Is it Moodiness or a Mood Disorder? How to Spot Potential Depression or Bipolar Disorder
Step aside, ADD and anxiety—mood disorders are fast becoming the most talked-about illness of the decade. From sitcom characters and celebrities to everyday adults and children, more and more people are being diagnosed with depression or bipolar disorder. Still, thousands of others continue to suffer, undiagnosed and untreated. How do you know whether your moodiness is a normal reaction to life or the sign of a serious medical disorder? Before you head for the Prozac—or endure another day of undiagnosed misery—get the facts on these often misunderstood illnesses.
There are two types of mood disorders: bipolar disorder (also known as manic depression) and depression (also known as unipolar depression). The symptoms of depression include a lack of interest in things that once brought pleasure, constant feelings of sadness and emptiness, and an inability to get things done. Bipolar disorder has all of the symptoms of depression as well as a mood swing called mania; people with bipolar disorder can cycle back and forth between the two states.
Scientifically defined as a “pathologically elevated mood,” mania can create feelings of euphoria, omnipotence, or hyperarousal that are caused by an imbalance of chemicals in the brain. People with mania may experience extreme exhilaration and other seemingly “good” feelings, but the mania can also manifest as agitation, scattered thoughts, and feelings of extreme emotional discomfort.
Depression and bipolar disorder share a range of other symptoms, including psychosis (a break with reality that can be characterized by hallucinations and distorted thoughts), irritation and anger, problems with attention and concentration (often misdiagnosed as ADD), and anxiety. Unfortunately, these symptoms are often misinterpreted as signs of other illnesses or personality defects, and the real culprit—a serious mood disorder—is often misdiagnosed or brushed off. People with undiagnosed mood disorders often mistake their illness for a flaw in their character, and can spend years desperately trying to “get their acts together and lead lives like regular people” instead of seeking psychiatric evaluation for an illness.
In reality, both depression and bipolar disorder are fairly easy to diagnose—once they are considered as real possibilities. Although a proper diagnosis must be made by a trained professional, here are some clues that may help you determine if your “moodiness” is a sign of a serious illness:
Suicidal thoughts: Thoughts of suicide are common among those suffering from serious depression. Whether action-oriented (I'm going to get a gun and shoot myself; I'm going to take a bottle of pills with a bottle of wine) or more passive (I wish I were dead; Things would be better if I were gone), suicidal thoughts are always a sign that a person’s brain chemistry is not functioning properly, and that professional help is needed immediately.
Unnaturally elevated moods: Mania can be so sneaky. When a person who has been depressed suddenly feels the cloud lift, it's natural to think that the depression has ended and that the person is finally “back to normal.” But for people with bipolar disorder, this is often the first stage of an unnatural, escalating mood swing in the opposite direction. Mania often feels so good—at first—that it's hard for people to recognize it, or acknowledge it as a serious problem. Unfortunately, feelings of euphoria or agitation can continue to intensify until the person no longer makes sense. Those who eventually experience full-blown manic episodes often end up hospitalized, but countless others who suffer from milder manic episodes (known as hypomania) often go untreated, or are treated only for depression. If you or those around you notice marked shifts in your energy, agitation, or feelings of well-being especially if they affect your sleep patterns, you may suffer from bipolar disorder. A psychiatrist or properly trained physician can diagnose your symptoms to determine whether you’re just recovering from depression or experiencing the flip side of this serious illness.
Be aware, too, that antidepressants can ignite dormant mania in people. For this reason, your physician should be aware that what seems a clear case of depression may actually mask the presence of bipolar disorder.
Mood swings vs. moodiness: Some people are just moody. They often react negatively to life events, or they may frequently experience bad moods, short tempers, and irritation. While these people may not be much fun to be around, they do not necessarily have a mood disorder. However, if a person’s moodiness affects his or her ability to work, make friends, or function relatively normally in society, a diagnosis of a potential mood disorder is called for.
Mood disorders involve exaggerated, extreme, or highly disproportionate responses to life events. A moody person may be quick to anger when someone makes a derogatory comment about him or her; a person suffering from a mood disorder may react to the same situation with suicidal thoughts. Moody people can usually be reasoned with; people with mood disorders lose insight into their own situations and often can't see that they need help. For this reason, it’s important that friends and family members understand the warning signs of depression and bipolar disorder, and that they know where to turn to seek help for their loved one. Use the following questions to help you determine whether you or someone you care about may be suffering from a bipolar-disorder mood swing:
• Have you noticed a significant change in everyday sleep patterns because you are feeling low or more happy than usual?
• Do friends, family members, or others comment on your inability to enjoy life, spend within reason, get along with others, keep a job, maintain a relationship, or stay in one place?
• Do you often wonder what the point of living is, or why nothing seems good? Are these feelings ever experienced along with difficulty in concentrating or performing simple tasks?
• Have you ever suddenly felt a wonderful surge of confidence that allowed you to talk with strangers or meet anyone you wanted? Have you ever lost your normal shyness and suddenly felt beautiful and unstoppable? Have you ever made reckless sexual or financial decisions, only to wonder a few months later, Was that me? What was I thinking? Has this been accompanied with a significantly reduced need for sleep?
• Do you go through periods of extreme or unexplained irritability? Do others tell you that you are often unreasonable? Do you kick or hit things (or people) to vent your annoyance or frustration?
• Have you ever found yourself thinking (or hearing a voice inside your head telling you) such things as, You should die. You have no right to be here and you should leave. People don't like you. You're a failure and a fake. Or, I'm a genius. I'm smarter than any other person in the world. I am invincible.?
If you answered yes to any of the questions above, you may want to talk to a health care professional about a possible mood disorder.
Mood disorders are not personality flaws or a sign of weakness. Like diabetes, they are documented physical illnesses, and they can be effectively treated—once a correct diagnosis is made. If you or a loved one may need help, getting that diagnosis is the first step to recovering from these disorders and living a joyful, healthy, productive life.
About the Author: Julie A. Fast is America’s leading voice for people with bipolar disorder. She is the co-author of Loving Someone with Bipolar Disorder: Understanding & Helping Your Partner (New Harbinger Publications, February 2004; $13.95, author of the upcoming book Take Charge of Bipolar Disorder. To learn more visit http://www.bipolarhappens.com.