Everyone experiences changes in mood from time to time. It’s normal to have days where you feel sad, and others where you’re elated. As long as your mood changes do not interfere with your ability to carry out daily activities, these fluctuations are mostly considered to be healthy.
However, if you have serious and constant shifts in your mood, and these shifts are characterized by frequent episodes of extreme happiness or extreme depression, it can be a sign of a mental health condition formerly referred to as “manic depression,” and now more commonly known as bipolar disorder.
Defining ‘Manic Depression’
Manic depression, or bipolar disorder, is a disorder that causes one to experience severe inconsistencies in mood, thoughts, and behavior. It has also been called “manic-depressive illness.”
People who are affected by this condition may experience constant shifts in mood, and also commonly go through intense periods of depression or mania, a mood characterized by periods of great excitement or euphoria, delusions, and overactivity. Manic depression does not occur in the same way for every person who suffers from it, however. Some mostly experience a depressive state, while others mostly experience manic phases. Sometimes, the depressive and manic symptoms can even occur together at the same time.
Manic depression typically develops in late adolescence or early adulthood. Based on diagnostic interview data published by the National Institute of Mental Health, an estimated 4.4 percent of adults in the United States experience manic depression at some point in their lives, and 2.9 percent of adolescents between the ages of 13-18 are afflicted by the condition as well.
The symptoms of manic depression vary in severity. A person who experiences manic phases may show different signs from a person who more often experiences depressive states. Sometimes, sufferers may not experience any symptoms for extended periods of time.
Signs of a depressive phase may include:
- Suicidal thoughts or intent
- Irregular eating and sleeping habits
- Extreme fatigue
- Feelings of worthlessness or aimlessness
- Difficulty with concentration or making decisions
- Changes in behavior
At the other end of the spectrum is the manic state, which is characterized by the following symptoms:
- Restlessness and an inability to focus on one thing at a time
- Long periods of overexcitement
- Extreme agitation or racing thoughts
- Taking on more work than one can handle or engaging in multiple tasks at once
- Having little need for rest or sleep
- Engaging in impulsive activities like gambling, binge eating, or risky sexual behavior
- Speaking a pressure to speak and talking loudly and rapidly
People with manic depression may also go through a state of hypomania — a milder form of mania that involves less severe symptoms. Before a person can be diagnosed with manic depression (bipolar disorder), they must have experienced one episode of mania or hypomania.
4 Types of ‘Manic Depression’
Generally, manic depression occurs in four different categories: bipolar I disorder, bipolar II disorder, cyclothymic disorder or cyclothymia, and “unspecified” or “other specified” bipolar disorder.
1. Bipolar I disorder
People who have bipolar I disorder have likely experienced one or more manic episodes. To be diagnosed with this condition, the phases of mania must last at least seven days, or be so extreme that the person has to be hospitalized.
2. Bipolar II disorder
Bipolar II disorder is a subset of manic depression in which a person never really goes through a full manic state, but experiences hypomanic episodes and shifts back and forth between depressive phases.
3. Cyclothymic disorder or cyclothymia
People with cyclothymic disorder usually experience a constantly unstable mood, coupled with hypomania and mild depression for a period of at least two years.
4. “Unspecified” or “other specified” bipolar disorder
When a person does not meet the criteria for bipolar I, II or cyclothymia but has still experienced periods of clinically significant abnormal mood patterns, the condition is known as bipolar disorder, “unspecified” or “other specified.”
Why Bipolar/Manic Depression is Often Misdiagnosed
According to a survey by the Depression and Bipolar Support Alliance, 69 percent of patients with manic depression are misdiagnosed initially and more than one-third remained misdiagnosed for ten years or more. Because manic depression has similar symptoms to other mental illnesses, like borderline personality disorder and unipolar depression, healthcare experts sometimes unknowingly provide inaccurate diagnosis to their patients based on similar or overlapping symptoms.
The consequences of misdiagnosis of manic depression are numerous, and devastating. Misdiagnosis leads people to seek treatment for the condition they don’t have, while the symptoms of manic depression are left untreated. These symptoms, if untreated, can increase the severity of the condition over time.
Misdiagnosis can be prevented when careful observation of an individual affected by the condition is carried out by a licensed and trained professional with a deep understanding of bipolar disorder. This involves physical examination of the individual, compiling a comprehensive history of symptoms of each depressive or manic episode, and gathering concrete information on the person’s pattern of behavior from those close to the individual.
Bipolar: Debunking the Manic Depression Myths
There have been great advances in the awareness, diagnosis, and treatment options for manic depression in recent years. However, public understanding of the condition is still low. One common misconception about manic depression is that having a mood swing is the same thing as suffering from bipolar. Despite the trivialization of the term “bipolar,” it is important to note that inconsistencies in a person’s mood may be a healthy and normal occurrence, rather than a sign of manic depression.
Another common misconception is that mania is somehow an exhilarating and exciting feeling. While a manic phase can give a person a feeling of exuberance, it also comes with negative outcomes like impulsive behavior, extreme irritability, and even hallucinations. Also, contrary to popular belief, substance abuse is not a contributor of bipolar, though it can certainly exacerbate its symptoms. The cause of manic depression remains mostly unknown, but it has been described as resulting from a combination of genetic and environmental factors, as well as discrepancies in brain structure and function.
One of the best ways to help a person affected by manic depression is by educating yourself about the myths and facts surrounding the condition, in order to help them deal with the symptoms effectively.
Living with Bipolar Disorder
Bipolar disorder, or manic depression, can adversely affect a person’s ability to perform daily tasks. For people like Elizabeth Horner, a psychiatric nurse who works with patients dealing with conditions like schizophrenia, manic depression, and clinical depression, living with manic depression herself has come with its setbacks and hardship. She described the disorder as one that has caused her periods of isolation and grief.
“I denied my bipolar disorder [manic depression] for well over a decade andonly recently came to accept its existence. I was finally able to look back at all my struggles with a clarity and wisdom that had been lacking in me for a long time,” she stated in an article for the National Alliance on Mental Illness.
In his interview with David Letterman, rapper Kanye West also opened up about his life after he was diagnosed with bipolar disorder, and described that the condition had led him to feel “hyper-paranoid” about everything and everyone. “You pretty much don’t trust anyone,” he said. He also mentioned that he chose to speak up about his diagnosis because of the discrimination faced by people who are affected by bipolar disorder.
Getting therapy and opting for a suitable treatment plan can help you manage the symptoms and live a happy and productive life.
Fighting the Stigma Associated with Bipolar Disorder
Bipolar disorder is a serious condition, but we can ease the difficulties for those living with it by being compassionate. This means avoiding the casual use of the word “bipolar” when referring to normal mood swings, as it belittles the magnitude of the impact of manic depression on people’s lives. It also means dispelling the notion that people living with bipolar are inherently violent, or that they are not efficient workers. Despite the challenges the condition brings, it is still very possible for people to live normal lives while managing it.
If you may be struggling with manic depression, or another serious mental health condition, it’s best to reach out to a licensed mental health professional. Connect with a therapist today, with online therapy.
If you are in a life threatening situation call +1 (800) 273-8255 or use these resources to get immediate help.