Q. My question is how does an individual know whether they have bipolar disorder? How do they know they're not just extra moody, or just a lousy person (if irritability is probably the most obnoxious and constant symptom)? Maybe the creative and wide-open thinking is just that? The irritability does seem fairly extreme (possible to hear people breathing and chewing from across the room) and there are sometimes very manic type situations (self-injury) but they only last several minutes not days or weeks. 

How does one know the difference between moodiness, sadness, extra-energy, creativity etc and manic depression? If a psychologist and psychiatrist diagnose bipolar disorder, is that good enough? It seems too easy to blame lots of lousy behavior on a diagnosed illness but maybe it's just lousy behavior and has nothing to do with a biological problem. Maybe the person is just in the wrong situation or just wasn't raised to function well socially and gets depressed because they should. Thanks again for advice. 

I realized after I sent the above note that I really hadn't given any detail so I'm adding that now. The person who was diagnosed is in their early 40s, male, and has experienced depression symptoms (prolonged sadness, social detachment, insomnia, low self esteem, numerous and uncontrolled visions of accidents and sickness involving loved ones) since mid childhood. In retrospect there was obsessive compulsive disorder (not diagnosed) just pre-adolescence. There are still some obsessive compulsive symptoms (checking, hand washing, counting, alphabet sizing words) but coping well. There was heavy drug use in adolescence and occasional 'fits' sort of like temper tantrums. Drug use is long over now. Since early adulthood there've been several periods of relief (few to several months duration) from depression with enormous energy, lots of creative activity (book writing attempts etc) increased appetite, heavy sweating, big dreams and fantasies. In recent years there's also been extreme irritability I think mostly riding on top of the energy but also with the depression. The irritability is very intense and sometimes escalates to self-injury and short-lived periods of confusion sometimes accompanied with flashing lights. Sometimes a feeling of euphoria and great sense of well-being comes on out of nowhere. Also music plays in the person's head very frequently almost constantly since early adulthood. Person has been checked for diabetes and thyroid condition. Person has no known bipolar disorder in family but does have immediate blood relations with migraine.


  A. All psychiatric diagnoses in North America are made using the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders). There are specific criteria set up for all diagnoses, and these diagnoses are usually made by a trained professional. These are medical diagnoses.

It would not make sense for an individual to do things over and over again that bring negative results to them. The person you describe likely wears a coat in winter and lighter clothes in summer. Therefore, they have already learned to change (in this case clothing) when they get negative feedback (cold in winter, hot in summer). If they keep doing damaging behaviors over and over, it is likely because they biochemically have to do so.