8 thoughts on “Bipolar Disorder or Moodiness? Recognizing the Differences

  • October 28, 2018 at 12:51 pm

    Hi Candida,
    Thank you for your very clear explanation of the diagnostic categories. However there is something lost if we only consider symptoms that are in the diagnostic criteria to be important.

    I didn’t see the twitter storm, and maybe my comment would be better there. But I don’t think you can say there is no evidence to link “moodiness” with bipolar disorder. There is actually good evidence that people with clinical bipolar disorder are more likely than average to report moodiness. For example, in this study of 100,000+ people in the uk: https://www.nature.com/articles/s41398-017-0012-7
    The investigators looked at mood instability defined as saying yes to the question ‘Does your mood often goes up and down?’ in people who met DSM-IV criteria for likely bipolar disorder (BD), major depressive disorder (MDD) or neither (whether or not a disorder had been diagnosed). The results were: “All mood disorder groups had a significantly greater proportion of individuals with mood instability compared with the control group, in which the prevalence was 35.3%. This proportion was highest in the BD group (74.0%) followed by … MDD (43.7%).”

    This implies that people with bipolar disorder are twice as likely than average to report moodiness – even though it is not an diagnostic symptom… My bet is that those with bipolar also had more severe moodiness. It is certainly a very prominent symptom for me – and I’m certainly not looking for another diagnostic label. I want my doctor to treat me, not a label.

    Best wishes.

    • November 5, 2018 at 11:40 am

      Thanks for your thoughtful comments. Moodiness does occur more often in those with mood disorders. Labels for the mood disorders themselves (as opposed to moodiness) are only relevant for thinking about treatment planning – medications and non-medications. The irritability and moodiness that is part of the package may well improve when we treat the mood disorder itself. I have certainly seen that in my practice – but sometimes the moodiness is a tougher target.

      As a patient, parent and physician I resonate completely with the idea that we must be treated as/treat a whole person, not a label. Labels – diagnoses – are valuable across the medical field to pick the right treatments. But a person is not their diagnosis. And brains don’t read the DSM – so our diagnostic work is only valuable when it is driven by the whole picture and not a checklist.

      Thank you again!

  • November 2, 2018 at 9:59 am

    Excellent article!! I have met many clients who believe they are Bipolar because they are “moody” any many laypeople who believe “moodiness” is Bipolar Disorder! This further lends to the stigma of mental illness and keeps people who needs help from getting it! Bipolar Disorder is very serious and can cause a great deal of damage to an individual and their family if left untreated. It’s very important to share what the true symptoms of Bipolar look like so more people can get treatment!
    I’ve also encountered so many people who may have been misdiagnosed with Bipolar Disorder because they failed to disclose their Substance Abuse to their doctors. Substance Abuse or Addiction can often mimic symptoms of Bipolar Disorder, which is another reason why it is so important to give a careful and comprehensive evaluation prior to diagnosing and treating.
    Thanks so much for this article! Very well written!

    • November 5, 2018 at 11:43 am

      Thank you Ruth! I am glad you found this helpful. Substance Use disorders are a very important factor – as conditions that can mimic bipolar disorder and that can co-exist with it – and frequently do. Treating all of the layers is crucial. Reducing stigma around substance use disorder treatment is essential to help those who are suffering feel more comfortable reporting symptoms and seeking medical care for those disorders.

  • November 2, 2018 at 12:19 pm

    Good day Candida,

    I’m a long-time sufferer of Bipolar Mood Disorder 1, a fan of Kay Redfield Jamison’s, ‘An Unquiet Mind’ and your and Joe Kraynak’s ‘Bipolar For Dummies’, as well as a seasoned
    social worker and mental health professional in Johannesburg, Gauteng, South Africa.

    I’ve been facilitating psycho-educational groups for fellow sufferers since 2004, and find ‘Bipolar Beat’ full of useful info for my groups, individual, couple and family counselling.

    Thank you very much Ruth H Katz MA Soc Sci cum laude University of Johannesburg, 1992.

  • November 2, 2018 at 3:17 pm

    I am studying disorders in my mental health class (MSW program at Capella University) and sometimes it can be very confusing when it comes to bipolar, depression, borderline personality disorder and ADHD. Based on some of my research, some of these conditions can co-exist at the same time and it makes for a very interesting diagnosis. Most of the case studies we are looking at, though, they describe classic symptoms only. Many people have told me that I was bipolar, but never a medical professional. However, based on what you write, mood disregulation disorder, along with ADHD and Borderline Personality Disorder seem to more accurately represent me. I am an overly positive person, but I get depressed a lot. I have stress and anxiety, and I often over think situations. Yet, I continue to work toward my MSW because now that I am understanding more of myself, I am better able to care for myself. Thank you for an interesting read. I will continue to do more research.

  • November 7, 2018 at 2:15 am

    I find all of this difficult. Perhaps, I am just a difficult person to diagnose, because I’ve been diagnosed Bipolar 1, ADHD, BPD, PTSD, ADHD, GAD, and even schizoaffective at one point. I have suffered for over 30 years now. And I have had such extremes that I would be laughing and then go right into sobbing. That was long ago before my first hospitalization, however. So, it would be really hard for me to separate all of these things from one another in the end. Because, I hold so many diagnosis and have been “moody”, manic, and depressed it would be very hard for me to delineate between all of them. In the end, I do not like the way we classify mental health disorder and feel we need to one day “scrap” the DSM altogether and use “Clusters” and perhaps use letters. I know that is radically different, but the labels do us disservice and we try to make everything “fit” to the label, when I feel so many of us suffer with more than one illness or we have have some symptoms, but not all features.

    I say this because labels become defining and confining in the end. I am ecstatic that we are moving forward and combating stigma, yet I still see every day people who talk extremely negatively about those living with “Bipolar”. Anyway, this probably isn’t appropriate for this post and I appreciate the clarity on the difference between the two. I just wish we could have a radically new way of labeling mental health issues as Clusters of various symptoms. It would be a challenge to change things in the end, and still yet some labels: Bipolar, Schizophrenia, and BPD come with such stigma that having that diagnosis alone is depressing. It’s kinda like Shrek being an “Oger” and everyone running away all the time. LOL.

    In any case, I got off topic. I just look at my own personal plethora of diagnosis and wonder is all these years it has mainly been PMDD and PTSD. It’s really difficult to know and to fit all symptoms into one diagnosis. I’ve ended up with so many different DX that it seems implausible. Oh, just my thoughts.

  • November 14, 2018 at 11:01 am

    Thanks. I noticed the same thing with myself and suspect a good deal of my “moddyness” comes from anxiety, which without medication is nearly constantly present for me. A lot of us have anxiety problems, whether linked to the disorder itseäf or secondarily. In my case it made me so much more reactive than I should have been even if I were on a calm part of my cycle.


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