by Sergio Silva, M.D.

Created on: August 21, 2009

While only a qualified mental health professional can diagnose bipolar disorder, it is by far the most over-diagnosed mental illness today (along with ADHD). This article will help you sort through some of the basics, to better prepare yourself for that talk with a psychiatrist or therapist, if you think you may be suffering from this disease.

The key is understanding mania. We all get depression, and we all understand that there are different levels of depression; most of us, thankfully, have never experienced true endogenous major depression. Mania, however, is widely misunderstood. The lay public and even many (if not most) mental health professionals mislabel various types of agitated moods as "manic episodes." There are different levels of mania as well, but even the simplest, lowest grade of mania-hypomania-is a step or two above and beyond any of the familiar forms of agitation all of us feel from time to time.

Do not confuse "mania" with other forms of emotional turmoil. Manic episodes can be characterized by elation, irritability or anxiety, for example, but they are not just euphoria, not simply aggravation. Mania is not even just extreme instances of these; mania is a sustained (usually weeks to months) state of psychomotor agitation, along with other neurovegetative signs (physical findings, like a decreased need for sleep, markedly increased libido and/or sped-up mental processes which manifest as super-fast thinking and pressured speech). In a nutshell, mania is like being on a stimulant drug, without the drug. There is sleeplessness and other forms of physical agitation, increased goal-directed activity, and increased risk-taking behavior. See below for disclaimers on each of these common, but commonly misunderstood, symptoms.

One major distinguishing characteristic is that manic episodes do not last minutes or hours, unless they are induced by stimulant drugs whose effects wear off. In that case, the diagnosis would be a substance-induced manic episode, which is not endogenous bipolar disorder. Bipolar disorder, or manic depression, occurs spontaneously, is often inherited, and usually starts fairly early in life (early adulthood or, less commonly, adolescence-rarely in childhood). It consists of alternating episodes of major depression (which usually comes first) and mania; untreated episodes of either of which last months, even years. Not minutes, or even hours! If you think you were "manic" last night (and you weren't high on drugs),

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