History UsefulNotes / BipolarDisorder

Most of the time, when a character is portrayed as having bipolar disorder, they are usually shown as being uncontrollable, {{hair trigger| temper}} {{Mood Swinger}}s - swinging from affable and pleasant to suicidal or raging in the space of minutes. Or, in constrast, a character will be called bipolar if they are moody, but are never shown actually suffering from their mood swings. Either way, as the disorder is only rarely portrayed in the media beyond these and other unrealistic, simplified forms, most people are unaware that in reality, bipolar disorder is a complex, multifaceted illness.

A good metaphor for the inner life of a bipolar individual is a roller coaster. At various points in the track, the rider can be moving fast or slow, and up and down, in various combinations. A bipolar person has no control over when their mood swings occur, but swings can be triggered by things like overstimulation, drug use, and positive or negative experiences. While a "normal" individual may experience such highs and lows, in the bipolar individual emotional shifts are far more [[MoodWhiplash sudden]] and [[UpToEleven extreme]], and are only tangentially related to the events experienced by the bipolar individual: The upsurge after a promotion at work may trigger an immediate crash into depression, the loss of a job may trigger a counter-surge of [[JustIgnoreIt devil-may-care optimism]]. For the most part the symptoms of bipolar disorder are governed by semi-regular cycles, and many who are aware they have the disorder take steps to preserve routine and keep this modicum of stability.

!!Mania:

Much of the HollywoodPsych behavior [[TheSchizophreniaConspiracy attributed to Paranoid Schizophrenics]] is actually result of a person with both paranoid schizophrenia (or just simple paranoia) ''and'' bipolar disorder [[note]]the two conditions are known to share certain genetic markers[[/note]] a week of living with racing thoughts and [[TheInsomniac no sleep]] gives plenty of time to build a RoomFullOfCrazy, and would make it hard for ''anyone'' to tell reality from their own delusions or [[WordSaladPhilosophy construct coherent sentences]]. Its no wonder they have to [[StringTheory plot everything out with string]] to keep track of it all. To make matters stranger, even a diagnosed individual aware of their condition [[ThroughTheEyesOfMadness may not be aware]] that they've transitioned from a hypomanic phase into a full manic phase: the same tunnel vision that gives them focus prevents them from noticing or caring about things like that they haven't slept in three days, so it's easy for those with more extreme bipolar disorder to begin with a perfectly reasonable task in mind and end deep in the madness place.

While bipolar II disorder normally does not have manic episodes, mania '''can''' be caused by antidepressants. Since bipolar II is often misdiagnosed as major depression, this naturally tends to lead to unexpected and unpleasant issues once the antidepressants take effect.

!!Mixed States.
Most with Bipolar Disorder actually spend most of their time in something vaguely resembling a neutral, relatively normal, state. Its only when the metaphorical roller coaster hits an extreme extreme hill or drop that a series of manic and depressive phases occur. In many cases, the name "bipolar disorder" is a [[NonIndicativeName misnomer]], because the experiences are not a simple matter of pure off and on.

A mixed state is a bipolar episode in which a person experiences mixed aspects of mania and depression at the same time. It can range from experiencing energy without joy, which leaves them feeling like they're going too fast, to being [[CryLaughing happy and sad]] at the same time, to being [[WhileRomeBurns content to do nothing at all]]. These states tend to be the most dangerous and unpleasant for the bipolar individual: the prolonged MoodDissonance one experiences can be a grating MindScrew, [[note]]sometimes bordering on self imposed MindRape[[/note]] and the inherent issues of combining a [[TranquilFury misanthropic mood and low energy]], [[TheUnfettered emotional burnout and intense focus on a goal]], or [[DeathSeeker lack of concern for ones own life]] and SuicidalOverconfidence are obvious.

When a Bipolar person does crash, the landing is often hard. The depressive state can be thought of as the natural result of the manic state's overclocking of the mind and body- [[HeroicRROD after running for so long at full tilt, it takes time to recover]] during which time they are BroughtDownToNormal. Given the contrast to high of the manic state, its little wonder the bipolar person is left feeling dejected, burnt out, and uninspired, and often [[MyGodWhatHaveIDone regretting impulsive decisions]] and [[TheAtoner damaged relationships]] of the manic phase. This leads many to self-medicate with stimulants and alcohol, to artificially extend or trigger the manic phase and blunt the misery of the depressive phase.

An individual with bipolar disorder is wise to learn to recognize the signs of these states, and respond accordingly to minimize their impact (I.E. seeking out friends and positive situations when in a high mood with low energy, or avoiding high stress situations and focusing on a constructive project when feeling angsty and restless).

