Types of Depression III- Bipolar Illness

screenshot_9_7_16__11_03_amAccording to statistics released by the Depression and Bipolar Alliance (DPA):

  • Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year. (National Institute of Mental Health)
  • The median age of onset for bipolar disorder is 25 years (National Institue of Mental Health), although the illness can start in early childhood or as late as the 40’s and 50’s.
  • An equal number of men and women develop bipolar illness and it is found in all ages, races, ethnic groups and social classes.
  • More than two-thirds of people with bipolar disorder have at least one close relative with the illness or with unipolar major depression, indicating that the disease has a heritable component. (National Institute of Mental Health)

What is Bipolar Illness? (Manic Depression)

In manic depression, the person’s mood swings between periods of depression and periods of extreme elation. Because this mood alternates between two poles, it’s now called bipolar disorder.


Persons with bipolar illness experience episodes of euphoria (expansiveness or irritability), with an inflated self-seteem or grandiose thinking and pleasurable, but risky behaviors, including sexual indiscretions and overspending. Ideas will skip sequence, the person is talkative, and more goal-directed than usual.  Kathyrn Greene-McCreight, a Christian who serves as a priest in the Episcopal church, describes her mania:

My method of dealing with bipolar energies was to dance with my daughter, who would would look at me with unbelieving delight, expecting a depressed mommy. I would garden. I would play the piano and sing at the top of my lungs all the show tunes I knew. This got rather loud and annoyed the children. I would avoid stores and thus the temptation to overspend. But being disciplined with oneself during this stage is very difficult; mania is almost defined by lack of discipline.

In her book, listed below, she examines her illness in the light of Scripture.

Diagnostic and Statistical Manual 5 Classifications (2013)

DSM-5, the updated standard by which clinicians diagnose mental disorders, devotes a separate chapter on bipolar and related disorders, and places it between depressive disorders and schizophrenia disorders. Bipolar I disorder represents classic manic depressive disorder (a full manic episode), except that neither a depressive episode nor psychosis has to be present for diagnosis.

Bipolar II disorder and cyclothymic (rapid cycling) disorder. In Bipolar II, the person has recurrent major depressive episodes with hypomania (less than a full manic episode). In this chapter there are now separate diagnostic criteria for “manic-like phenomena” associated with the use of substances (either substances of abuse or prescribed medications) or with medical conditions.

Other Specified bipolar and related disorders. To encourage further study, the DSM5 includes bipolar-like phenomena that do not fulfill the diagnostic criteria for bipolar I disorder, bipolar II disorder or cyclothymic disorder, e.g., short-duration hypomanic episodes (less than fully manifest) and major depressive episodes; hypomanic episodes with insufficient symptoms and major depressive episodes; hypomanic episode without prior major depressive episode, and short-duration cyclothymia.

The major critique of the new classification focuses on its dependence on consensus rather than on objective criteria (Angst).

If you see yourself in these symptoms and you have not been diagnosed, you need to check it out with your primary care physician, pastor or counselor.  Like Greene-McCreight, Christians struggle with mental illness just as they do with physical illness. Jesus seeks your healing.

 [Sources: Emanuel Severus and Michael Bauer, “Diagnosing bipolar disorders in DSM-5” International Journal of Bipolar Disorders2013, 1:14. Jules Angst, “Bipolar disorders in DSM-5: strengths, problems and perspectives,” International Journal of Bipolar Disorders2013, 1:12. http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder  Kathryn Greene-McCreight, Darkness Is My Only Companion: A Christian Response to Mental Illness, Brazos, 2006, 31.

About Grose

Gordon Grose loves most to write, speak, and preach on the message of hope from the book of Job. Using drama, video, and PowerPoint, he has preached and presented this message of hope to churches around the country. Grose pastored three congregations 25 years, then served 12 years as a pastoral counselor in a Portland, Oregon counseling clinic. He now serves with Good Samaritan Counseling Services, Beaverton, OR. A graduate of Wheaton College (IL), Gordon-Conwell Theological Seminary, Brandeis University, and Boston University, he comes from a rich and varied background in theological and counseling training. In 2015, Gordon published Tragedy Transformed: How Job's Recovery Can Provide Hope For Yours, a book about turning to Job for hope after tragedy. If you have experienced life challenges or personal tragedy, visit his Transforming Tragedy (gordongrose.com) blog to learn more. TragedyTransformed.com provides a sample of Gordon's speaking as well as an opportunity to purchase copies of his book.
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