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How Can You Bipolar? Let Me Count the Ways…

The official handbook of mental health providers, the Diagnostic and Statistical Manual of Mental Disorders (or DSM, as it's known for short), breaks bipolar disorder down into categories. Most people are familiar with just bipolar 1 and bipolar 2. Both types of bipolar have a complex set of definitions and requirements that need to be met to qualify for the diagnosis.

My bipolar category

But categories are, by design, exclusionary. What if you don't meet the highly specific criteria found in the DSM for bipolar 1 or 2? What if your up symptoms don't last long enough to be labeled hypo/mania? What if you experience mostly depression with little upswing? Is your experience and your suffering real?

Of course it is. In fact, that's what my experience has been. I have experienced loads of depression, classic hypomania, and manic symptoms. But since my mania didn't last long enough to meet DSM requirements, it's not bipolar 1.

A "residual" category?

Yet, it had features that are past bipolar 2. I technically fall into a "residual" category, which the DSM includes as a kind of catch all. If you do too, know that you're not alone. In fact, the majority of people with bipolar disorder, don't actually fall into the categories of bipolar 1 or 2!1

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The big takeaway here is that your experiences of bipolar mood shifts are valid, even if they don't fit the cookie-cutter categories of bipolar that you're reading about on the internet.

What if I mostly experience depression?

Many people, including my friends, with bipolar disorder were originally misdiagnosed with major depressive disorder. It makes sense – we show up for help when feeling depressed, not when feeling energetic and productive!

For years, especially in my teens, depression was my constant companion and greatest foe. I had moments of relief in which my mood stabilized and even escalated to a concerning level. But after months of endless darkness, this just felt like a lucky break!

Dr. Jim Phelps, a leading thinker on the topic of the bipolar spectrum, refers to this colloquially as "cycling into normal." Reading those words and others in his book Why Am I Still Depressed? absolutely changed my life.2

Why label it at all?

Many of my peers and even some colleagues don't like the label of a diagnosis. After all, these terms can carry a heavy amount of connotation and stigma. People can feel pigeon-holed or over-identify with a medical or psychiatric label.

After 25 years, I'm honestly indifferent to them. I understand that diagnostic terms are a necessary evil in some ways. They give doctors a common language in which to communicate in order to coordinate the most effective treatment.

For example, the medical treatment for bipolar is different from that of unipolar depression. If someone with bipolar is prescribed antidepressants, it can actually make them worse (been there!) so an accurate diagnosis is crucial. But aside from that – I understand that many feel there is something arbitrary about these terms.

Where can I learn more about my bipolar type?

It's best to consult with an expert on bipolar to get a clear diagnosis and the best treatment for your mood symptoms.

If you're experiencing ongoing, episodic depression that you're struggling to treat, I'd recommend checking out the book Why Am I Still Depressed? It breaks down lesser-discussed end of the bipolar mood spectrum and what to do about it. This book changed my life and may change yours as well.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.