Bipolar Happens Blog – Julie Fast

Bipolar Disorder FAQ

There are questions I regularly get regarding bipolar disorder- what better way to answer them than in a newsletter!

#1 WHAT IS THE DIFFERENCE BETWEEN MANIC DEPRESSION AND BIPOLAR DISORDER? 

There is no difference. Manic depression is the old name of the illness. The term bipolar disorder better represents the reality of the symptoms- as there is a lot more to bipolar than mania and depression. When I first started managing my own illness in 1998, I made the discovery that bipolar has many, many mood swing symptoms outside of mania and depression including: anxiety, psychosis, mixed episodes, paranoia (a form of psychosis), OCD and ADHD symptoms and so many more! The diagnosis of ‘bipolar disorder’ represents the illness as a continuum between the lows and the highs with many, many symptoms in between.

#2 WHAT IS THE DIFFERENCE BETWEEN BIPOLAR I(ONE) AND BIPOLAR II (TWO)? 
It’s often difficult to know the difference between the two main types of bipolar disorder. It can even be difficult for health care professionals to explain unless they have had special training on the topic. When you know the facts, you can see that the difference between the two is actually quite simple.

Bipolar I and Bipolar II (two)have the exact same symptoms in terms of depression and both have mania.  The difference between the two diagnoses is the type of mania a person experiences. Bipolar I (one) has full blown mania while Bipolar I has hypomania.

What is the difference between full blown mania and hypomania you may wonder? The difference is intensity.

Full blown mania if untreated usually leads to a hospital stay- especially if it’s someone’s first episode. This episode usually starts around the age of 20. The mania can start off mildly with a sense of creativity and then spin out of control very quickly. When my partner Ivan had his first full blown episode it started with agitation and confusion, then moved into a complete behavioral change as he started to talk more than usual and couldn’t hold a coherent thought. The night before he went into the hospital, he wasn’t able to remember how to write a check or even have a normal conversation. He was seemingly very creative, but it was agitated and not fun and very scattered. He talked over people and moved around very rapidly. His face looked different and he talked with a different voice. He had what is called dysphoric mania- in other words he didn’t feel very well! This mania was accompanied by severe psychosis.

Euphoric mania is the opposite of dysphoric mania. When it’s full blown, it’s very dangerous as it feels so good. The person almost always refuses help when they are really euphoric. When a person has euphoric mania, they feel no pain and have no reasoning ability- and most importantly, they can’t see the consequences of their behaviors as they feel invincible. This is very, very dangerous mania as it can just seem like excessive enthusiasm, creativity and charisma from the outside.

All full blown manias lead to disasters and most people go into a deep depression if medications are not used successfully.

Hypomania

Hypomania is much less intense and doesn’t put a person into the hospital. As with full blown mania, a person can have euphoric and dysphoric hypomania. Extreme psychosis is rare with hypomania- though it’s common to have grandiose thoughts as well as negative thoughts. I get euphoric mania at the beginning of my hypomanias. Nothing feels as good as euphoric mania- absolutely nothing- but I always do something stupid and I always crash. I work very hard at preventing hypomania.

As I say in my book Take Charge of Bipolar Disorder, it’s essential that you have a distinct diagnosis of either Bipolar I or Bipolar II as the treatments for the two can be quite different! You have to know if you have full blown mania or hypomania. No matter what form you have, the mania is serious- you can make horrible and life altering decisions when you’re full blown manic or even hypomanic. Prevention is the only way to make sure this doesn’t happen.