Are People with Bipolar Disorder Always Manic or Depressed?

This article busts the myth that people with bipolar disorder are always either manic or depressed.

It's Mental Health Monday again and I'm answering a question from a friend. 

Regarding bipolar disorder, she asks:

"Are people with bipolar disorder always either really high or really low with no in between? Or is that a stereotype?"

I've lived with and around quite a few people with bipolar disorder. Some don't even realize they have it, but most of them do. I've seen what it's like in adults and in children (there's a notable difference between the two), so I can answer this accurately.

Bipolar Mood Cycles Vary Person to Person

Cycles vary individual to individual. However, with adults there does seem to be a pattern. For instance, Scotty became somewhat irritable on the 10th of each month. By the 12th, he was in full blown rages and, a few days later, would be in full-blown mania. Sometimes, even manic psychosis

The 10th-16th of the month. Every month. Then he would mostly sleep for a few days. Otherwise, he was in a completely 'normal' mood for all other parts of the month.

Similarly, my adult son is irritable around the 30th of the month. This irritability increases for a few days and then goes away around the 5th of 6th. He doesn't experience mania. He has a different type of bipolar disorder than Scotty had. 

I've read that some people can experience mania (or hypomania) for several weeks followed by depression for the same number of weeks. I've also read this could be years. (For instance, three years in a mania, followed by three years in a depression, followed by 3 years of 'normalcy.')

For teens, the experience is similar to the adult cycles. I've actually not measured out exactly what happens with Alexis. She's so quiet and keeps herself out of the way when she's in bad moods. 

She's much more concerned about being polite than letting her moods vent, so I never really know where she's at in the cycle.

Children Cycle More Frequently

Lorelai, however, is a different story. Having the same type as her father, she couldn't hide it if she tried. Those moods are very 'in your face.' I always know what her mood is, whether I want to know or not. 

Bipolar disorder in the very young (she was born with it), looks quite different from teen and adult bipolar. I'll save all that for another post, but I can tell you how the ups and downs.

Just before she was diagnosed, I saw a pattern. It was daily. She was 7. 

  • 11 a.m. - She would become somewhat irritable. 
  • By 1 p.m. - she was in a mania, exhibiting rage and audible hallucinations.
  • By 8 p.m. - she was at the lowest of lows, crying and saying things like "Mommy, I don't want to live! I don't want to live! Mommy, please, I'm so sad, I just don't want to be here anymore."

Manic to depressed 8 hours. Every single day of her life. 

That's when I went in search of an answer. I never would have guessed bipolar. It sounds so logical now, but as I stated before, the rest o the symptoms look quite different in a very young child.

Due to her frequent cycling, it may seem she was never not in a manic or depressed mode, but she wasn't between 9 p.m. and 11 a.m. 

Unfortunately, she was asleep most of that time. Until she wasn't.

Because I sought out answers and treatments, I no longer see those highs and lows with the same frequency. As long as I watch her eating and sleeping schedule, she goes long periods without having them. 

The only time she has any sort of episode is when she stays up all night and sleeps in the day (backwards sleeping) or meals are delayed (low protein and blood sugar). As long as I keep those two things in check, she's fine.

People with Bipolar Disorder Are Normal People with Normal Moods

The answer to the original question is 'no.' People with bipolar disorder typically do not live in a constant fluctuation of mood, from one polar to the other. For the most part, they're experiencing life the same as anyone else. Their moods are intensely felt, but not out of control, leaning to one end of the spectrum or the other.

The term bipolar disorder is a misnomer. I disliked when "experts" decided to change the name, because it does give the wrong impression. The former usage of manic depression was more accurate, I think. It is a type of depression that may be preceded by mania (or hypomania) in some. 

However, there are several types of bipolar and not everyone actually experiences mania or hypomania. I'll discuss that in next week's Mental Health Monday post.

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