I believe the public has a major misconception regarding which symptoms are consistent with bipolar disorder and which are not. It is evident when patients present for an initial psychiatric evaluation because they (or their family and friends) are worried that they are "bipolar." However, in many cases, the symptoms they report are often consistent with a completely different class of diagnoses.
It is easy to confuse major depressive disorder (MDD), bipolar disorder and many of the personality disorders because they can all present with seemingly similar symptoms. These disorders can significantly impact a patient's mood and quality of life. However, with proper evaluation and treatment, their prognoses are all much improved.
While the symptoms are similar, the treatments for these diagnoses are very unique. That is why is it so important to get the correct diagnosis!
The major misconception that I consistently come across is that many patients believe bipolar disorder causes dramatic mood changes over the course of a single day. This is absolutely not true and causes many people to unnecessarily believe they are "bipolar."
In fact, bipolar disorder classically causes mood swings that last days if not weeks at a time. For example, patients with bipolar disorder will be irritable or have an elevated mood consistently for several days in a row or longer. These periods are then followed with distinct periods of normal mood or depressed mood.
Therefore, if your mood switches, and is reactive to external stressors, multiple times throughout a single day, this is likely not bipolar disorder.
Do you or someone you know suffer from severe shifts in a single day and/or extreme mood reactivity to external stressors, that impair relationships, ability to work and quality of life? If it is not bipolar disorder, you might be wondering what causes these type of mood swings that occur everyday and throughout the day?
Let's start with defining the symptoms we are talking about:
- Your mood can be fine in the morning and then something will set it off and you become angry, irritable or sad the rest of the day (e.g., You are doing fine until someone says something mean, cuts you off while driving, cancels plans etc.).
- Conversely, you will often wake up upset or sad and then something good happens (e.g., you get a promotion at work, your spouse/significant other surprises you with a gift, you get paid, etc.) and your mood quickly improves. Your mood feels like a "yo-yo."
A highly reactive and unstable mood can have a large negative impact on all facets of a patient's life because the swings are unpredictable and uncontrollable.
An "up and down" and highly reactive mood, which has been consistently this way throughout the majority of a patient's lifetime, is consistent with the symptomatology of a personality disorder. Personality disorders are chronic and unyielding patterns of thought and behavior. Conversely, bipolar disorder presents with distinct periods of elevated or irritable mood that last days to weeks. It is possible to have both diagnoses. Therefore, having one should not exclude the other from being evaluated.
The more we talk about mental illness the way we talk about physical illness, the less stigma mental health will carry and hopefully more people will be comfortable getting the care that they need. Share this article with friends and family who might benefit from knowing the difference between bipolar disorder and personality disorder.
You can read more about my thoughts on evaluating and treating borderline personality disorder here.
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