What is bipolar? / Types of Bipolar #mentalhealth #bipolar

What is bipolar? / Types of Bipolar

Bipolar recovery requires finding out about causes, but first we may need some understanding of the psychiatric bipolar categorisation in use today.

Receiving medications for bipolar disorder is a serious thing, with patients on average dying 20 years earlier than the general population. However, with no medical tests for bipolar, it has only ever been a way of saying, “Something is wrong with your moods but we do not know what is causing it.”

With such a wide meaning then:

  • Are we all, from time to time, a bit bipolar?
  • Are there as many forms of bipolar as there are people in the world?

Bipolar is about categorization rather than diagnosis. Diagnosis means identifying causes, so technically speaking no one can ever be diagnosed as bipolar because bipolar categorization is reserved for people where the cause is not being identified. Bipolar categorization is about labeling.

There are four main categories of bipolar:

1)      Bipolar 1: This is the label given to people who admit to having low energy moods and have been seen to have some extremely high energy moods, whether associated with positive or negative feelings. This is equivalent to the old Manic Depression, other than; the highs in bipolar often being unpleasant with negative feelings or a confusing mix of positive and negative feelings, rather than the traditional manic depressive’s high which was considered to be a kind of ‘happy’ time for the person experiencing it. When the bipolar label first became available to psychiatry in 1980 this was the only type of bipolar.  Although the numbers with this label continue to grow it still accounts for less than 2%* of the adult population.

2)      Bipolar 2: This relatively new label is probably the fastest growing in the UK and may already have been applied to nearly 10%* of the adult population. It is used for people who admit to having low energy yet have never been seen to have extremely high energy moods. It tends to be given to people who previously would have been described as depressed as well as to people who suffer from fatigue syndromes where mood changes seem to be their main problem.

3)      The next less severe bipolar option is called cyclothymia, rather than bipolar 3. It again informs us, “Something is wrong with your moods but we do not know what is causing it.”

4)      Bipolar 4: This can be used when there is no dispute about a prescribed drug or ‘street’ drug triggering the damaging high energy moods. (It is unlikely to be used if the trigger is thought to be ‘a legal high’, nicotine or caffeine.)

At first a label can help us find support, however, bipolar labels stay on our (UK) health records for life, often preventing professionals from looking for or tackling the causes of our troubles.

In many ways the exact label is not so important. The part that needs to be tackled is the cause or causes. Only by getting to grips with what causes us to be seeing a psychiatrist can we start to make a lasting recovery, otherwise we will continue to have to manage/cope with moods we do not want to be having.

I am hoping I can help readers to find and tackle the causes of their disordered moods.

Roger A. Smith

31st January 2014

*In the UK it is difficult to know exactly how many people are affected as many people are not told what is in their medical notes. I would like to hear from anyone who can provide up to date estimates of numbers affected.

Bipolar or Adrenal Fatigue – Part 3 of 3

There are many conditions that lead to bipolar diagnosis. Adrenal dysfunction is just one possibility as discussed here in response to a member of the Institute of Optimum Nutrition.

Thank you for your useful contribution to my comparison of adrenal dysfunction with bipolar diagnosis.

Poor diet is one of the main causes of mood disorder, so the link to the Institute of Optimum Nutrition is going to help a lot of readers. The nutrients mentioned are all important and as you know there is a lot more about our diets that need to be taken into account. Moving on from a bipolar diagnosis will involve dietary improvements as part of a recovery plan.

In saying adrenal fatigue is mistakenly being diagnosed as a psychiatric disorder I was very much thinking all forms of bipolar other than the old manic depression diagnosis that involves people getting extremely busy, having grandiose plans and as you say, “have enough energy to rush around.” This state is described as mania and may also involve noticeable loss of touch with reality, with delusions and/or hallucinations.

In the more modern forms of bipolar, which are now by far the more common diagnosis, there is a much closer match with adrenal fatigue. With the Bipolar 2 diagnosis the patient has long periods of low energy and negative feelings, with short-lived periods of having a little more energy often not even noticed by friends and relatives. With another form of bipolar called cyclothymia the periods of low mood are not usually disabling but just keep on happening, and again without any extreme highs.

What I have noticed is that like me, people may initially see a doctor when having plenty of energy and asking for help, but after several years of involvement with psychiatry the high energy periods become shorter and less extreme until the pattern of moods looks more like on-going fatigue.

I am sure we are agreed that Adrenal Fatigue is best not described as a psychiatric disorder. I am hoping is that my articles will remind doctors that there are many reasons for apparent mood disorders. The other imbalances you mention (hormones, nutrients, food intolerances, blood sugar) do cause imbalanced moods and do need to be addressed first along with external stressors.

Most people who start off appearing to ‘be bipolar’ eventually end up fatigued and coping with exhaustion becomes our biggest daily challenge. (As discussed elsewhere sedative psychiatric drugs can cause more fatigue.)

Too often a bipolar diagnosis is given without looking for other possible causes. Adrenal Fatigue is just one of these possibilities and there are many more that I wish could be checked out before psychiatric labels are considered.