Child and Adolescent At-Risk Evaluation for Bipolar Disorder Program at UT Health San Antonio

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  • Dr. Roybal, I’m Bipolar. I’ve Been Told That By Everyone I Know My Whole Life.

    But what does that mean? What is bipolar disorder? Many people use the term “bipolar disorder” to reflect people they know who switch emotions quickly, from happy to anger, or happy to sad, within minutes or an hour. Although this can occur in people with bipolar disorder, this quick mood dysregulation, as professionals often call it, does not define the illness. Sometimes people think they are bipolar because they feel they have these rapid emotional changes or sometimes they are told they are in passing. So at one point is mood dysregulation called bipolar disorder? To be considered bipolar, you have to have mania, or one previous manic episode. Manic episodes are defined by either an elevated mood state with increased energy OR an irritable mood state with increase energy. If you don’t have either one of those, you do not have mania, and you would not have bipolar disorder. “Ok… sometimes I’m really, really up and then I’m really irritable and every little thing annoys me… so does that mean I have bipolar disorder?” Well, no, there are still some other criteria. These are -
    1. Decreased need for sleep
      • This is not just, “Oh it takes me forever to fall sleep or I am waking up a lot in the middle of the night.” This is when you only NEED 2-3 hours of sleep at night and you are NOT tired the next day. You can do this for several nights in a row and then inevitably at some point, whether it be a week later, a month later, or 10 months later, you crash and fall asleep for a long time.
    2. Increased distractibility
      • Think “squirrel!” in the Disney movie “UP” but it happened every few seconds/minutes.
    3. Grandiosity or Inflated self-esteem
      • “I’m the best! No one is as good as me at (insert activity here).” If extreme, these thoughts can be delusional. On the mild side, it can look like increased self-confidence.
    4. Hypersexuality or increased interest in sex, intimacy.
      • This can manifest in wearing more makeup, brighter, more revealing clothing, and on the extreme side hooking up with different partners in a short period of time.
    5. Racing thoughts or Flight of ideas
      • This is when thoughts are coming in to your mind so quickly you can’t sort them out or when you start talking about one topic, then don’t finish and move onto another topic that may or may not be completely unrelated. People cannot follow what you are saying.
    6. Increased volume and/or rate of speech
      • You talk so fast and/or so much people cannot interrupt you or understand what you are saying.
    7. Increase risk taking in pleasurable activities
      • This is when you might go on shopping sprees and spend hundreds or thousands of dollars on items you don’t need, or you become a dare devil and engage in dangerous physical activities
      You have to have THREE (3) of the 7 symptoms above that must occur at the SAME TIME as an elevated mood with increased energy OR FOUR (4) of the 7 symptoms above if you have irritable mood with increased energy. And none of these symptoms should have occurred during the use of medications, or drugs, including alcohol. You do have to have these symptoms for a certain period of time to be diagnosed with different types or severity of bipolar disorder. See a psychiatrist in order to determine that. Stay tuned for the next blog…. What does bipolar disorder look like in kids?