Diagnosing Bipolar Disorder Can be Challenging
Mania and Hypomania
The ups – let’s talk about the ups for awhile. We all have our moments of elation, giddiness, or bliss. This is perfectly normal, as are those days when we get up on the “right” side of bed and the world seems to spin in our direction. If someone has hit the genetic jackpot, he or she can feel something like this nearly everyday, with fame and fortune and friends gravitating to them like iron filings to a magnet. Indeed, people with bipolar disorder have proved to be some of society’s most smashing success stories.
But nature is rarely that kind. Sometimes she sends us crashing back into depression. Other times that intoxicating sense of elation starts escalating out of control. One may start talking fast, spending money and engaging in inappropriate activities. Or the magic may start to wear off, as winning behavior deteriorates into crass and embarrassing caricature. Sometimes the elation turns sour, into a dysphoric rage that makes social and family life hell for all concerned.
So terrible is the havoc that bipolar disorder can bring on that a University of Texas at Houston study has estimated the present value of lifetime cost of the illness for an individual ranges from $11,720 for those with a single manic episode to $624,785 for those non-responsive or with chronic episodes. This includes medical care, as well as unemployment and reduced earnings.
Generally, someone in a state of sustained elevation is said to have “hypomania.” Sadly, that person is the last one to think they need help. Either the high is too intoxicating or the problem lies with the rest of the world.
Full blown mania turns up the heat. If one hasn’t wrecked their life while in a state of hypomania, they’re a prime candidate going into mania. These tend to be your 911 cases, bordering on and breaking through into psychosis. Nevertheless, an antipsychotic medication or tranquilizer can bring down a person with mania in a matter of hours or less, though long-term stabilization can be a lot more problematical.
But even with our brains firmly held in place by the best medical science has to offer, there is no peace of mind. At any minute, any second, at the slightest provocation, we’re all too aware that the insides of our skulls can break loose from their pharmacological moorings and indiscriminately tear down what took us a lifetime to build.
Simply losing a night’s sleep may trigger a manic episode, not to mention the stress from work or a relationship breakup. And past trauma, bad lifestyle choices, and failure to manage stress conspire to set us up like sitting ducks.
Hence the need for vigilance. Many people with bipolar disorder are encouraged to keep mood journals, which they and their psychiatrists track like meteorologists keeping watch on baby hurricanes in the Caribbean.