By David Joel Miller.
Just how common is Bipolar Disorder?
There are people out there with Bipolar Disorder as we currently understand Bipolar. Some people who really have this issue never get diagnosed and miss out on the treatment they need. From some of the things on the web today it is hard to see how anyone could escape getting this diagnosis. For more on this dilemma see the post Bipolar – Misdiagnosed or missing diagnosis?
If professionals give out a diagnosis too freely then it stops having any meaning. So just how common is Bipolar Disorder and what should we think about people who sort of have it?
Humans are not the only creatures on earth who act “bipolar.”
Think about some of the symptoms. Elevated expansive mood, reduced need for sleep, increased impulsivity and heightened sexuality. Hum—
It is hot here now, but only a few weeks ago it was spring. From the window in my office I watch the birds in the trees and on the lawn. There are a lot of native doves in my immediate area. For a while, just after Valentine’s Day those doves woke me up in the morning. They were cooing constantly and the mating – can’t describe that and stay P. G. rated. When pursuing and being pursued by mates their temperament can best be described as irritable. Are doves Bipolar? Are they only Bipolar in the spring time?
Every spring the days start getting longer, the creatures on planet earth respond by becoming more active, they and we humans with them, think about reproduction. If birds breed in February they have babies by Easter. Humans seem to breed just as fast but we take longer to get the babies done.
Then in the fall time the doves seem to disappear. So do the humans on my block. All those exercise freaks stay indoors. As the days get shorter the mood among humans gets gloomier. This may be one reason we have so many holidays in the fall and winter, Halloween, American Thanksgiving, Christmas and New Year’s all in a couple of months. We do this to cheer ourselves up. We also see extra depression during those months of less light.
If birds are affected by the changes in weather, humans are affected and other animals also, it is difficult to go on describing these mood fluctuations as a mental illness.
We know that some people are affected by the seasons more than others. The degree and magnitude of mania and depression vary from one person to another. When have we crossed the line and turned normal human emotions and feeling into a pathological disorder?
There are also milder variations in human behavior we call “personality.” Talking about personality types, wondering why we are the way we are, is an interesting study. One needs to be careful in learning about personality to not make the first year student mistake and start seeing pathology where none exists. Not everyone who is moody, sleeps less, is irritable or extra sexual needs to be diagnosed and put on medication.
As a therapist I known there are lots of folks who would benefit from talking to a counselor about their problems. We also known that insurance wants us to be sure they are mentally ill and meet the criteria for “medical necessity” before insurance pays for the treatment. The challenge is to stick to the criteria and make sure only people with a real mental illness get treated using insurance money, while still trying to help all the people we can. Professionals continue to debate exactly where the lines of a disorder should be drawn.
At this point we have three for sure reasons why someone’s symptoms get severe enough that they get the diagnosis.
1. Your issue interferes with “occupational functioning,” which includes school for children and volunteer work if you are disabled.
2. It interferes with “social functioning” which mainly means you have poor or no relationship with family and friends.
3. Your issue causes you “subjective distress,” meaning a whole lot of emotional pain.
Having a personality that is not as you would like it may be painful but I hesitate to throw that in with mental illness. So if you are too introverted, impulsive or have some such personality trait, you can work on that, but you are not likely to be severely enough impaired to be diagnosed with a mental illness.
Some people may have “bipolar trait” or a “bipolar temperament” these are things you may or may not choose to work on in yourself improvement projects. “Hyperthymic Temperament” and Hyperthymic Personality Disorder” is just such a condition. Hyperthymic Personality Disorder is a common name NOT a specific diagnosis. DSM Personality Disorders are far more severe than Hyperthymia.
My thinking is that if you have characteristics like this you may want to consider being screened by a profession and keep an eye out for the possible development of Bipolar Disorder.
One thing we professionals should avoid doing is turning everyone who is different into a pathological condition.
So is everyone Bipolar? The DSM-4 reports that the prevalence of Bipolar I and Bipolar II combined is more or less 2%. Irritable, moody, impulsive and sexual people – that is just about all of us.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books