Hypomania is essentially very similar to TheMadnessPlace trope- it is characterized by intense focus on tasks, HyperAwareness; high mood and energy; extreme levels of optimism, creativity, productivity, and inner motivation; [[TheDeterminator high mental endurance]], and reduced sleep cycles. This, to some, may sound desirable, or even pleasant. Indeed, it is true that many successful artists, inventors, and entrepreneurs have been formally diagnosed as bipolar, and one of the most common motivations for bipolar individuals who stop taking their medication is missing the "rush" of hypomania.

When a Bipolar person does crash, the landing is often hard. The depressive state can be thought of as the natural result of the manic state's overclocking of the mind and body- [[HeroicRROD after running for so long at full tilt, it takes time to recover]] during which time they are BroughtDownToNormal. Given the contrast to high of the manic state, its little wonder the bipolar person is left feeling dejected, burnt out, and uninspired, and often [[WhatHaveIDone regretting impulsive decisions]] and [[TheAtoner damaged relationships]] of the manic phase. This leads many to self-medicate with stimulants and alcohol, to artificially extend or trigger the manic phase and blunt the misery of the depressive phase.

->''"And when you're up you're up\\
and when you're down you're down\\
and when you're only halfway up\\

-->-- '''The Grand Old Duke Of York''', ''Traditional Nursery Rhyme''

->And when you're up you're up\\

you're neither up nor down
-->--'''The Grand Old Duke Of York''', ''Traditional Nursery Rhyme''

-->'''The Grand Old Duke Of York''', ''Traditional Nursery Rhyme''


Most of the time, when a character portrayed as having bipolar disorder, they are usually shown as being uncontrollable, {{hair trigger| temper}} {{Mood Swinger}}s - swinging from affable and pleasant to suicidal or raging in the space of minutes. Or, in constrast, a character will be called bipolar if they are moody, but are never shown actually suffering from their mood swings. Either way, as the disorder is only rarely portrayed in the media beyond these and other unrealistic, simplified forms, most people are unaware that in reality, bipolar disorder is a complex, multifaceted illness.

If hypomania is comparable to having had too much caffeine, a full manic state would be comparable to the effects of a high dose of amphetamines or cocaine- but with the effects lasting for days. The manic individual has a very short attention span for anything outside of whatever they are currently fixated on, including things like [[ForgetsToEat eating]] and [[TheInsomniac sleeping]]. They have little impulse control with regard to their fixations- many find themselves spending everything they have on a whim that they rapidly forget about; compulsively pursuing a task to completion with no regard to whether it is [[{{Workaholic}} productive]], [[JustOneMoreLevel unproductive]], or [[PolishTheTurd simply inane]]; or giving in completely to hedonistic behavior. The manic frequently experiences what is known as "Acromegaly"- the feeling that they are [[AGodAmI invincible and can accomplish any task]].

A good metaphor for the inner life of a bipolar individual is a rollercoaster. At various points in the track, the rider can be moving fast or slow, and up and down, in various combinations. A bipolar person has no control over when their mood swings occur, but swings can be triggered by things like overstimulation, drug use, and positive or negative experiences. While a "normal" individual may experience such highs and lows, in the bipolar individual emotional shifts are far more [[MoodWhiplash sudden]] and [[UpToEleven extreme]], and are only tangentially related to the events experienced by the bipolar individual: The upsurge after a promotion at work may trigger an immediate crash into depression, the loss of a job may trigger a counter-surge of [[JustIgnoreIt devil-may-care optimism]]. For the most part the symptoms of bipolar disorder are governed by semi-regular cycles, and many who are aware they have the disorder take steps to preserve routine and keep this modicum of stability.

While becoming less of an issue as public awareness and professional understanding of the disorder rises, there are many challanges to diagnosing bipolar disorder. By its fluid, intermittent nature it is easy for the disorder to be mistaken for other issues, or missed entirely until an extreme manic phase reveals the true nature of the problem.

There are several gender specific issues in the diagnosis of Bipolar disorder, not least that the HystericalWoman trope frequently leads to dismissal of even blatant symptomns in women. Even in a professional context, extreme bipolar disorder is difficult to differentiate from borderline personality disorder, clinical depression, or even abnormally extreme PMS. [[note]]Yes, this can be a thing. The fact that hormonal shifts are yet another of the many triggers for a phase shift doesn't help matters any.[[/note]]

Finally, in both genders, there is a tendancy to either [[TheUnfettered give in completely to ones own chaotic emotions and impulses]], often on the misguided advice to BeYourself [[note]]the problem being that a bipolar person has shades of "me", and not all of them are [[EnemyWithin healthy to indulge]][[/note]] or decide that their fluctuating emotions cannot be trusted and attempt to [[EmotionSuppression suppress them entirely]]. Both of these can further mask the disorder as impulse control issues, or antisocial behaviors.

