Dr. B here with our series on demystifying the DSM. Today I'm going to be talking about Bipolar I. This is the most severe type of bipolar. Although the DSM clearly distinguishes bipolar 1, bipolar 2 and cyclothymia, I see clinically that this is more like a continuum. Bipolar diagnosis does not necessarily mean a severe mental illness, but Bipolar I - severe can be very, very debilitating and cause disability. So, it's really on this continuum. When we talk about bipolar one, this is the classic manic depressive that people think about when they think about bipolar. This is someone who has clearly had at least one manic episode in their life. A true manic episode, and possibly some additional hypomanic episodes with depressive episodes. So, how do we determine the difference there? A true manic episode? Clearly, if you're looking at it clinically, it clearly looks abnormal, right? You can even have psychotic features in a true manic episode. So many people have insomnia and insomnia can be a symptom of depression, anxiety, lots of things. So, it's not the diagnostic criteria for bipolar, but often it's not that they're complaining of not being able to sleep, they don't need a lot of sleep, they'll sleep for two hours and be fine and function. So that's a true manic episode of having this elated energy that they don't actually need sleep is one of the main things that we see in that true bipolar one is not very common. Less than 1% of the population have true bipolar one. In the next video when we talk about Bipolar 2, that's a different story, and it's harder to diagnose. Because you have mania, you have hypomania, and you have depression. And many times, people are only seeking treatment during that depressive episode. Manic episodes are often high-risk behavior. Things that are out of character. I have had several clients tell me that they become hypersexual during their manic episode. They could, you know, go on shopping sprees. There are risk taking behavior like drinking and driving things that are out of their character during those manic episodes, and they can identify it afterwards as being completely out of character for them. And so, making sure to when giving that true bipolar 1 diagnosis that there is clearly evidence of a true manic episode with the depressive episodes. Unfortunately, bipolar one clients are the most likely to complete suicide because the extremes go so quickly from, you know, being on top of the world to literally wanting to die within 24 hours. So, the. You know, it just goes very quickly. Unlike someone with depression or the depressed mood, it takes a long time to get to that feeling of suicidality. Bipolar one is truly a biochemical problem and likely will need medication. So, it's important to make sure that we clearly identify those bipolar 1 diagnosis in really looking for the suicidality, protecting them from that piece, and talking very seriously in the beginning about long term. Medication compliance, so that is bipolar 1 diagnosis.
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Dr. Cristi Bundukamara, Ed.D, PMHNP-BC --- A Psychiatric Mental Health Nurse Practitioner and a Doctor of Healthcare Education has experienced unimaginable trials that have caused many feelings such as depression, anxiety, anger, & overwhelming stress. 
However, she has developed a new pathway to becoming Mentally Strong & Choosing to be Happy.  With purpose, Dr. B has developed the phases that were refined within the Mentally STRONG Method that she created and wants to share with you.

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