Coming to Terms

Bipolar is simply an adjective synonymous with mood change, right? Even if you know better, it seems popular culture has essentially reduced this major mental illness to something in a thesaurus.

In the Abnormal Psychology courses I teach, one goal is correcting misconceptions of mental illnesses so students don't misdiagnose patients based on casual lingo and simplified misunderstandings driven by pop culture. An inordinate amount of time is spent clarifying that Bipolar Disorder is not simply a fleeting bout of moodiness.

Source: Gert Altmann/Pixabay

People with Borderline Personality Disorder are moody, too, but their moods are driven by reactivity and require quite a different protocol than someone with endogenous mood cycling. These misunderstandings also perpetuate stigma about mental illness. "That guy was so bipolar! He just flipped and threw a bottle at me." In other words, Bipolar patients are surely dangerous and to be avoided.

Even speaking with colleagues I cringe upon hearing "Bipolar." It's a term that's been cheapened and now seems so non-clinical. Kay Redfield Jamison, Ph.D., wrote a poignant memoir on living with Type 1 Bipolar Disorder called An Unquiet Mind, which I require students to read. In it, she discusses the merits of the earlier term Manic-Depressive Illness (MDI). I can't deny that it is more accurate given it is more descriptive. Perhaps Manic/Depressive (with a backslash instead of hyphen) would be even more precise, as it connotes not only distinct mania or depression, but also that the waters tend to meet in "mixed episodes."

The clinically-descriptive nature of MDI brings an air of seriousness that can't be so readily mishandled or abused. It makes one stop and realize there are distinct affective alterations, not just some occasional ups and downs implied by modern concepts of "Bipolar." In fact, John McManamy wrote a book inspired by this misconception called Not Just Up and Down. "You're so Manic-Depressive" doesn't roll off the tongue for pejorative quips so easily, either. But I digress.

It is my hope that if students and new practitioners can keep a clinical description in mind, it will bring about a tendency towards more accuracy when considering a Bipolar diagnosis. It also helps to learn about the lived experiences of people with the illness.

Source: Pouria Teymouri/Pexels

To help readers understand the needs of MDI patients and their experience, I've asked my colleague, Gabe Howard, to share his thoughts on the topic. Gabe is a fervent professional mental health advocate, spurred by his own lived experience with MDI. Stay tuned for the 11/30/2020 post where Gabe will explain what he wished all treatment providers knew to work effectively with MDI patients.