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Difficult personality or Bipolar Disorder?

People suffering from bipolar disorder are often labeled “crazy” along with schizophrenic patients and borderline personalities. They “win” that label with their emotional lability and extreme moods. If you are the partner of someone with bipolar disorder, you surely know how exhausting and confusing communication with them is. The swings from sadness to euphoria can disrupt the balance of even the most level-headed person. Here’s what you need to know.

Bipolar disorder and other affective disorders

Affective disorders is an umbrella term for all mood disturbances. This category includes depressive and anxiety disorders, which I have already written about, as well as all bipolar and related disorders. So how do we distinguish them from each other?

Bipolar Disorder, Type 1

It was known in the past as manic depression or affective psychosis. It is easily recognizable, because of the alteration of two contrasting states – mania and depression. During the manic episode, people experience elevated mood and increase in energy levels. They initiate numerous projects or activities. They may become expansive or even irritable, impulsive, reckless. In this stage, self-esteem is boasted. Sleep patterns change, as people need less sleep. They become excessively talkative, easily distracted or angry. Some severe cases involve halucinations as well.

We all go through some days like this, and we sometimes even cherish them, as they make us feel more efficient and optimistic. But if the state continues for a week or longer, things might easily get out of control.

In a manic episode, people don’t usually recognize something is wrong. It is only obvious to their relatives and friends. Thats why it is often relatives that bring them to therapy. Undergoing a single manic or hypomanic episode is sufficient for diagnosing bipolar disorder. In most cases, however, things don’t end there. The manic episode is replaced by a depressive one, which might continue from two weeks to several months.

Bipolar Disorder, Type 2

Until recently, Bipolar 2 has been viewed as a milder version of Bipolar Disorder, mainly because people with Bipolar 2 spend the most of the time in depression. The euphoric states never fully meet the criteria for a manic episode, because symptoms are of either lesser severity or shorter duration.

Frequently Bipolar Disorder is confused with Borderline Personality Disorder, which is also characterized by emotional lability and impulsivity. They are not mutually exclusive, which means both may be present.


Cyclothymia is in reality the milder version of Bipolar Disorder. It consists of periods of manic and depressive symptoms, which alternate over at least two years. In that sense, cyclothymia can be interpretted as a chronic labile mood. It is perceived as more typical of women. However, it is equally spread among men and women.

Other types of Bipolar Disorder

Substance abuse might cause certain symptoms of Bipolar Disorder. Their onset may be during both intoxication and withdrawal phases. The same is true for the intake of some medications. Medical conditions, such as hyperthyroidism may also cause bipolar symptoms.

Treatment of Bipolar Disorder

The majority of bipolar cases are referred to treatment by relatives of the patients. This usually happens during a manic episode, when relatives cannot handle the eccentric, impulsive or sometimes even dangerous behavior. In such cases I strongly recommend consulting a psychiatrist for a faster stabilization of the current episode. Then I continue with CBT treatment, focused on emotional regulation skills. Those who actively seek treatment themselves usually do it during the depressive episode, when medication is redundant.



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