Bipolar Disorder

Britney Spears

Bipolar affective disorder (BAD) is a lifelong psychiatric illness characterized by severe and extreme mood instability. Also referred to as manic depression, people with bipolar fluctuate between periods of intense high and low moods like baseball fans following their beloved team deep into the October playoffs (Go GIANTS!!!). Many mainstream films have portrayed characters suffering from BAD – Mad Love, Bulworth, Running With Scissors, and King of California. Numerous famous folks have also been associated with the illness, including Beethoven, Edgar Allen Poe, Vincent van Gogh, and Britney Spears.

As its name suggests, people with bipolar vacillate between poles of euphoria, irritability, and depression, like a perpetually swinging pendulum. The mood episodes are sustained, autonomous, and occur independently of external circumstances and are not caused by substance use. For example, a person who flies high on cloud nine by winning the lottery, falls despondent after carelessly losing the winning ticket, and then becomes enraged when intoxicated at the bar is not bipolar. Moreover, people who experience severe mood instability that is triggered by interpersonal relationship difficulties are often misdiagnosed with BAD, but instead may suffer from borderline personality disorder (BPD).

The expansive or abnormally irritable moods are referred to as mania or hypomania, with the former being more intense and severe.  A manic episode lasts for at least one week and is accompanied with symptoms such as decreased need for sleep, grandiosity, hypertalkativeness, racing thoughts, increased goal-directed behavior, and impulsivity in pleasurable activities like spending money and sexual indiscretion. Psychosis may even ensue. Feeling energetically on top of the world, manics may generate many creative and innovative ideas. Our world would definitely not be as advanced and inspiring as it is today without the actors, entrepreneurs, mathematicians, musicians, and writers who lived with bipolar disorder.

Mania becomes concerning and problematic when people begin to lose their insight and judgment, making ill-advised decisions and engaging in destructive behavior – remember Britney Spears shaving her head completely bald and attacking an SUV with an umbrella? Social and occupational functioning may be profoundly impaired, necessitating involuntary inpatient hospitalization and mood-stabilizing medications.

Depressive episodes are more psychologically distressing to the individual than manic ones. Would you rather be anhedonic and socially withdrawn or elated and running around Nordstrom maxing out your credit cards?  Depression occurs 3 times as often than mania and raises the risk of suicide. Up to 50 percent of people with BAD attempt suicide, and 15 percent die from completing it.  Kurt Cobain, who was suspected of suffering from bipolar depression, sadly ended his life with a self-inflicted gunshot wound to the head.

BAD is a chronic illness which causes episodic and persistent functional debilitation. Psychiatric treatment is necessary to stabilize mood and maintain day-to-day functioning. Referred to as an illness that “benefits mankind at the expense of the individual,” I wonder if the aforementioned famous manic depressives were aware of their generosity in bestowing upon us The Fifth Symphony, The Tell-Tale Heart, and Starry Night, respectively. And I certainly cannot forget to include Oops!…I Did it Again.