Welcome to Bipolar in Focus. I'm Jane Pauley. Do you think you might have bipolar or maybe someone you love? How would you know?
Dr. David Kahn of Columbia University and New York Presbyterian Hospital is here. How would you know?
Someone with bipolar illness is going to show or experience a change in their mood from the way that they usually are.
Depression is the most obvious mood change that people will really feel in themselves, a feeling of sadness,
a loss interest in usual activities, difficulty sleeping, loss of energy, feelings of worthlessness, thoughts of suicide.
And on the flip side of that, someone with bipolar illness may come out of the depression to experience a manic episode, very different from being depressed.
A feeling of a mood that's very expansive, that's very elevated. They may feel fine but people around them are the ones who might notice that there is a change really above normal in a sense.
At some point, if someone is coming out of a depression, a loved one might feel some relief. What would make someone know this change is tilting into a bad direction?
Because when someone is starting to become manic, it's too much. They're too optimistic. They're judgment becomes impaired. They stop sleeping normally. They have too much energy.
They may begin to behave in ways that are indiscrete.
Their speech can begin to speed up and their thoughts can begin to race ahead and pile on top of one another to the point where they stop making sense to people around them
even though the person with the condition might feel that they're brilliant.
But when the consequences of their plans, their behavior, their activities become apparent -- people around them really try to put the brakes on them because they realize what's happening.
One of the signature symptoms, it doesn't sound like what we think of as mania and that's irritability. I mean, what level of irritability would be symptomatic of bipolar?
A person who is getting manic does not like to be stopped in their tracks. And when they feel that there are limits being put on them or that there are constraints from the capacities --
of the mere mortals who surround them to follow them into action. A person who's manic can become extremely angry, very testy, very irritable the minute that they feel constrained.
There are certain behaviors that are weirdly consistent with bipolar. One of them is shopping, spending money.
What does that look like because shop 'til you drop is the definition of our culture?
The tip off here is a person who is normally -- has a credit card bill of x amount per month. Suddenly, the pattern changes.
There is a compulsiveness to it that's out of character for the person, a shift from their usual spending that gets them into financial trouble.
When you see it clustering with these other mood symptoms, that can very much be part of the manic episode.
What are some of the other behaviors that are signature symptoms?
Very, very high physical energy, moving around a lot, being very distractible, trouble sitting still, staying up all hours of the night, excess of social activity,
being on the phone constantly, planning to travel when normally wouldn't need to or intend to do that.
What is the sexuality issue?
The sexuality issue can be a very serious one. People who become manic can have a very heightened libido. Sometimes, they can express that within a relationship that they have --
but it can often lead to sexual liaisons outside of a relationship and be very destructive to a marriage or to a partnership.
All that said, why is it so hard to miss?
Because the person with mania feels really good. They will put off people around them who want to stop them or think that something is wrong by intimidating them.
The person with mania often has been depressed for a long time. People around them are relieved to see them come out of the depression. And until it really gets out of control --
it may just look like a super good state, the best I have felt in years until it accelerates to the point of destructiveness.
Well, thank you, Dr. Kahn. And thank you for watching Bipolar in Focus.