The best comparison of hypomania for those who are not bipolar is an adrenaline rush or extreme stimulant use. If you have ever had any sort of "mountain top experience", had way, way too much caffinene, or chain-smoked cigarettes, you have had an experience similar to a brief bout of hypomania-except that hypomania typically lasts anywhere from [[HourOfPower several hours to several days]].

If hypomania is comperable to having had too much caffiene, a full manic state would be comparable to the effects of a high dose of amphetamines or cocaine- but with the effects lasting for days. The manic individual has a very short attention span for anything outside of whatever they are currently fixated on, including things like [[ForgetsToEat eating]] and [[TheInsomniac sleeping]]. They have little impulse control with regard to their fixations- many find themselves spending everything they have on a whim that they rapidly forget about; compulsively pursuing a task to completion with no regard to whether it is [[{{Workaholic}} productive]], [[JustOneMoreLevel unproductive]], or [[PolishTheTurd simply inane]]; or giving in completely to hedonistic behavior. The manic frequently experiences what is known as "Acromegaly"- the feeling that they are [[AGodAmI invincible and can accomplish any task]].

Much of the HollywoodPsych behavior [[TheSchizophreniaConspiracy attributed to Paranoid Schizophrenics]] is actually result of a person with both paranoid schizophrenia (or just simple paranoia) ''and'' bipolar disorder [[note]]the two conditions are known to share certain genetic markers[[/note]] a week of living with racing thoughts and [[TheInsomniac no sleep]] gives plenty of time to build a RoomFullOfCrazy, and would make it hard for ''anyone'' to tell reality from their own delusions or [[WordSaladPhilosophy construct coherent sentences]]. Its no wonder they have to [[StringTheory plot everything out with string]] to keep track of it all. To make matters stranger, even an diagnosed individual aware of their condition [[ThroughTheEyesOfMadness may not be aware]] that they've transitioned from a hypomanic phase into a full manic phase: the same tunnel vision that gives them focus prevents them from noticing or caring about things like that they haven't slept in three days, so its easy for those with more extreme bipolar disorder to begin with a perfectly reasonable task in mind and end deep in the madness place.

Most with Bipolar Disorder actually spend most of their time in something vaguely resembling a neutral, relatively normal, state. Its only when the metaphorical rollercoaster hits an extreme extreme hill or drop that a series of manic and depressive phases occur. In many cases, the name "bipolar disorder" is a [[NonIndicativeName misnomer]], because the experiences are not a simple matter of pure off and on.

An individual with bipolar disorder is wise to learn to recognize the signs of these states, and respond accordingly to minimize their impact (ie seeking out friends and positive situations when in a high mood with low energy, or avoiding high stress situations and focusing on a constructive project when feeling angsty and restless.

But what exactly do we mean by mania and depression? In the context of bipolar disorder, these are both abnormal and often disabling mood states, much more severe than anything a healthy person would go through for any prolonged period of time. They do not merely affect mood, but impact every part of how a sufferer thinks, perceives and interacts with the world, and in many cases even biological rhythms like sleep cycles, metabolic rate, blood pressure, and even body temperature. The name "bipolar" is actually somewhat of a misnomer: there are several states commonly experienced by bipolar individuals, with the manic and depressive states only being the two most extreme and recognizable. A bipolar person has no control over when their mood swings occur Swings can be triggered by things like overstimulation, drug use, and positive or negative experiences, but for the most part are governed by semi-regular cycles.

Much of the HollywoodPsych behavior [[TheSchizophreniaConspiracy attributed to Paranoid Schizophrenics]] is actually result of a person with both paranoid schizophrenia (or just simple paranoia) ''and'' bipolar disorder- a week of living with racing thoughts and [[TheInsomniac no sleep]] gives plenty of time to build a RoomFullOfCrazy, and would make it hard for ''anyone'' to tell reality from their own delusions or [[WordSaladPhilosophy construct coherent sentences]]. Its no wonder they have to [[StringTheory plot everything out with string]] to keep track of it all. To make matters stranger, even an diagnosed individual aware of their condition [[ThroughTheEyesOfMadness may not be aware]] that they've transitioned from a hypomanic phase into a full manic phase: the same tunnel vision that gives them focus prevents them from noticing or caring about things like that they haven't slept in three days, so its easy for those with more extreme bipolar disorder to begin with a perfectly reasonable task in mind and end deep in the madness place.

