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Do you have Bipolar Disorder? Probably not.

I often have clients who tell me in a well-meaning and honest manner that they are, or a family member is, "bipolar." My first question is, "Which kind, Bipolar I or Bipolar II?" This is usually met with a blank stare. There are massive differences between the two types. But my point is that the term "bipolar" is usually misused in the first place, to refer to someone who has an unstable mood and is very irritable.

Severe irritability and a hair trigger is usually a symptom of anxiety, depression, or—very often—abuse or trauma, rather than a bipolar disorder. Whereas Bipolar I and II are relatively rare, fully 50% of individuals seeking therapy/psychiatric services have a major trauma in their past, and irritability and mood instability are major symptoms.

Better minds than mine have put information on the internet explaining Bipolar I and II, and I have pasted links below. I would like for you to notice that the descriptions focus on the presence of “mania” or “hypomania” as major factors in the diagnosis, and that they do not focus on being irritable. Additionally, the mood changes in Bipolar I and II usually happen randomly or gradually, unlike the “drop of a hat” irritability of someone with anxiety, depression, or PTSD. Click to see more:

Bipolar II

Bipolar I

Unfortunately, I often see the term “bipolar” used as an insult toward women, especially those who may have had difficult lives (the term “borderline” is also used), including by mental health professionals. And clients accept it, and feel unfixable or stigmatized. We have got to stop it with the labels. It’s like kids on a playground. While I am just as trained to diagnose as the next guy, I am much more interested in child development, family, and a person’s unique life story when it comes to treating mental illness.

*Note: One objection another clinician might have to what I have written here is that when an individual actually has Bipolar I or II, he or she can be highly irritable in the manic or hypomanic (respectively) phase of the illness. This is true. But in this post, I am addressing cases in which close examination of a client’s history demonstrated no evidence of a manic or hypomanic episode, ever.

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