In Part I of The Language of Bipolar Disorder, I covered several broad terms that relate to the disorder. It included symptoms or diagnoses that patients may not often hear, but can definitely affect treatment. Knowing these terms is an important part of being your own advocate. Professionals have a problem remembering that patients don’t always know what they’re talking about. Doctors and therapists are constantly surrounded by terms and actions related to their expertise and it can be difficult suss out what a patient may or may not know. It’s a balance between making sure the patient is informed while, at the same time, not coming across as pedantic. In my experience, they are also relieved when a patient has educated themselves and they don’t have to explain something for the umpteenth time that day. Here are some terms you may frequently encounter.
Acute: As a kid, I was often diagnosed with “acute sinusitis.” My mother and I would joke that it wasn’t cute at all. I think that’s hilarious, but I’m also easily amused. Well, in medical terms, acute is kind of a big deal. When a disease or a disorder is “acute” that means it comes on quickly and severely, but is relatively short-lasting. In bipolar disorder, some of the phases we go through are severe depression and severe mania. Though, when you’re in the midst of it, it does not seem short and it’s definitely not cute.
Comorbidity: It can be a little confusing if you’re not familiar with the term. We usually think of “morbid” as something relating to death or something disturbing. When you stick the “co-” prefix on it, though, things change. All it means is that there are two or more diseases/disorders that are occurring at the same time. It sounds simple, but the way the disorders interact can change treatment or diagnosis. For instance, there is evidence that when a patient has bipolar disorder that is comorbid with migraines, they might have a different subtype of bipolar disorder. Knowing this can change the patient’s medication regimen so that both problems are treated as one problem instead of two, since some migraine medications are also used to treat bipolar disorder.
Functional Impairment: This one is pretty straight forward. When your brain is not performing at its best, that’s functional impairment. Some examples are memory problems, the inability to focus, slow reactions/speed of thought and a lack of inhibition. On the most basic level, it’s brain farts and brain fog.
Disability: There are two different ways you can think about disability. From a medical standpoint, it’s when your illness interferes with your life in such a way that normal function just isn’t possible. It’s debilitating. For example, when you’re so depressed you aren’t able to get out of bed, that’s a disability. Then there’s a legal standpoint. The U.S. government offers financial assistance under Medicare to people with certain disabilities. In the instance of bipolar disorder, in order to receive that financial assistance you have to prove that you have a medical disability and that disability is severe enough that you cannot hold a job. Lots of forms and lots of hoop-jumping.
ICD-10/DSM: In order to receive a diagnosis, you have to meet certain criteria. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is basically the bible of psychiatry in America. For each mental illness, there is a list of symptoms a patient must have in order to receive a particular diagnosis. For example, if you’ve never had a full-manic episode, you don’t have bipolar I according to the DSM.
The International Classification of Diseases (ICD) is the diagnosis that your doctor is going to put on your visit record that goes to your insurance company. It’s currently in version 10. The biggest difference between the DSM and the ICD-10 is that the ICD diagnosis is considerably more flexible. For example, one day you may get a diagnosis of “F31.7 Bipolar affective disorder, currently in remission,” but on the next visit it may be “F31.1 Bipolar affective disorder, current episode manic without psychotic symptoms.”
These terms are pretty broad. Some of them don’t even just apply to bipolar disorder or mental illness. Keep them in mind for your next visit. They’ll probably come in handy.
For more on The Language of Bipolar Disorder, you can read part I.
You can find me on Twitter @LaRaeRLaBouff