I met with a psychiatrist today who after going through some questioning with me said that she believes that I have bipolar depression 2. And listening to it be described it just sounded like life. Everyone has highs and lows. Everyone I know is grumpy on Monday and happy on Friday, that’s normal. So what makes bipolar 2 different?
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Bipolar 2 is far more insidious than regular life. I was diagnosed about 12 years ago after my third breakdown knocked me out of work long term yet again. I had been on a long term roller coaster that I just wanted to get off and getting the answer and some medication has made a huge difference to my life.
The mood still goes up and down but nowhere near what it did. I don’t feel like I am constantly living on a cliff edge about to fall off, even when things are going well. Most of all, I haven’t been suicidal in several years.
Those extreme feelings are not normal. Everyone has ups and downs, but most people don’t feel like their world is about to collapse around them and that they just want to end it all on the regular.
Bipolar disorder gets revised significantly in every version of the DSM, which is what psychiatrists use to diagnose mental disorders. Keep in mind that the definitions of these things fluctuate over time and will likely receive a significant update whenever the next version of the DSM comes out. The current version of the DSM (DSM-5) has a lot of issues, but so does the prior version (DSM-4).
The mania in Bipolar 1 isn’t just an elevated mood. Its an elevated mood that basically borders on a sort of very happy schizophrenia. IE, you’re so happy and have so much energy that you begin engaging in activities that you should be aware will have harmful consequences, but are so distracted by your abnormally high energy level that you essentially become become delusional (though you’re not hallucinating).
Bipolar 2 is intended to capture people who have episodes of severe depression that alternate with periods of a significantly elevated mood that is abnormal but doesn’t reach the level seen in Bipolar 1. This is not supposed to be the normal highs and lows of life. Its supposed to be:
“I’m so depressed that I cannot function for a minimum of one week at a time.”
Followed by:
“I am so euphoric that I cleaned my entire house, then cleaned it again because I just have so much energy and also I’m not sleeping nearly as much as I normally do.”
And:
“Despite that my energy level is not so high that I am engaging in activities that are reckless or harmful to me or others when doing such activities is atypical for me.”
The disorder isn’t in the highs and lows, it’s in the *extremes* of those highs and lows, and their erratic nature.
Imagine a car. A car can speed up when the gas pedal is pressed, it slows down when you use the brakes, it turns when you turn the wheel. All of these things are normal for a car, and even when the car does something unusual (stops really sharply, jerks to the side) it usually has a clear cause that makes sense (someone pulled the parking brake, or one tire blew out).
But what if your car just sometimes accelerates way harder than normal and runs at full speed all the time for a week straight? What if your car can’t go more than half its normal speed for a month? What if what *should* be a very normal issue (hitting a small rock) causes an unusually big reaction (the entire car flips over)? We’d pretty rightly assume that something was a little off in that car, and we’d want to fix it so we could to get a more reliable driving experience.
Your brain is the car. Everyone has their highs and lows, but bipolar disorders describe a pattern of highs and lows that aren’t “normal”, in as much as we can say any person is “normal”. Something in the bipolar brain is swinging too hard, too far toward high energy and low energy and it can cause serious problems in the person’s life.
The difference in intensity, other people don’t feel as high or low of emotions as those with Bipolar 2 do.
Bipolar 2 is defined as having a depressive episode that lasts at least two weeks and a hypomanic episode that lasts at least four days.
Being grumpy on Monday because your work/school week is starting again isn’t depression and being happy that your work/school week is over on Friday isn’t hypomanic.
There are a multitude of symptoms that define a diagnosis. Any diagnosis is a starting point that may help someone find a path that better manages those mood swings. Realistically, not everyone needs treatment for every diagnosis, but when mood swings affect your daily life, life becomes more difficult.
For me it’s the juxtaposition of everything mattering and then nothing mattering. That is really exhausting.
Also, a cycle of a week sounds extremely rapid. Bipolar goes from a depression to a manic high, and these generally need to be ongoing for a few weeks each.
People with bipolar 2 have highs and lows that interfere with their life. During “high” phases, they make bad decisions because they’re overly optimistic, they take risks, they start new ventures without really planning them through. Spending money frivolously, taking drugs or sleeping with people you shouldn’t sleep with is also common. Or saying things to friends and family that you shouldn’t have said
During the depressive phase they have problems doing normal tasks, like cleaning their home, washing themselves and performing at work.
All these things can seriously screw up your life, and that’s why it’s a disorder and not just “normal” highs and lows
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