrect assessment. Antidepressants, a common treatment for unipolar depression, can trigger manic or hypomanic episodes in bipolar people.
Bipolar disorder is often misdiagnosed because patients generally seek treatment only for depressive symptoms. Intense emotional highs can feel euphoric and even be a temporary asset. Patients screened for mood history may not recognize past mania or hypomania, especially if symptoms were mild.
What to Watch Out For
There are two main types of bipolar disorder: Bipolar I and Bipolar II. The hallmark of Bipolar I is mania, a distinct period of abnormally and persistently elevated, expansive, or irritable mood that may involve psychosis and require hospitalization. Bipolar II features hypomania, a mild form of mania that is less debilitating and does not progress towards psychosis.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition defines a manic/hypomanic episode as having three or more symptoms persisting for one week, or any length of time if hospitalization is required.
Mania/Hypomania Symptoms:
● Inflated self-esteem or grandiosity
● Decreased need for sleep without becoming tired
● Increase in goal-directed activity (work/school/social)
● Restlessness
● More talkative than usual
● Flight of ideas/racing thoughts
● Distractibility
● Excessive irritability
● Reckless behavior such as spending sprees, impulsive business decisions, erratic driving and sexual indiscretions
● In severe cases, delusions and hallucinations
Self Awareness is Key
If you’ve been diagnosed with major depressive disorder it’s smart to be vigilant for signs of bipolar disorder. If you take antidepressants, be mindful of how they make you feel. Let your prescriber know if you become hyper, very irritated or suicidal. Take notice of your thoughts, feelings and actions. Consider getting screened for bipolar disorder if the above symptoms sound familiar.
