How good are you at spotting bipolar behavior? Below are five hypothetical situations. Let's get started:
Situation One. You have a crazy idea that dog mascara will be the next big thing. You drive everyone nuts talking about the idea. You become obsessed. You literally bet your life putting your mad scheme into action.
Situation Two. Party time. There is something about John Phillip Sousa that brings out your wild side. You jump onto a table, strip off your top, and start gyrating madly, making suggestive gestures, whooping loudly.
Situation Three. Your sister calls you up. It's coupon night at the Olive Garden she enthuses. Are you interested? Yes you reply. You haven't been out of the house in ages. They might have that all-you-can-eat pasta. How cool is that?
Situation Four. Home alone, with your favorite death scene opera arias, deeply absorbed in a bleak Russian novel, indulging in your most morose existentialist fantasies. You mother calls, deeply upset that you blew off the family barbecue.
Situation Five. You have just been downsized, but you are remarkably upbeat, confident you will find an even better position soon enough. The people around you are amazed at your positive attitude.
Situation One. This is the classic grandiosity scenario, coupled with pressured speech and goal-oriented behavior. Since the DSM only requires three of seven symptoms to meet the mania/hypomania threshold, technically you may have entered into the realm of bipolar.
But wait a minute: Is your dog mascara idea grandiose or visionary? Keep in mind, the chronically normal are the ones who laughed at Columbus and Edison and everyone else who managed to rub two neurons together to form an original idea. These people possess no ability whatsoever to distinguish grandiose from visionary.
So - if you have an idea that excites you, doesn't it make sense to talk about it and maybe do something about it? This is the history of every successful enterprise, from the Sistine Chapel to Disneyland to Apple Computers.
In the final analysis, it's the result that counts. If your dog mascara turns out to be the next Disneyland or Apple Computers, you are considered normal. Hold on - that's all wrong. Walt Disney and Steve Jobs both had their business disasters. Were they crazy? Yes. Is crazy always bad? Food for thought.
Situation Two. This is the classic dancing-on-the-tables scenario. Clearly manic, right? Hold on. What if that person is Marilyn Monroe? If life of the party is normal to you, if no bad things are about to happen as a result (such as picking up an STD), can you truly be regarded as out-of-control? And who decided that the stuck-in-the-muds of this planet, the terminally boring, should be holding us in judgment?
Situation Three. Wait a second. Surely, there is nothing wrong with going to the Olive Garden. Hear me out: Context is everything. Thus, in situation number two dancing on tables may be okay, so long as it is characteristic of the individual's usual behavior, such as being Marilyn. If you're not Marilyn, your friends should definitely be worried.
So what is wrong with going to a family restaurant? Nothing. We are not looking at behavior. We are looking at markers - a sign of cycling activity. Thus, if you have bipolar II or something in the bipolar spectrum (loosely described as "soft" bipolar), then your uncharacteristic acceptance of an invitation to get out of the house may be an indication of the "up" phase to your illness. This may be as high as your up ever goes, not even close to mania or hypomania. Nevertheless, you have cycled up, and the up may not last. Pretty soon, you will be back in your usual depression.
But what kind of depression? Your "up" may tell you that your depressions are of the highly recurrent type, which may mean a bipolar approach to your treatment and coping techniques.
Situation Four. This is your classic depression scenario. But before you rush to judgment: Are you depressed or thinking deep? Our society extremely over-values extraversion and sociability. A good many of us prefer staying home, absorbed in our dark thoughts, playing with ideas, connecting to great thinkers, finding beauty in unexpected places. And your mother is expecting you to give that up so you can hear Aunt Maggie yammer on and on about how you need to find a boyfriend or girlfriend? Give me a break.
Situation Five. Positive thinking is a zillion-dollar industry. Virtually all self-help books are rewrites of each other, each with their own gimmicks such as "the secret." Yes, we can all use help in turning around our negative thinking, our destructive ruminating, and all the rest. But let us not devalue the power of depressive realism. Depression is when the rose-colored glasses come off. If we pay attention, we listen to the signals, we acknowledge reality - then we change our behavior and our lives improve.
When personal disaster strikes, depression may be considered the "normal" response. The positive thinker, by contrast, may be stuck in denial, possibly manic, unable to make the necessary course corrections, headed toward disaster.
By now you get the picture: We are too quick to judge ourselves according to rules established by people who have no business telling us how to run our lives. Likewise, we need to be mindful of when we stray from our usual behavior, even when it appears "normal" to these very same people. The key is "uncharacteristic," a much-overlooked DSM term that is right on the money.
In short, symptom checklists are only the start. This is why to "know thyself" is so vital.
Much more to come ...