Bipolar disorder Questionnaire Self-test
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Do you get manic?
- Have you had periods of time where you felt highly self-confident much more so than usual?
- Have people ever commented that you were not your normal self and you were behaving in a hyper, agitated or excessively intense way?
- At the same time did you feel in a very irritable mood or even have irritable outbursts shouting at people or starting fights and arguments?
- At the same time were you so full of energy that you didn’t need much sleep?
- At the same time you are much more talkative and your speech was speeded up?
- You had racing thoughts in your head and you couldn’t slow your mind down?
- Your thoughts and focus jump from one thing to another and you couldn’t stay on track?
- You are much more active and did many more things than usual?
- You are much more social and outgoing than usual, perhaps this is in marked contrast to other phases where you were lacking social confidence and more withdrawn (during depressive phases).
- You are much more interested in sex perhaps even leading to risky or regrettable sexual behaviour.
- You are much more impulsive and emboldened than usual engaging in risky behaviours including sexual behaviours, risky financial ventures, gambling, excessive spending.
Self-diagnosing from a questionnaire isn’t definitive but if have periods where you could answer yes to 6 or more of the above all at the same time it looks like you probably get manic.
Note that you may not feel you’re being impulsive or risk-taking but that’s just the elevated norepinephrine changing your perception so that you think everything’s gonna work out all right even when it quite possibly isn’t, look at your behaviours and activities to judge whether or not you’ve been impulsive and risk-taking not at how it felt. Elevated norepinephrine reduces how concerned we are about the possibility of failure (it gives us what psychologists call low risk aversion), the same thing happens when you’re under the influence of alcohol, when you’re sober you know you shouldn’t drive a car when you’re drunk even when you’re drunk you may still know you shouldn’t drive a car but the imbalance your neurotransmitters in your brain alters your perception of risk and make you think it will be okay. I have my own bipolar disorder completely under control now and very I rarely get manic but when I used to get manic I used to remind myself that I have the same ability to make sensible decisions and judgements as when I’m drunk and I would forbid myself from making any big decisions until I have brought a manic attack under control.
A manic episode is characterised by:-
- a profoundly disturbed mood characterised by a mixture of elation/euphoria but there isn’t always euphoria,
- there may be agitation and depression mixed in which feels anything but euphoric,
- an irritable mood,
- grandiosity or inflated self-esteem, diminished need to sleep,
- increased libido and interest in pleasurable/hedonistic activities,
- impulsivity and risk-taking which when combined with increased interest in hedonistic activity often leads to engaging in destructive high risk behaviours such as driving too fast, affairs, drug taking, excessive spending, gambling,
- excessive talking,
- everything is speeded up, speeded up talking, speeded up moving, speeded up thinking in mania this can go to a level of racing thoughts, racing incoherent speech and jumping from one idea to another,
- a flood of ideas/plans sometimes crazy ideas sometimes not bad ideas but generally bold and risk-taking ideas coupled with grandiose overconfidence in one’s abilities and impulsivity may lead to potentially harmful and damaging behaviour including excessive spending, gambling, bankruptcy.
To qualify as mania according to psychiatric medicine the above condition should last for at least seven days but I find that restriction at all useful; I’ve had bouts of the above lasting just a night.
A hypo manic episode is characterised by:-
- lots of energy,
- speeded up speech and body movements,
- enthusiasm, elevated mood,
- irritable mood,
- grandiosity or inflated self-esteem,
- diminished need to sleep,
- increased creativity lots of new ideas often good ideas,
- incredible increased productivity,
- increase libido.
Hypomania similar to for mania but less extreme, when a person is in a manic state it’s obvious to everyone that they are either high on drugs or mentally ill, in a hypomanic state however the person may just appear to be enthusiastic and really on form with lots of creative ideas and full of energy. People with mania get a diagnosis of bipolar pretty quickly, people with hypomania on the other hand may go for years without their manic depressive condition being recognised for what it is; they may only present themselves to their doctor when they are depressed and receive a diagnosis of a person who is normally full of energy but suffers from bouts of depression.
