Do I Really Have Bipolar?

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What if someone is telling you that you have bipolar, but you don’t think that the diagnosis is correct?

A reader asked a really good question on my blog post “Dealing with Bipolar Disorder Denial.” She wanted to know what to do if someone in your life—a friend, loved one, coworker—tells you that they believe you might have undiagnosed bipolar, but you’re questioning it as an incorrect diagnosis.

Here is my reply to the person who felt that doctors and the people around her were trying to push a bipolar diagnosis that didn’t feel right:

“It would be a true bummer to be told you have bipolar when you don’t. But—and there is always a but—whoever thinks you have bipolar must have a reason. There must be behaviors that are causing people to think about the symptoms of  bipolar disorder, not just depression. If you’re working with educated health care professionals who actually understand the illness, it might be that they see something in your behavior that you simply can’t.”

I was manic for 15 years before someone actually said to me, “You’re manic and you have been manic all of your adult life.”

This shocked me. How could I possible miss something like mania? How did all of the therapists and naturopaths I saw from age 19 to 31 (when I was finally diagnosed) miss all of this? There are two answers:

They didn’t ask, but more importantly, I didn’t tell anyone about my other symptoms because I just thought I was a screw up. I had no idea that bipolar was a mania- and often psychosis-based illness and that I needed to discuss my behaviors outside of depression. I didn’t know what mania or psychosis looked or felt like in other people, so I never thought to talk about my non depression symptoms. Living with intense anxiety, but not knowing what to call it, meant that went unreported as well.

In honor of your desire to assess your own moods and make your own decision about bipolar, I have created a list of questions that will help you decide what to do next in terms of a diagnosis. Bipolar disorder is very easy to diagnose . . . if the person asking the questions knows what to ask about mania! Bipolar is a mania illness. (This bears repeating since the diagnosis can cause confusion for people.) Yes, depression is an enormous part of the mood swings, but you can only have bipolar if you have mania.

Here are a few questions that will help YOU decide about the diagnosis. 

Have you ever been depressed and needed plenty of sleep and then one day, you felt upbeat, filled with energy and literally could get by on about four hours sleep without being tired the next day? 

Have you ever had a cascade of ideas flow through your brain so quickly that you can hardly write them down and then you get started immediately on the project and get SO much done, but suddenly, all of the air goes out of your balloon and the project that once felt brilliant and amazing just sits there and never gets finished? 

Have you ever made sudden, enormously important life changing decisions without telling anyone, such as deciding to move to Japan and just getting everything together and doing it?   Do you then brush away the concerns of others by saying, “I’m just going through changes! I need a different life! I want to change!” 

Have you ever felt an enormous rush of anger—one so powerful that you wanted to put your hand through a wall or through someone’s face? Were you shocked and stunned by how fast these thoughts appeared and how dangerous they are?

These questions will help you know if you have bipolar as they are directly related to mania.  If you already have depression and can say yes to even one of the questions above, you can confidently ask questions about bipolar disorder and if the diagnosis fits what you experience. 

About the author
Julie A. Fast is the author of "Loving Someone with Bipolar Disorder," "Take Charge of Bipolar Disorder," "Get it Done When You’re Depressed" and "The Health Cards Treatment System for Bipolar Disorder." She is a columnist and blogger for BP Magazine and won the Mental Health America journalism award for the best mental health column in the US. Julie was also the recipient of the Eli Lily Reintegration award for her work in bipolar disorder advocacy. Julie is a bipolar disorder expert for the Dr.Oz and Oprah created site ShareCare. Julie is CEU certified and regularly trains health care professionals including psychiatric residents, social workers, therapists and general practitioners on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People Magazine. She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called "Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis and Depression." You can find more about her work at JulieFast.com and BipolarHappens.com.
7 Comments
  1. Two things: OMG! You not only describe me, you describe my father who died 36 years ago. The 2nd thing is a (hopefully) quick story. I was diagnosed with depression in my 20s, though I certainly displayed manic behavior in my teens as well as severe depression during elementary school. I was finally diagnosed with bipolar at age 41. Not long after, I divulged this to a trusted, long-term friend. Her response, verbatim, was, “Oh, Carolyn! I thought you knew!”

  2. How do you differentiate symptoms from other disorders that are similar, for example, trauma related issues? Severe traumatic experiences can have the variability of mood that resembles bipolar; anxiety or getting stuck in fight or flight can look a lot like mania, as can insomnia from depression, or a mixed episode. Anger outbursts, distrust/paranoia, difficulties sleeping (too much or little), moving along just fine then overwhelmed with trauma memories and dissociating into a sudden frantic escape into projects to forget, etc. etc.

    With trauma these “symptoms” can fluctuate the same as with bipolar. If traumas happened early in life (PTSD isn’t just limited to veterans) the start of symptoms can historically look the same as bipolar. Even if trauma happens later in life it can be difficult to determine since bipolar can also start up later in life. Many people are in denial of the impact traumatic events have on their life (maybe even totally blocking the memory but not the consequences), the same way those with bipolar can struggle to recognize its expression in their life; time between fluctuations of symptoms making this quite difficult for both.

    Misdiagnosis of one for the other can happen even with experienced professionals. How can we as patients be helpful in getting the help appropriate to our situation when symptoms look like one disorder but are actually another, not only trauma or bipolar, but others that share common expressions? Does it take failing all treatment options for one with a shoulder shrug that it then must be the other?

  3. Nobody is qualified to make a diagnosis of bipolar disorder except a psychiatrist or other medical doctor who has been properly educated and trained. No license=no diagnosis. In fact, it is illegal to do so. If any person has not been diagnosed by a qualified doctor, then that person cannot be accused of having any condition. One might suggest that there is a possibility, but no more. I get very angry when people self-diagnose and then act as if that judgement has enough weight to be of any use. I get even angrier when completely unqualified people try to diagnose someone else. Until a doctor has made the diagnosis, it is not valid.

    I remember a case in a city about 50 miles away from me some years back. A man killed his brother in the front yard. Even as the man was being taken into custody, the family began screaming that he had “undiagnosed bipolar disorder.” I hit the roof. First of all, medical conditions are not something that can be discussed as an explanation for behavior during any newscast or in any new story. It is highly unethical. Second, it is impossible to determine that anyone has “undiagnosed bipolar disorder.” Once it is determined that they have it, then they are diagnosed. That can only be done by a qualified doctor. Until then, nobody knows any such thing. It was obvious that this family thought that they could get the living son released by claiming something that, first of all, was not even true, and second of all, had no bearing on the issue at hand.

    These kinds of things are what cause the stigma we have to live with, and we need to fight it every day. Bipolar disorder does not cause people to kill other people. That perception needs to be destroyed right now. We are perfectly sane. Just because we have problems, that does not make us nonhuman monsters.

  4. Julie,
    I think the questions that you ask “that will help YOU decide about the diagnosis” are some of the best I have ever seen. They helped me, the partner of a person with undiagnosed BP. I wish the psychiatrist who saw my partner asked him these questions.

  5. Hello,
    Can I ask. After you found out or that you were what was the route you took to recover! What has worked for you?
    Thanks in advance

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