- Hey, everybody, since I
feel like there have been a lot of conversations recently
about bipolar disorder, some correct, but some very
stigmatizing and wrong, today I want to discuss
what Bipolar I and II are, how it can feel to those who have it, and what can be done to
best manage our symptoms. Now, first, I just want you to know that when properly treated,
people with Bipolar Disorder live wonderful and fulfilling lives. So often it seems that people
only want to talk about those who aren't managing their symptoms or who are publicly struggling and mention them as if they represent everyone with Bipolar
Disorder, but they don't. And I also wanna mention that
anyone with a mental illness is still personally
responsible for themselves and what they do. They may just need some
professional support to get them into a place where they can make positive
choices, and that's okay. Showing compassion and understanding as someone works to manage
their symptoms and be better is the most helpful thing that we can do. And I also want to quickly
explain how Bipolar I and Bipolar II are diagnosed. And of course, the DSM itself
is not the end all and be all, but it just gives us
some symptoms to notice or think of and lets us know
how it could be diagnosed. And if you don't know, the DSM is the "Diagnostic and Statistical
Manual of Mental Disorders." Let's talk about Bipolar I Disorder first. In order for someone to be diagnosed with Bipolar I Disorder, they must meet the criteria
for a manic episode. This manic episode could have happened following a hypomanic episode, and I'll get into what that
is in a minute, or not, and it could be followed by
a depressive episode, or not. But one must have a manic episode in order to be diagnosed
with Bipolar I Disorder. Now a manic episode lasts
for at least one week and we can have, and
now I'm just gonna read, you know, what the DSM says. It says that we have to
have, "A distinct period "of abnormally and persistently elevated, "expansive, or irritable mood." We can also have an increase
in goal-oriented behavior, like starting a ton of new projects, deciding to clean the whole
house, or start a new business, just to give you a few examples. And during this week or more, we must have three or more
of the following symptoms. Number one, inflated
self-esteem or grandiosity. Number two, decreased need for sleep. That's the one that gets me every time. I notice it in my patients. They'll feel like they feel rested after two or three hours of sleep. Number three, they're
more talkative than usual or feel this pressure to keep talking. If someone's in my
office experiencing this, it's like I can't get a word in edgewise. They're speaking so
quickly, and so pressured, like all the words kind
of string together, and that is another symptom. Number four, they'll
have a flight of ideas or subjective experience
that thoughts are racing. Like there's just so many
good things happening, so many ideas flying into their head it's hard for them to
kinda pin any of them down. Number five, distractibility. They can be easily drawn to unimportant or irrelevant external stimuli, and it can be reported by
themselves or observed, you know, it's kind of like that, the joke people make, even
though I know this isn't funny, but they'd be like, "Oh, squirrel." Like, it can feel like that. They're talking about
one thing and because, think of all the other stuff happening, rapid speech, so many
thoughts in their head, it's like other things, the
other thoughts that pop in can pull them over and focus on that. And number six, an increase
in goal-directed activity. This can be either socially or at work. And they can also have
psychomotor agitation, which is when it's like really
hard for us to sit still. We can feel very irritable. I think the irritation that comes along with Bipolar Disorder isn't talked about enough and
this psychomotor agitation is when we're just, (grunts),
"I feel so agitated, "so worked up," like
we have so much energy coursing through our body. And seven and finally,
is excessive involvement in activities that have high potential for painful consequences,
like going on buying sprees, making bad business investments,
and stuff like that. And it's also important to
know that manic episodes cannot be caused by a substance or another medical condition. This kind of just happens on its own as a result of our Bipolar Disorder. And for many of my patients, mania can feel okay while it's happening. We have so many thoughts and ideas, we don't feel like we need any sleep, and we feel just incredibly
good about ourselves. We can feel productive and unstoppable, but just remember, it's very short lived. And when it's over, a lot of my patients report feeling embarrassed, sad, and hate that they acted
out the way that they did. When we are manic, we can
make really bad choices. Kind of like what I
was referencing before, like going on a shopping
spree and overspending. And when I talk about overspending, it's like buying six boats in one day or spending tens of thousands
of dollars on clothes. Or we can be more promiscuous
than we usually are, often in reckless or dangerous ways. I've had many patients cheat
on their spouses while manic and feel terrible afterward, some sleeping with complete
strangers or sex workers. And we can also feel like
every idea we're having is our best yet. And we can reach out
to people in our lives to tell them about it
