I am often asked by youth I work with to explain the diagnosis of Bipolar Disorder. It is such a complex disorder with many symptoms and varying degrees of severity; how do I fit this all in? As a grad student, I was asked this question by a youth. So, on the spot I came up with a drawing to try and help him understand. I found that not only did it help to explain the disorder, but track how he was from day to day. Bipolar is major shift in mood that can happen quickly or over a period of time. It is a hard concept to think of – especially if you cannot necessarily identify the moment that triggered such a dramatic shift from high to low with such intensity.
Picture this: a straight line, now a wavy live over the straight one. There are rounded waves above and below the line. This could be any one of us on any given day. The straight line is sort of that neutral feeling. Not necessarily happy, sad or angry – maybe just sort of content - neutral. The waves above the line are those happy, exciting, good times. Then the line dips, but slowly below the line. This may be a down day, sorta sad or even angry about something. Whether above or below the line, we probably got there in a means we could remember and it probably happened gradually. Even if this dip below was a loss (death, loss of job, separation etc), we have the emotional control to hopefully slow ourselves down. Throughout the course of a day and even overtime, we ebb and flow over and under the straight line at a pretty steady, “controlled” pace.
Those who suffer with Bipolar disorder do not always ebb and flow so easily, nor do they always have control when they want it, or need it. Take that same line but instead of waves and dips, draw sharp peaks and valleys – sharp inclines and declines at all different heights going pretty far above and below that line. There is no rounded wave or dip in between, there is no gradual climb out of that aggravating day or back into neutrality - it just happens and fast. Once in that valley below the line – a person could be there for a few hours, days even a week, maybe longer. As they shoot back up, they pass right by “neutrality,” or if they land there – it is usually for a short time. Peaks vary, but are often where one would rather be; grandiose, anxious, impulsive, risk taking, incredibly energetic…until that line falls out from underneath.
Sounds like a pretty dramatic way to explain the disorder, but when used as a visual it gets the point across. People then often place themselves on the dips or waves or the peaks or valleys and then use the diagram to help them remember what triggered that peak or induced that valley.
So, where do you fall today?