BIPOLAR II IS…

… my diagnosis. Not my choice. Bipolar II is characterised by Dr Jim Phelps as “mood swings but not manic”.

I know a lot of people hate labels and there’s much stigma around the diagnosis of bipolar – you must be a crazy person – but I feel at ease with this diagnosis. Plus I hate stigma and would like to actively reduce it. It seems right and fits my experience – over the course of a lifetime. There’s a family history of bipolar II and upon reflection, I wonder if my sister was bipolar rather than borderline personality disorder and if a diagnosis could have saved her life. But rumination is pointless.

We cannot change the past.

My very trusty (now former…) psychiatrist, recommended Dr Phelps’ site. It’s an extremely comprehensive website if you ever want to know the full ins and outs of bipolar II. He points out that although there’s a genetic component, research shows more than 226 genes involved in, but not exclusive to, bipolar. If it was purely a genetic disease, my lay person’s interpretation is a lot more of us would have it. Thankfully that is not the case.

Environmental factors are apparently a huge contributor to someone who is already genetically vulnerable.

I’ll give you a quick rundown (courtesy of Jim) of the difference between bipolar I and II. And why bipolar I receives earlier and easier diagnoses than bipolar II. The main characteristics of both bipolar I and II are mood swings, manic behaviour and major depression. First I’ll steal a quote and image from Dr Phelps.

Until very recently, depression and “manic-depressive illness” were understood as completely independent: a patient either had one or the other. Now the two are seen by most mood specialists as two extremes on a continuum, with variations found at all points in between, even though only some points have names.
https://psycheducation.org/diagnosis/

Unipolar on the left being straightforward, major depression – usually chemical rather than situational – while bipolar I on the right is the classic manic-depressive we’ve all heard of. Most people with some kind of mood disorder in this category (and there’s apparently conjecture borderline personality disorder is, in fact, part of the mood spectrum) are likely to fit into the green-yellow shades.

Of course, those of you fortunate enough not to experience depression as a disorder (as opposed to a situational experience), won’t recognise yourself here at all. But there are enough of us around who do find ourselves somewhere on this pretty rainbow of depression, so I thought I’d share. It also helps me unpack my own diagnosis and current experience.

As I couldn’t find an infographic explaining the difference between major depression, bipolar I and bipolar II, I created my own.

Obviously a diagnosis of any serious illness – physical or psychological – needs to be done by an appropriate medical professional. But if like me, you’re curious with Google searches then the above may help for a bit of preliminary research.

People ask me why on earth my diagnosis has taken 30 years.

Outstanding denial and emotional masking on my behalf, alongside the acceptance of depression and periods of hypomania as normal. Friends say they noticed periods of hypomania but never mentioned it. And of course, if you turn up to a psychologist or GP feeling depressed, they see no evidence of hypomania. Bipolar I, however, is characterised by full mania episodes, potential psychosis (losing touch with reality) that most often lead to hospitalisation and earlier diagnosis.

Suicide statistics for bipolar I and II are alarmingly similar.

Our pooled results indicate that individuals with BPII are at marked risk for attempting suicide and that this risk resembles the alarmingly high suicide risk associated with BPI.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536929/

Another downfall to the late diagnosis for bipolar II is pharmacological treatments for depression can eventually make bipolar worse. It can escalate to the point of being noticeable and diagnosable, but not before suicidality reaches a breaking point. Untreated, bipolar I and II are dangerous illnesses.

Upon admission to this psychiatric hospital two weeks ago, I was extremely unwell. Today they reiterated exactly how sick I am. It’s not a quick fix and it’s a serious condition. So two weeks may turn into many more as experts try to stabilise my currently extremely volatile and vulnerable moods.