Examples of Bipolar Disorder Cases given by John O’Reardon MD
Back to hypomania. It is important for many reasons not least of which is that it is very easy to miss. Patients will remember their depressions very clearly as the pain of them is not easily forgotten. However, hypomania wash over and don’t have the same dramatic intensity as mania. By definition if one gets hospitalized with a disturbed elevated mood state it must be mania.
Hypomania can lurk in the background for a long time even though those close to the patient know there is something wrong. In this sense hypomania is insidious and can wreak a lot of havoc in one’s life before the diagnosis is made. I can think of at least 3 examples from my career in which chronic hypomania lead to financial ruin or nearly so.
Joe is a 55-year-old gentleman who has had a successful career in business. He never got depressed but always had more energy than anybody else to the extent that others found him exhausting to be around. His wife Alice for many years believed there was something wrong with him but could never get him to see a doctor. He got into investing in stocks and overestimated his prowess. Over the period of 5 years Joe lost about one million dollars. When he finally recognized what had happened he fell into a terrible depression which took about three years of treatment before he got better.
The second patient, Angela, was a lawyer in her 60s. Like Joe she too developed a grandiose sense of herself and her abilities. Like Joe she too took to investing in the stock market. She lost about $750,000 in all with money she took out of her retirement account. Now she is in a financial hole that it will take a long time to dig out of.
The third patient, Margaret, 70 years old, had a successful antique business. She had had hypomania and depressions over the years but never got any treatment. As can happen her hypomania worsened and she began to slip into mania. She went to a house clearing auction in which most items for sale were routine and had no antique value. In her disturbed state she started to bid competitively on every item bidding way above its true worth. It got so bad that that other attendees would bid against her just to see how high she would go. At the end of the auction she had spent $100,000 with no recompense available.
So it is evident from these stories that hypomania can be destructive. And recognition of it is key to diagnosing bipolar disorder. What they have in common is diagnosis and treatment did not begin until very serious consequences had occurred in their lives. If diagnosis had occurred earlier much harm could have been prevented.
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