The Bipolar Spectrum

As well, the spectrum may be viewed as illness meeting temperament, or state meeting trait. At what point, for instance, does a naturally upbeat disposition become a pathological mania? And what happens when an upbeat individual gets depressed? Do mixed states result?

Unfortunately, the DSM-IV does not take the spectrum into consideration. It is totally clueless regarding the fine points of cycling and mixed states. The DSM lumps recurrent and chronic depression together into a unipolar entity, instead of merging recurrent depression into bipolar. Moreover, it only recognizes mixed states where full-blown depression meets full-blown mania, totally ignoring the reality of mixed hypomania and other variations.

As for schizoaffective, confusion reigns supreme.

If your psychiatrist or therapist mistakenly treats the DSM as the bible, then he or she may not have accurately dialed in your diagnosis, with profound implications for your treatment. A new edition of the DSM is scheduled for 2012, but there is no guarantee that this installment will get it right.

"Know thyself." Now, more than ever, your life is riding on it.