So you have been diagnosed Bipolar or DMDD, what does that mean?

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Disruptive Mood Dysregulation Disorder differs from Bipolar in that it is the newest diagnosis to come out in the DSM-IV used by doctors for diagnostic criteria. It may contain some of the following symptoms or may just look like someone who is lacking the ability to control emotions. It is going to be one of most-used diagnoses we see up and coming in children. But there is way more to it than just a spoiled child throwing temper tantrums, as it is important to understand that it is a neurobiological brain disorder (NBD)

Bipolar in a Box*: The diagnostic Criteria

*Please keep in mind that just because you know yourself, perhaps diagnosed with Bipolar I or II, or have a loved one or patient with bipolar, none of us can be put into a box or a stereo-type. You cannot assume that just because one person acts a certain way, that all people with bipolar act that way. Here are some generalities, but they may or may not apply to you or your loved one.

Please read them only to gain a better understanding of the disorder, without judgment, and try to read it in light of the fact that this is a medical condition, not a moral or character flaw. The brain literally does have a mind of it’s own, and judging someone for reaching out for help in any way they can get it is like denying a diabetic insulin.

FORMAT IN A CHART: Symptoms differ from person to person but may include some or many of the following:

Bipolar Disorder I & II

• Periods of major depression interspersed with episodes of mania
• Bipolar I is a more severe form, with full manic episodes that may include hallucinations and delusions
• Bipolar II patients have more symptoms of depression and identification of mania may be delayed (often-times diagnosed with depression first)
• Onset is frequently in young adulthood
• Moods not usually related to external events

Mania Symptoms

• Extremely silly, optimistic, euphoric, or irritable moods
• Volatile anger, aggression, agitation
• Inflated self-esteem, confidence, grandeur
• Decreased need or ability to sleep
• Bizarre, racing thoughts or ideas
• Rapid or excessive speech
• Lack of focus, easily distracted, or hyper focused
• Impulsive, risky behavior
• Excessive spending
• Promiscuity, hyper sexuality
• Substance Abuse
• Highly impaired ability to function

Hypomanic Symptoms

1. Flight of ideas, jumping from topic to topic
2. Filled with energy
3. Flooded with ideas
4. Driven, restless, and unable to keep still
5. Channels energy into wildly grand ambitions
6. Often works on little sleep
7. Feels brilliant, special, chosen, perhaps even destined to change the world
8. Can be euphoric
9. Easily irritated by minor obstacles
10. A risk taker
11. Overspends in both business and personal life
12. Acts out sexually- elevated sex drive
13. Sometimes acts impulsively with poor judgment and painful consequences
14. Fast talking, witty and gregarious
15. Confidence can make him/her charismatic and persuasive
16. Prone to make enemies and feels persecuted by those who don’t see vision and mission

Source: John Hopkins Symptoms & Remedies (New York: Medletter Association, 1999), 344; Current Medical Diagnoses & Treatment (New York: McGraw-Hill, 2004), 1029; John D. Gartner, The Hypomanic Edge- The Link Between (a little) Craziness and (a lot of) Success in America (Simon & Schuster, 2011)

Do you feel like you completely understand Bipolar now? Unless you have been in the shoes of every bipolar individual, you can’t fully understand. It can be confusing, but imagine trying to live with it. When the brain cannot think and process properly, actions and behaviors are difficult if not impossible to control. This makes it difficult to differentiate between chosen behavior and the “disorder’s behavior”.

I am not saying that all actions and wrong choices that people with bipolar make should be blamed on the disorder, but most things would not have happened had the brain been properly nourished and balanced. An imbalanced, under-nourished brain will act out.

Mania can look like:

1. Anger
2. Rage
3. Agitation
4. Frustration
5. Picking pointless fights
6. Hypersensitivity (“Surround Sound” effect to stimuli like chip chewing, noises, crowds)
7. Exaggerations
8. Lying/Story telling
9. Compulsive uncontrollable shoplifting/ Shopping sprees
10. Impulsive
11. Lack-of common sense/ Logical decision making
12. Won’t quit talking, pressured speech
13. Impetuous behavior
14. Doing things out a character (like a prudent person having one-night stands or partying)
15. Sudden changes in normal activities and behaviors
16. Brilliant creativity

Mania can feel like:

1. You can do anything, accomplish anything
2. Your heart is going to explode
3. Mind is racing ahead of you, won’t shut up or turn off
4. Many thoughts and ideas at once
5. A Ferris wheel that won’t stop
6. Like everyone else is in slow motion
7. Sounds and sensations are in your cells
8. Colors are more brilliant and beautiful
9. Ideas are brilliant and original
10. Anything is possible
11. You see red and can’t control what you do
12. Paranoia
13. Everything everyone does is stupid and annoying
14. No one understands you/ no one gets it
15. Every decision you make is right
16. Every decision you make is wrong
17. Choice, reason, and logic is completely taken away from you
18. You would run every friend or relationship off without meaning to
19. Just being in the moment without regard to consequences

I hope this helps give a better understanding. The best way I can describe how horrible of a disorder this is is like this:

Imagine if someone hijacked your body, took it for a joy-ride, and then returned it battered, bruised, beaten, and depressed. It is like being a run-away who was forced heroine and then became an addict without voluntarily taking the first hit. If you or a loved one have a brain disorder, it can be devastating for everyone involved. Understanding, forgiveness, and love are the best medicines available for this condition.

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