Recently, it seems like the diagnosis of Bipolar disease, what was previously called Manic Depression, has been on the increase. The word "Bipolar" is being thrown around by professionals and lay people. Family members toss it out at others in the family. Here's the thing. Bipolar does not mean moody. It is not emotional volatility or an anger management issue. It is not PMS. Bipolar disease is a condition in which the patient suffers serious depression for some time, weeks to months, and then slides into a manic mood for weeks or months. Not minutes or hours.
Depression is characterized by lack of ambition, extra crankiness or irritability, isolation, inexplicable fatigue, etc. The manic phase is a time when the patient is abnormally active. Patients undertake unrealistic lofty projects, spend recklessly, become hypersexual and usually sleep less. This mania is not a normal good mood. It is not a moment of levity. It is an abnormal, dysfunctional period of overdoing. It is not merely a break from depression.
Since we have new better drugs to treat depression and bipolar disorder, we are diagnosing more subtle cases. When the medicines are less harsh and have fewer side effects, then it is worth it to treat milder cases. In the past, when the only medications we had were dangerous and had potentially serious side effects, only the most severe, debilitating cases of bipolar disease were treated. I am grateful to be practicing medicine in a time when these more refined drugs are available.
In the Jersey Shore-Real Housewives culture we live in, moodiness and emotional ups and downs are accepted. We seem to have lost the ability to temper our reactivity. This is not a disease. It is not Bipolar Disorder. It is an unfortunate social phenomenon, not a diagnosis. Please understand the difference and choose your words carefully.