- Hey, everybody, since I feel like there have been
a lot of conversations recently about bipolar disorder,
some correct, but some very stigmatizing and wrong,
today I want to discuss what Bipolar I and II are,
how it can feel to those who have it,
and what can be done to best manage our symptoms.
Now, first, I just want you to know
that when properly treated, people with Bipolar Disorder
live wonderful and fulfilling lives.
So often it seems that people only want to talk about those
who aren't managing their symptoms
or who are publicly struggling
and mention them as if they represent
everyone with Bipolar Disorder, but they don't.
And I also wanna mention that anyone with a mental illness
is still personally responsible for themselves
and what they do.
They may just need some professional support
to get them into a place
where they can make positive choices, and that's okay.
Showing compassion and understanding
as someone works to manage their symptoms and be better
is the most helpful thing that we can do.
And I also want to quickly explain how Bipolar I
and Bipolar II are diagnosed.
And of course, the DSM itself is not the end all and be all,
but it just gives us some symptoms to notice
or think of and lets us know how it could be diagnosed.
And if you don't know, the DSM is the
"Diagnostic and Statistical Manual of Mental Disorders."
Let's talk about Bipolar I Disorder first.
In order for someone to be diagnosed
with Bipolar I Disorder,
they must meet the criteria for a manic episode.
This manic episode could have happened
following a hypomanic episode,
and I'll get into what that is in a minute, or not,
and it could be followed by a depressive episode, or not.
But one must have a manic episode
in order to be diagnosed with Bipolar I Disorder.
Now a manic episode lasts for at least one week
and we can have, and now I'm just gonna read,
you know, what the DSM says.
It says that we have to have, "A distinct period
"of abnormally and persistently elevated,
"expansive, or irritable mood."
We can also have an increase in goal-oriented behavior,
like starting a ton of new projects,
deciding to clean the whole house, or start a new business,
just to give you a few examples.
And during this week or more,
we must have three or more of the following symptoms.
Number one, inflated self-esteem or grandiosity.
Number two, decreased need for sleep.
That's the one that gets me every time.
I notice it in my patients.
They'll feel like they feel rested
after two or three hours of sleep.
Number three, they're more talkative than usual
or feel this pressure to keep talking.
If someone's in my office experiencing this,
it's like I can't get a word in edgewise.
They're speaking so quickly, and so pressured,
like all the words kind of string together,
and that is another symptom.
Number four, they'll have a flight of ideas
or subjective experience that thoughts are racing.
Like there's just so many good things happening,
so many ideas flying into their head
it's hard for them to kinda pin any of them down.
Number five, distractibility.
They can be easily drawn to unimportant
or irrelevant external stimuli,
and it can be reported by themselves or observed,
you know, it's kind of like that,
the joke people make, even though I know this isn't funny,
but they'd be like, "Oh, squirrel."
Like, it can feel like that.
They're talking about one thing and because,
think of all the other stuff happening,
rapid speech, so many thoughts in their head,
it's like other things, the other thoughts that pop in
can pull them over and focus on that.
And number six, an increase in goal-directed activity.
This can be either socially or at work.
And they can also have psychomotor agitation,
which is when it's like really hard for us to sit still.
We can feel very irritable.
I think the irritation
that comes along with Bipolar Disorder
isn't talked about enough and this psychomotor agitation
is when we're just, (grunts), "I feel so agitated,
"so worked up," like we have so much energy
coursing through our body.
And seven and finally, is excessive involvement
in activities that have high potential
for painful consequences, like going on buying sprees,
making bad business investments, and stuff like that.
And it's also important to know that manic episodes
cannot be caused by a substance
or another medical condition.
This kind of just happens on its own
as a result of our Bipolar Disorder.
And for many of my patients,
mania can feel okay while it's happening.
We have so many thoughts and ideas,
we don't feel like we need any sleep,
and we feel just incredibly good about ourselves.
We can feel productive and unstoppable,
but just remember, it's very short lived.
And when it's over, a lot of my patients
report feeling embarrassed, sad,
and hate that they acted out the way that they did.
When we are manic, we can make really bad choices.
Kind of like what I was referencing before,
like going on a shopping spree and overspending.
And when I talk about overspending,
it's like buying six boats in one day
or spending tens of thousands of dollars on clothes.
Or we can be more promiscuous than we usually are,
often in reckless or dangerous ways.
I've had many patients cheat on their spouses while manic
and feel terrible afterward,
some sleeping with complete strangers or sex workers.
And we can also feel like every idea we're having
is our best yet.
