What Is the Bipolar Spectrum?
The bipolar spectrum is a term used to refer to conditions that include not only bipolar disorder as traditionally defined (that is, clear episodes of mania or hypomania as well as depressive syndromes) but also other types of mental conditions that can involve depression or mood swings without manic or hypomanic episodes -- including some impulse control disorders, anxiety disorders, personality disorders, and forms of substance abuse. Some psychiatrists find the "bipolar spectrum" concept to be a useful framework for thinking about the driving force behind a wider range of mental health problems. Others, however, argue that symptoms alone often aren't diagnostic, and may reflect other conditions that have their own unique causes and treatments; critics also point out that treatments used for bipolar I or II disorder may not necessarily be safe or effective for conditions that only "loosely" resemble bipolar disorder.
The Bipolar Spectrum: Bipolar I - IV?
Bipolar disorder is traditionally defined by four main forms:
- In bipolar I disorder, a person has at least one manic episode lasting at least a week. He or she also has multiple episodes of major depression. Without treatment, the episodes of depression and mania usually repeat over time. Time spent with depressive symptoms, may outnumber time spent with mania symptoms by about 3 to 1.
- In bipolar II disorder, a person has a milder form of mania, called hypomania, lasting several days or longer. Periods of depression, though, outnumber the time spent with symptoms of hypomania by almost 40 to 1 in many people with this form of the disorder. Because hypomania can be mistaken for ordinary happiness or even normal functioning, bipolar II may often be misdiagnosed as depression alone (unipolar depression).
- In bipolar disorder not otherwise specified (more recently called "not elsewhere classified"), people have symptoms of mania or hypomania that are too few in number or too short in duration to meet currently accepted definitions of a manic or hypomanic syndrome or episode.
- In cyclothymic disorder (sometimes unofficially called bipolar III), a person has hypomanias (as in bipolar II disorder) that alternate frequently with brief periods of depression. When present, though, the symptoms of depression do not last long enough and involve enough symptoms to define major depression as a full syndrome.