This document is aimed toward the person living with Bipolar Disorder, Depression, and their respective loved ones.
I write it with the assumption that the Survivor will inevitably do incredible damage to their relationship; if it hasn’t happened yet, it will at some point.
Youngstrom prefers “rapid relapsing” or “rapid episoding” to indicate the pattern of distinct but recurring mood shifts.
“What that tells us is that even if we get you back to where we want you, we have to be on guard for relapse because this has jumped you already four different times in the past year,” he explains.
Paranoia and disordered thinking (not making sense) are other hallmarks of psychosis.
Catatonia (paralysis of movement and speech) can occur during severe depression.
“It gives us more clinical information about how to treat, about prognosis, and so on.” This is not actually a diagnostic category.
Formerly called Bipolar Disorder Not Otherwise Specified, this is a kind of stopgap when symptoms don’t clearly indicate one of the other bipolar diagnoses.
For example, hypomanic periods recur without any depressive interludes, or there are near-hypomanic episodes that don’t last four days or don’t have the right number of symptoms.
This specifier can be applied to either a manic or depressive episode to indicate a break with reality, such as hallucinations (seeing or hearing things which aren’t there) and delusions (believing things that aren’t true).
Hearing voices, receiving special messages, taking on a different identity (often that of a religious or famous figure), and being convinced of a special mission (again, often religious) are common psychotic symptoms.
Although depression is the prevailing mood state for many people who have a bipolar diagnosis, it’s the manic symptoms that dictate which particular diagnosis is given.