'cause we're excited. Or we could try to get
them to invest in it. Some of my patients have even tried calling their business
partners or colleagues at like three in the morning to tell them about their great new venture. So you can start to see
why this can be hard to come down from, and the realization that we've acted in ways
we normally wouldn't can be difficult to cope with. Not to mention, if we
got onto social media to share all of our racing thoughts or hosted a live stream while
we did something embarrassing. While we're manic or
hypomanic, we're not ourselves, and we can't think clearly, and we really just need to get some professional help and honestly, sleep for a few days. Next I wanna briefly
discuss Bipolar II Disorder because it's often ignored
or rolled into Bipolar I. I think a lotta people assume that there is just Bipolar Disorder,
They don't even know that there are these two
different components, but I want you to know that
Bipolar I and Bipolar II can look and feel very different. Oh, and if you want a
more full description of both Bipolar Disorders, you
can watch my videos on them and I will link my playlist
at the end of this video. So stay tuned till then. Now in order to be diagnosed
with Bipolar II Disorder, we must meet the criteria
for a hypomanic episode and have had a current or
past major depressive episode. And hypomania is what those with Bipolar I usually kind of hit on their way to mania. It can be just as
uncomfortable and embarrassing and it has the same list of symptoms, but it's usually just not as severe, lasting at least four consecutive days instead of an entire week. And if I'm doing my job correctly, when I see my bipolar
I patients in hypomania start to get a sense of this elevated mood or lack of need for sleep,
I get them in immediately to see their psychiatrist and I do my best to prevent them from going
into full-blown mania. And all in all, hypomania
is just uncomfortable and upsetting as mania, it
just doesn't last as long. The real issue I see in
my Bipolar II patients is in their major depressive episodes, and that is when, if you're
wondering what that is, it's when we have a depressed mood and loss of enjoyment in things, as well as at least five of the following, changes in our appetite or sleep patterns, feeling fatigued, having an
inability to concentrate, thoughts of death or suicide,
feeling easily agitated or like our thoughts and
actions are kinda slowed. And finally these symptoms must occur for most days during the
same two-week period. And what I find most common is those with any Bipolar Disorder spend a majority of their time in a major depressive episode. And too often, when we go
and see a psychiatrist, they prescribe us an antidepressant, which would help, if
we only had depression. But if we do in fact
have Bipolar Disorder, that can push us out of depression into a hypomanic or full manic episode. For many of my patients with Bipolar II, that's how they find out that
it's not just depression. But for those with Bipolar I, while that can be the case
too, everybody's different, but it's usually noticed before that, when they have their first manic episode. And while an antidepressant
may not be a good fit for those of us with Bipolar Disorder, mood stabilizers and atypical
antipsychotics can help. And that's why it's vitally important that we see a psychiatrist,
get properly assessed, and find a medication
regimen that works for us. A lot of artists or celebrities talk about how medication
doesn't let them create the way that they want to, or they don't feel like themselves. But I have to honestly say
that I think it's best for us to be on medication so that we can prevent any of the highs and lows from happening, which can stop us from having to deal with any of the consequences from those highs and lows later on. And I don't think you just have to be put on whatever medication they recommend. Feel free to ask questions about them. What are the side effects? How long do I have to be on this? See if there are other options out there. And know that you might
have to try out a few until you find the one that works with you and helps you feel like the
best version of yourself. And seeing a therapist
is really important, too. They can help us understand
our own experience with Bipolar Disorder,
because like I said, everyone is different, what our early signs of
hypomania or mania are, and they can give us some tools to deal with the depressive symptoms
that usually follow. Like our physical health, we
have to look after ourselves. And those with Bipolar
Disorder are no different. We need to get a supportive
and understanding mental health team and possibly
have some things in place to prevent us from taking
any destructive action, like putting a limit on
our debit or credit cards, or having our family,
or maybe our roommates, change our passwords for our social media when we feel, you know,
an episode coming on, like maybe we don't need as
much sleep as we used to, or doing whatever we
can to keep us feeling and acting like ourselves. Overall, I just hope that this video helped you better understand
what Bipolar Disorder is and that it doesn't mean
we're crazy or out of control. Just like any mental illness, it needs proper treatment and support. And when we have that, we can live a wonderful
and fulfilling life. Thank you so much for watching and I will see you next time, bye. (upbeat music)
