The problem about being manic depressive (bipolar) is that there is no conclusive test for it. There is no blood test, no clear symptom, nothing really to measure. This makes it really difficult to (a) determine if you might be manic depressive or (b) determine if the diagnosis given to you by a psychiatrist or doctor is correct.
Since there is not really a conclusive test for being bipolar, what you need to do is see if the evidence in your past (anything from the last year to the last twenty years) supports the idea that you might be manic depressive. If the evidence does seem to show that you might be bipolar, then the best course of action for now is to act as if you are bipolar, even if you don’t believe that you are.
Before you check past evidence, remember two things. First, you have to be honest with what you remember. Do not make excuses for the actions in the past (“that doesn’t really count because I was stressed out from moving”) – just note what you did and how you felt at the time.
The second thing is that you can change your mind. You are gathering information and sometimes the information might indicate that you might be bipolar and sometimes it might indicate that you aren’t. It often depends on which information you have gathered so far. Sometimes the information may not be conclusive and you may not be sure what to believe. That’s ok too. Just because you think you are bipolar today doesn’t mean you can’t change your mind tomorrow. Or vice versa. It does take quite a while for all this to settle down and for you to make a judgment you feel comfortable with.
Here are some of the things to check:
Are you currently exhibiting signs of mania or depression?
You’ve probably already checked all the symptoms of mania and depression and compared it to what has been happening to you over last few weeks. This is just a reminder. Don’t forget that your symptoms might be milder or slightly different than what is described here and that other web sites have additional descriptions. If you want you can check the list of the criteria used by the American Psychiatric Association, you can too.
Have you had Low/Depressed periods in the past?
Using the symptoms / signs from above, examine the last five or so years to see if there have been periods in which you have been depressed. You can check further back in time than five years – I was able to remember some of my depression symptoms as far back as when I was seventeen (15 years in the past).
Be careful with memory though – it tends to show you what you want. I’d recommend that you pay closer attention to things that happened in the last few months as you are likely to remember events and how you were feeling with more clarity and in better detail.
My experience has been that the depressed periods are relatively easy to notice because they stand out as problem times. Be on the lookout for low periods in the past that you thought were caused by the following:
Overwork. The onset of my depression frequently happened at the end of a period of high productivity and hard work for me. I therefore used to assume that I was tired because of all the time and effort I had been putting out. But it wasn’t so. All it meant was that either the depression kicked in and brought my productive period to an abrupt halt, or I just switched from being manic and full of energy to being depressed and tired all the time.
Arguments. With friends, or family, or co-workers. And then I would get tension headaches, and my mind would start rambling down all sorts of paths and I would be extremely annoyed with the person, or consider breaking off the relationship, or plot revenge. And if I was feeling down, I would attribute feeling down to the argument that happened. And it would make sense because I would be constantly thinking about it. But it turns out that the reverse was true. I was thinking about the argument because I was depressed and not I got depressed because of the argument.
Making Hard Decisions. I can remember times in my life when I thought my low periods were caused by problems that seemed difficult or unsolvable at the time. For example, just after I got my Bachelor’s degree I couldn’t get a job in my field. There I was, young and eager, and having to deal with the fact that I would have to set aside all my hard earned knowledge and do something else. For nearly two months I did pretty much nothing except going bowling and wandering the beach all day and night trying to decide what to do (okay, so it doesn’t sound as if I was in agony, but I was, all right.). When I finally got excited on what I would do next, I thought it was the decision itself that pulled me out of my low mood.
Now I’m not so sure. The aimless wandering and the other things I did during that time are remarkably similar to the symptoms of depression. It’s not clear to me that my mulling over the topic for two months helped my decision either, and the transition from not being able to do anything constructive to a sudden flurry of activity is just like my current transitions from depression to hypomania. I now suspect that I was depressed and had I not been I would have been able to make the same decision in a few days instead of two months.
Stress and Time Management. I always thought that stress caused my low moods. And perhaps it did to some extent. But I also wonder how much my low moods caused me to do things which increased my stress. It was a kind of a vicious circle.
I do know that a lot of the stress was caused by poor time management. Now a lot of people have problems with time management, but it annoyed me how often I would start being organised and keep to it for a while and then everything would fall apart in a matter of two to three days. And fall apart completely to nothingness, not just be bending under the strain.
One of the things that convinced me that I was manic depressive was the start / stop madness of my time management. I’m a little too smart to be so stupid about keeping things in order but yet I was never able to keep things in order. And later on when I started keeping a mood chart, it turned out that the start / stop pattern of my time management exactly matched my mood chart.
Have you had Manic/Productive periods in the past?
You also need to check to see if you have had manic periods in the past. It tends to be more difficult to check for periods of mania because they tend not to have been problematic. In fact, unless the mania caused a disruption in your life or finances, it is likely that you will not see your manic periods as anything other than really efficient or really good times in your life.
When checking your past for mania, look at your happiest or most productive or most satisfying times. You need to check to see if along with your good times you had the symptoms of mania. These times don’t need to deal with office work only. It could include starting up a good relationship, doing a lot of volunteer work, doing well in studies, or having a particularly memorable vacation. Periods of mania tends to have an intensity that makes the period memorable when reminiscing a few years down the line.