And we can reach out to people in our lives
to tell them about it 'cause we're excited.
Or we could try to get them to invest in it.
Some of my patients have even tried
calling their business partners or colleagues
at like three in the morning to tell them
about their great new venture.
So you can start to see why this can be hard
to come down from, and the realization
that we've acted in ways we normally wouldn't
can be difficult to cope with.
Not to mention, if we got onto social media
to share all of our racing thoughts
or hosted a live stream while we did something embarrassing.
While we're manic or hypomanic, we're not ourselves,
and we can't think clearly, and we really
just need to get some professional help
and honestly, sleep for a few days.
Next I wanna briefly discuss Bipolar II Disorder
because it's often ignored or rolled into Bipolar I.
I think a lotta people assume that there
is just Bipolar Disorder, They don't even know
that there are these two different components,
but I want you to know that Bipolar I and Bipolar II
can look and feel very different.
Oh, and if you want a more full description
of both Bipolar Disorders, you can watch my videos on them
and I will link my playlist at the end of this video.
So stay tuned till then.
Now in order to be diagnosed with Bipolar II Disorder,
we must meet the criteria for a hypomanic episode
and have had a current or past major depressive episode.
And hypomania is what those with Bipolar I
usually kind of hit on their way to mania.
It can be just as uncomfortable and embarrassing
and it has the same list of symptoms,
but it's usually just not as severe,
lasting at least four consecutive days
instead of an entire week.
And if I'm doing my job correctly,
when I see my bipolar I patients in hypomania
start to get a sense of this elevated mood
or lack of need for sleep, I get them in immediately
to see their psychiatrist and I do my best
to prevent them from going into full-blown mania.
And all in all, hypomania is just uncomfortable
and upsetting as mania, it just doesn't last as long.
The real issue I see in my Bipolar II patients
is in their major depressive episodes,
and that is when, if you're wondering what that is,
it's when we have a depressed mood
and loss of enjoyment in things,
as well as at least five of the following,
changes in our appetite or sleep patterns,
feeling fatigued, having an inability to concentrate,
thoughts of death or suicide, feeling easily agitated
or like our thoughts and actions are kinda slowed.
And finally these symptoms must occur
for most days during the same two-week period.
And what I find most common is
those with any Bipolar Disorder
spend a majority of their time
in a major depressive episode.
And too often, when we go and see a psychiatrist,
they prescribe us an antidepressant,
which would help, if we only had depression.
But if we do in fact have Bipolar Disorder,
that can push us out of depression
into a hypomanic or full manic episode.
For many of my patients with Bipolar II,
that's how they find out that it's not just depression.
But for those with Bipolar I,
while that can be the case too, everybody's different,
but it's usually noticed before that,
when they have their first manic episode.
And while an antidepressant may not be a good fit
for those of us with Bipolar Disorder,
mood stabilizers and atypical antipsychotics can help.
And that's why it's vitally important
that we see a psychiatrist, get properly assessed,
and find a medication regimen that works for us.
A lot of artists or celebrities
talk about how medication doesn't let them create
the way that they want to,
or they don't feel like themselves.
But I have to honestly say that I think it's best for us
to be on medication so that we can prevent
any of the highs and lows from happening,
which can stop us from having to deal
with any of the consequences
from those highs and lows later on.
And I don't think you just have to be put
on whatever medication they recommend.
Feel free to ask questions about them.
What are the side effects?
How long do I have to be on this?
See if there are other options out there.
And know that you might have to try out a few
until you find the one that works with you
and helps you feel like the best version of yourself.
And seeing a therapist is really important, too.
They can help us understand our own experience
with Bipolar Disorder, because like I said,
everyone is different,
what our early signs of hypomania or mania are,
and they can give us some tools to deal
with the depressive symptoms that usually follow.
Like our physical health, we have to look after ourselves.
And those with Bipolar Disorder are no different.
We need to get a supportive and understanding
mental health team and possibly have some things in place
to prevent us from taking any destructive action,
like putting a limit on our debit or credit cards,
or having our family, or maybe our roommates,
change our passwords for our social media
when we feel, you know, an episode coming on,
like maybe we don't need as much sleep as we used to,
or doing whatever we can to keep us feeling
and acting like ourselves.
Overall, I just hope that this video
helped you better understand what Bipolar Disorder is
and that it doesn't mean we're crazy or out of control.
Just like any mental illness,
it needs proper treatment and support.
And when we have that,
we can live a wonderful and fulfilling life.
Thank you so much for watching
and I will see you next time, bye.
(upbeat music)