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Wednesday, July 14, 2004

After I posted on coming out to my congregation about my bipolar the other day, a couple of folks asked me to talk about how I was diagnosed with the disorder, and what symptoms to be on the lookout for in friends and loved ones.  Per their request, here's a follow-up diary entry.

My diagnosis was fairly easily made.  First of all, my wife is a counselor, and could spot the symptoms.  I am told that this is not unusual.  For whatever reason, the "highs" of bipolarity are pretty hard to spot for those who suffer from them.  It's common for people to be treated for depression without the manic side being noticed.  That was case with me, until one night I came home and in a fit of rage spent half an hour screaming, swearing and disassembling some moving boxes in our basement.

I maintain I had good cause:  a parishioner had just accused me of causing his wife's heart problems, after I'd spent the better part of a week with them in the hospital.  But more level-headed people tell me that I was exhibiting classic bipolar symptoms.

In any case, I'm reluctant to speak about how to diagnose bipolar.  First of all, I'm not a doctor.  Let me be very clear about this:  there is no substitute for a psychiatric evaluation with major mood disorders.  Do not diagnose yourself or somebody else, and don't let your family physician or counselor do it either.  Have it confirmed with a psychiatrist.

That being said, here's what the National Institute for Mental Health lists as common symptoms of bipolar disease:

Signs and symptoms of mania (or a manic episode) include:

    * Increased energy, activity, and restlessness

    * Excessively "high," overly good, euphoric mood

    * Extreme irritability

    * Racing thoughts and talking very fast, jumping from one idea to another

    * Distractibility, can't concentrate well

    * Little sleep needed

    * Unrealistic beliefs in one's abilities and powers

    * Poor judgment

    * Spending sprees

    * A lasting period of behavior that is different from usual

    * Increased sexual drive

    * Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

    * Provocative, intrusive, or aggressive behavior

    * Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:

    * Lasting sad, anxious, or empty mood

    * Feelings of hopelessness or pessimism

    * Feelings of guilt, worthlessness, or helplessness

    * Loss of interest or pleasure in activities once enjoyed, including sex

    * Decreased energy, a feeling of fatigue or of being "slowed down"

    * Difficulty concentrating, remembering, making decisions

    * Restlessness or irritability

    * Sleeping too much, or can't sleep

    * Change in appetite and/or unintended weight loss or gain

    * Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury

    * Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

More information here and, in a longer (pdf) version, here, from the National Alliance for the Mentally Ill (NAMI).  

You may hear me talk more about NAMI at some point, as they are an advocacy as well as support group.  (For example, they back the Wellstone Mental Health Parity Act.)  NAMI also supports a Depression and Bipolar Support Alliance, whose website contains links for confidential screenings for bipolar and depression.

Fellow Kossite "Helen in MD" also recommends this site, which has a Mood Disorder Questionnaire, as well as some more in-depth articles.

Whew, is that enough information for you?

NSU - 4efer, 5210 - rulez

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