A mixed state is a bipolar episode in which a person experiences mixed aspects of mania and depression at the same time. It can range from experiencing energy without joy, which leaves them feeling like they're going too fast, to being happy and sad at the same time, to being [[WhileRomeBurns content to do nothing at all]]. A good metaphor for the inner life of a bipolar individual is a rollercoaster- at various points in the track the rider can be moving fast or slow, and up and down, in various combinations. Most with Bipolar Disorder actually spend most of their time in something vaguely resembling a neutral, relatively normal, state. Its only when the rollercoaster hits an extreme extreme hill or drop that a series of manic and depressive phases occur.

But what exactly do we mean by mania and depression? In the context of bipolar disorder, these are both abnormal and often disabling mood states, much more severe than anything a healthy person would go through for any prolonged period of time. They do not merely affect mood, but impact every part of how a sufferer thinks, perceives and interacts with the world.

* '''Mania.''' Mania is described by the DSM as at least a week (or any amount of time that requires hospitalization) of "severely elevated mood." Which sounds pleasant, or even desirable. Up until you 'come back down'. Mania also has a dark side- people with mania have very short attention spans and often end up spending everything they have on a whim that they rapidly forget about. It can end very badly. This is one possible form of mania--mania can also be a state of energy without joy, which leaves them feeling like they're going too fast.
** The best comparison for mania for those who are not bipolar is stimulant drug use. If you've ever used amphetamines or cocaine (or even just had way, way too much coffee/chain-smoked cigarettes) you have had a similar experience to mania (or hypomania in the coffee and chain-smoking example) - the difference is that a bipolar person who doesn't do mood charting often doesn't know or understand they've entered an altered state, that the time to comedown is often far longer than with any drug (making for much more stress on the body and mind - the only thing that approaches a long-term severe manic episode for this is a methamphetamine addiction where the substance is continually used), and there is no "defined time of effect," e.g. the crash, when it happens, can be the next minute or the next year.
* '''Mixed States.''' A mixed state is a bipolar episode in which a person is manic and depressed at the same time. It can range from being depressed but not lethargic to being happy and sad at the same time, which is hard to describe but certainly exists.

- Incomplete. Will add to the index once this is done. -

* '''Mania.''' Mania is described by the DSM as at least a week (or any amount of time that requires hospitalization) of "severely elevated mood." Which sounds pleasant, or even desirable. Up until you 'come back down'. Mania also has a dark side- people with mania have very short attention spans and often end up spending everything they have on a whim that they rapidly forget about. It can end very badly.

* '''Mania.''' Mania is described by the DSM as at least a week (or any amount of time that requires hospitalization) of "severely elevated mood." Which sounds pleasant, or even desirable. Up until you 'come back down'.

Most of the time, when a character portrayed as having bipolar disorder, they are usually shown as being uncontrollable, hair-trigger MoodSwingers - swinging from affable and pleasant to suicidal or raging in the space of minutes. Or, in constrast, a character will be called bipolar if they are moody, but are never shown actually suffering from their mood swings. Either way, as the disorder is only rarely portrayed in the media beyond these and other unrealistic, simplified forms, most people are unaware that in reality, bipolar disorder is a complex, multifaceted illness.

* '''Mania.''' Mania is described by the DSM as at least a week (or any amount of time that requires hospitalization) of "severely elevated mood." Which sounds pleasant, or even desirable

- Uncomplete. Will add to the index once this is done. -

Most of the time, when a character portrayed as having bipolar disorder, they are usually shown as being uncontrollable, hair-trigger MoodSwingers - swinging from affable and pleasant to suicidal or raging in the space of minutes. Or, in constrast, a character will be called bipolar if they are moody, but are never shown actually suffering from their mood swings. Either way, as the disorder is only rarely portrayed in the media beyond these and other unrealistic, simplified forms, forms, most people are unaware that in reality, bipolar disorder is a complex, multifaceted illness.

In the most basic sense of the term, bipolar disorder is defined by the presence of mania. Someone who is depressed for the vast majority of the time but has had a single manic episode is bipolar, as is the rapid cycler who goes through different moods in months, weeks, or even days, and is the cyclothymic who, while never incapacitated by their depression or mania, still suffers from mood swings much more dramatic than an healthy person would go through. As you can see, this definition still leaves a lot of room for all the forms bipolar disorder can take.