The DSM

Bipolar symptoms are hard to describe.  The medical establishment has lists of symptoms they use to diagnose this disorder; they are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).  Mania is characterized by a period of mood disturbance where the person experiences an abnormally and persistently elevated, expansive, or irritable mood for at least a week.  Three or more symptoms from the following list should be present before the mood disturbance can be called manic:  elevated self-esteem (grandiosity), less need for sleep, more talkative than usual (pressured speech), the feeling that thoughts are racing (flight of ideas), abnormally low attention span (distractability), increase in goal-oriented activity (psychomotor agitation), and risk-taking behavior (such as buying sprees, sexual experimentation, or poor business decisions.).

Depression is characterized by loss of interest or pleasure in life activities for at least two weeks.  Five or more symptoms from the following list should be present and cause severe disruptions of a person’s life before the mood disturbance can be called depressed:  low mood (depressed mood), low interest or pleasure in all or most activities (anhedonia), significant unintentional weight loss or gain, sleeping too much (hypersomnia) or too little (insomnia), slowing of activity (psychomotor retardation), loss of energy (fatigue), feelings of worthlessness or excessive guilt, unable to think, concentrate, or be decisive, and recurrent thoughts of death (suicidality).

The bipolar person can switch from one pole to another very quickly or very slowly and can have periods of normal functioning in between them. Mania can be fun.  Depression is never fun.  In my personal experience, mania is scary.  I have had periods of high functioning that you could call hypomanic, which is when the symptoms are less severe than in full-blown mania.  I think most of my time between the birth of my middle child and my youngest child was spent in hypomania, in that I had the goal-oriented behavior and the drive to accomplish my goals without the excesses of true mania.  But my truly manic episodes feature a high level of irritation, a low need for sleep, pressured speech, and grandiosity, where I have big dreams and plans that had no basis in reality.

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2 thoughts on “The DSM

  1. I think of my Mom’s manic stages as her “angry bird” stage. And I can think of times when I got angry about something, where later, reminiscing, I wondered why that made me mad. I made it a point to apologize often to my family.

    I think psychiatrists are on DSM -IV, now, aren’t they?

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