Although I wouldn’t wish the pain of bipolar disorder on anyone, I am sort of glad to find out another accomplished, beautiful movie star has joined our manic-depressive group. After spending five days in a mental health facility, Catherine Zeta Jones has been diagnosed with bipolar II disorder. I like to call bipolar II the “Diet Coke” of bipolar, if you recall the scene from “Austin Powers” when Dr. Evil says to his son, Scott: “You’re quasi-evil. You’re semi-evil. You’re the margarine of evil. You’re the Diet Coke of evil. Just one calorie, not evil enough.”
That’s how I view bipolar II: one calorie short of bipolar I. Those with bipolar II experience the same symptoms as persons with Bipolar II, just not to the extreme. For example, when I get manic, I don’t hallucinate. I may not even seem manic to a person who doesn’t know me well. I might talk a little faster, have more energy, and, in general, feel much more confident than I would if I were not manic. In fact, my form of “grandiosity” is simply not needing to solicit so many affirmations to feel okay about myself.
The subtle symptoms can make it difficult to tease apart bipolar II from major depression.
To better clarify the distinction between bipolar I and bipolar II, here is a description from the smart doctors at Johns Hopkins School of Medicine as published in their Depression Bulletin (also see our Bipolar Beat description):
Just as there are many forms of depression, there are several types of bipolar disorder. The two main subtypes are bipolar disorder I and bipolar disorder II. What’s the difference?
The primary distinction is that bipolar disorder II only involves hypomania, not full-blown mania. Bipolar disorder I involves true mania.
Signs and symptoms of mania (or a manic episode) include:
- Excessive “high,” overly good, euphoric mood
- Extreme irritability
- Increased energy, activity, and restlessness
- Racing thoughts and talking very fast, jumping from one idea to another
- Distractibility and inability to concentrate
- Diminished need for sleep
- Unrealistic, grandiose beliefs in one’s ability and powers
- Poor judgment
- Spending sprees
- A lasting period of behavior that is distinctly different from usual behavior
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms listed above for most of the day, nearly every day, for one week or longer. If the mood is irritable, four additional symptoms must be present.
Hypomania is a mild to moderate level of mania and is generally a less destructive state than mania. It may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Therefore, even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can turn into severe mania in some people or can switch into depression.
By definition, a manic episode may include psychotic symptoms (such as hallucinations or paranoia) during the euphoria. About one-half to two-thirds of people with mania have psychotic symptoms. In hypomania, no psychotic symptoms are present.
Image credit: Wikipedia/Georges Biard