During periods of hypomania I have worked with the students of my old secondary school to set up the first web site of any secondary school in my country. I have been president of the youth group of my mosque and had three extremely successful and well remembered social events in a period of three months. I have hosted one of the largest Divali celebrations ever in my country. I wrote the payroll program that our family business still uses a decade later. I have renovated my townhouse in record time. I have gone out, met, and started great relationships (which I could not sustain, alas). I have written really good poetry. I have done the whirlwind vacation of six cities in seven days to visit friends. I have lost five pounds in two weeks by going to the gym every day and pushing myself as hard as I could.
All of these were memorable tasks. And all were done effortlessly by me. And I don’t think I can repeat them now that I am calmer. That is what mania is like – intense, wonderful, and nearly impossible to sustain. In all of the examples above I can remember and identify the symptoms of mania in my daily activities. I don’t regret doing them and they certainly display me at my best, but I also have had to admit that I did them when I was manic.
Saying that you were manic in some of your good times can tarnish the image of them somewhat so there is a reluctance to admit that you were manic at the time. Still, the point here is to see if you had symptoms of mania and you have to be honest when you look back at your memories.
Mania doesn’t only cause you to have great times; it can cause problems, particularly with spending money and anger. In your past, have there been times when you spent money recklessly or splurged for some expensive thing. How were you feeling at the time. Also look at times when you have had major arguments. Mania tends to cause you to escalate even little arguments and tends to make you cruelly accurate when arguing. Was your anger irrational in hindsight (it would have felt correct at the time)?
So, you kind of know what to look for when checking your memories. Here are some additional tips.
Don’t trust just your memories of what happened. If possible, ask someone what they saw you doing. You’d be surprised how often someone else noticed details that you weren’t even aware of at the time. Remember, it is difficult for anyone to see their own faults and flaws.
Be very careful of cause and effect. We often tend to say we were in a low mood or that we were irritable because of things that were happening around us – too much work, too much stress, a spouse behaving stupidly, etc.. That’s how we are programmed to think – things happen and we react to them. However, if you are manic depressive, cause and effect can become muddled.
It is possible that we get into a low mood which then makes work harder which then causes us stress. Or we can go manic and then decide that our spouse is behaving stupidly. Our moods can be the cause of the problems, not the result of them. This reversal of cause and effect is very common with manic depressive persons.
So you think might think that an some event in your life caused you to be feeling either on top of the world or moody and miserable. In fact reverse is true. It is because you are in a high or low mood, you focus on an event and say that is the reason for how you feel.
When you are looking at what has happened in the past, look carefully to see whether your mood caused the problem or was the result of it. And yes, it can be extremely difficult to separate the two.
Don’t find problems where none exist. There is a tendency to find symptoms of mania and depression if you go looking, even if they are not present. You have to be honest in admitting the symptoms are present if this is so. But you also have to be able to be honest about saying that the reason you had a bad spell three years ago was because your boss overloaded you with work and you were having a difficult pregnancy and your three year old son broke his leg and that it had nothing to do with depression.
Manic or depressive episodes happen over and over again and tend to show the same patterns each time they happen, even if the specific problem is different. When you are looking in the past, look for situations in which the same indicators for depression or mania keep reappearing. Or check to see if your symptoms of mania and depression are common enough that you are familiar with them.
It is likely to take a few months to do all the checking and to weigh all the information before you are satisfied. It’s ok, this is not a simple decision that can me made in just a week. Ignore the persons who want a quick decisive answer from you – it just does not happen that way.
Remember, you can change your mind as to whether you are or not. There is nothing wrong with that. And it is hard to know. As late as two years past my diagnosis, I used to wonder if I actually was bipolar or if anything was wrong and I was faking it.
Once you sift through your memories you will start coming to some conclusion on whether you might be bipolar or not.
If you don’t think you are bipolar, then it’s the best possible news. Being bipolar has its rewards, but more often than not it is a hassle.
If you appear to have many of the symptoms of being bipolar, what’s next?
Well, if you’ve already been diagnosed, now you have something other than just the doctor’s word to support the diagnosis. Trust me, that’s a big relief and it goes quite a ways to making you feel more friendly towards your doctor.
If you weren’t sure you were bipolar and you were on this website just to check, then now is the time to start thinking of visiting a psychiatrist. I know this is not so easy to do as we all have our hang-ups and fears about going to a psychiatrist, but it is indeed something you are going to have to do soon.
In either case, I strongly recommend that you write down the situations in the past when you think you might have been either depressed or manic. I also recommend printing out anything from this website or other websites that sound a lot like what you have done or felt (or are currently feeling), and particularly the pages on the signs for mania and depression.
The reason for having the information is that you are going to have to tell some of the people around you that you might be bipolar or that you want to go to a therapist. Having a stack of paper to support your position always makes it more likely for your parents / spouse / girlfriend / friends / etc. to accept that perhaps you might be correct and to listen to what you would like to do next.
The stack of information is also useful if you have family or friends who tell you that there is nothing wrong with you, that you are just lazy, or weak willed, or looking for attention. Such people probably aren’t looking after your best interests, they are probably looking after theirs.
Whatever you do, don’t go into denial. Keep an open mind. Bipolar disorder does not go away and frequently becomes worse over time. If you think you might be bipolar, I strongly recommend that you get an official diagnosis. If it found that you are not bipolar, then you will have peace of mind. If the diagnosis is positive, then you will have a headstart in dealing with it. Either way you come out better than ignoring your fears and worries.