How Easy is it to Recognize Bipolar Disorder?

Diagnosing mental illness isn't as easy as diagnosing physical illness. There are no simple blood tests or exams to check for the chemical imbalances involved. The process can take years and is often complicated by other factors such as substance abuse and relationship problems.

Bipolar disorder, formerly referred to as manic-depressive, is characterized by mood swings, cycling between manic episodes and depressed episodes. One of the many reasons bipolar disorder is often missed is because patients are more likely to seek treatment only during depressive periods which then causes a misdiagnosis of depression. They may receive treatment and medication for the depression aspect of the disorder which only solves half of the problem.

Characteristics of a depressive episode include:
Sleep disturbances, either sleeping too much or not sleeping enough
Isolation, lack of interest in socializing, having very little contact with friends and relatives
Change in appetite - increased or decreased - which may also cause weight gain or loss
Feelings of hopelessness, worthlessness
Lowered ability to focus, concentrate
Any mention of suicide or talk of final arrangements

Many patients do not seek help for or acknowledge manic periods because the mania may actually be enjoyable, particularly in contrast to the depression. There is also the possibility that a patient is experiencing hypomania, a less severe form of mania, which may just seem to them like happiness.

Manic episodes may include the following:
Insomnia
Increased energy and activity
Grandiose thoughts, "great ideas"
Racing thoughts
Increased sexual desire
Excessive spending

The switch between manic and depressive moods is referred to as "cycling". The two types of bipolar disorder - bipolar 1 and bipolar 2 - are mainly differentiated by the length of the episodes and the amount of time in between. Bipolar 1 typically involves manic episodes and depressive episodes that each last days or weeks at a time. "Rapid cycling" occurs in bipolar 2 and refers to four or more episodes within a 12 month period although many patients with bipolar 2 report experiencing as many as 3 or 4 episodes within a month, some even as rapidly as one week.

Some patients may also experience "mixed episodes" which, as the name implies, is a combination of both mania and depression. Others may have manic episodes so extreme that they are considered "psychosis".

Unfortunately, all of the variations of frequency and intensity make bipolar disorder difficult to diagnose and to treat because there is no "cookie cutter" one size fits all treatment. There can be several months or years of trial and error with medication and some medications may also cause symptoms to worsen. Working with your psychiatrist and addressing any concerns with potential side effects is crucial to treatment for bipolar disorder.

Getting back to Britney Spears, a quick overview of her behaviors over the past few years certainly indicate the likelihood that Britney is definitely dealing with bipolar disorder. Her behavior during last week's incident at her home when police were called after she refused to release her boys and she was taken to the hospital is a classic case of mania and maybe even a psychotic episode. Her actions were just so out there, it's no wonder so many people were shocked that she wasn't on drugs, to the point of not believing the news that her drug test came back clean.

Unfortunately, like many people living with a mental illness, Britney may (hopefully) just be starting out on the long road of recovery. Rather than paparazzi and "yes men", she needs to take some time away from the spotlight, live her life in private (as hard as that may be for her), and get the help that she so obviously needs for her own sake and for the sake of her children.