To qualify for hypomania in psychiatric medicine the above condition should last for at least four days but again I don’t find this restriction useful.
It may surprise you to know that you can be diagnosed with bipolar disorder without having depression, you just have to have one manic episode once in your life and your diagnosis bipolar disorder, although I have met a few people that only get the manic side the majority of people will also have periods of depression that are in many ways the antithesis of the manic state.
What’s the difference between mania and hypomania?
The useful difference is principally the severity or intensity of the condition and how impairing it is to your life, mania is so severe that it probably completely impairs your life and everyone around you probably immediately recognises that you are either high on drugs or you’ve gone bonkers and ill quickly call for the police or a doctor.
Technically according to the psychiatric diagnostic manual the length of duration of the episode is also important with manic episodes being longer than hypomanic episodes however in practice I really don’t find that to be useful at all, I was basically hypomanic Monday to Friday at work for about seven years, I was fully functional, productive and successful until I gradually burn myself out and sunk down into a five-year long depression; real people often don’t fit into the textbook categories perfectly.
Why recognising mania in oneself can be difficult
When you’re in a state of mania you can be too out of balance to recognise that you are out of balance, your comprehension of what’s going on and how your behaving can be too compromised to recognise that bipolar illness has hijacked your brain, even when people around you are telling you that you’re not well and you need to take some medicine you may think you’re fine and maybe they should take their medicine; the false irrational and illogical beliefs that manifest can become fixed in the mind and take over the mind so they become your reality and when other people are saying what you’re thinking is irrational or illogical you think you’re right and they’re wrong. With practice over time however it is possible to learn to recognise when you are in a bout of mania and start treating it.
When you are in a state of hypomania although you are far more rational than in a state of mania it lacks the frenzied crazy intensity of mania and it doesn’t really feel crazy at all, you have lots of energy lots of ideas you getting lots of things done so what’s the problem. One of the challenges of hypomania is to not only recognises but understand that it is a problem state, you’re probably engaging in some degree of risk-taking, you are overspending your energy probably your finances and certainly your brain circuits can’t sustain that level of activity and eventually it typically collapse into depression.
I said earlier that euphoria isn’t always present in mania or hypomania but when it is it can present another problem which is that even if you know you manic/hypomanic you may not want to treat or stop it because it feels good and not only did it feel good compared to normal but most of the rest of the time you may be in a depressed state so it’s like a relief for respite from the pain of depression.
Do you get bipolar depression?
- Have you had periods of time lasting two weeks or longer a feeling in a terribly low mood, sad and hopeless to the extent that it made it difficult for you to live your life normally?
- During this time did you have a loss of interest and pleasure in most things including things you usually enjoy?
- Did you also experience a change in your appetite either you lost your appetite or ate a lot more than usual, perhaps this caused the change in your weight?
- Did you also experience changes in your sleep either you are very sleepy and sleeping a lot longer than usual or perhaps waking much earlier than usual in the morning?
- Did you become physically slowed down?
- Was your mind very unsharp and did you experience poor concentration?
- Did you have intense feelings of painful hopelessness and helplessness or feeling numb and hopeless?
- Did you have thoughts of suicide?
If you answered yes to more than half of the above and they persisted continuously for a couple of weeks that depression.
Bipolar disorder is clearly and highly genetically inheritable so another consideration that would indicate you may have bipolar disorder is if you have relatives that have been diagnosed with bipolar.
What’s the difference between bipolar disorder and ADHD?
In both mania and ADHD that can be excessive talking.
In both mania and ADHD that can be distractibility.
In both mania and ADHD there can be increased physical agitation.
In mania there is often an increase in goal directed activity this is a little different to the often ‘on the go’ energetic behaviour in ADHD.
In bipolar mania there is often elevated mood, grandiosity, super confidence, decreased need for sleep and hypersexuality the things are not characteristics of ADHD
The information on this page is just meant as a helpful guide and not for you to make a definite self-diagnosis, if you think you have bipolar disorder book an appointment with a psychiatrist and ideally more than 1 to get a second opinion.
Even if you do have bipolar syndrome there are many different versions and possible outcomes.
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