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.

Taking a break

bipolar balance

knowing our limits

A long time ago when I was very anxious I was given a drug to calm me down. I calmed down too much and I was given a drug to pick me up. I picked up too much and was given a mood stabilizer. With this came a diagnosis of bipolar disorder. These days, some might say that this was ‘Bipolar 4’ – The type induced by taking inappropriate medication.

For my quest to make it easier for people to be ‘undiagnosed when they never had bipolar disorder’ or ‘when the risks of becoming unwell again have receded’ it is paramount that I stay well.  If there are doubts about my health there will be a lot of people not wanting to listen to the ideas I put forward about recovery after bipolar diagnosis.

I have been busy for a few weeks with submission of the manuscript for our book on bipolar diagnosis for nurses.  This is now with the publishers with the publication date set for 12th December 2011. Now, I feel I can pick up the blogging again.

Doubters might say, “That proves he has a mood disorder. He blogs every few days then has to stop for a month – clearly he can’t cope.”

More realistically we all juggle the projects we are involved with, stopping and starting. Recognising how much we can realistically achieve and what can be stopped and restarted is a sign of healthy thinking. If I am at fault, it is in my feeling that I need to apologize for not blogging… This is driven by anxiety not by bipolar disorder.