Symptoms of mania

I was told at a recent meeting that only 40% of bipolar patients exhibit the classical symptoms of mania - flight of thought, rapid speech, grandiose ideas, risk-taking behaviour.  The rest of the bipolar population may show rages during which they smash telephones and punch holes in walls.  I asked how he would distinguish between true bipolar disorder and a behavioural problem that might be treated with therapy.  He responded that it really wasn't important and that meds would be appropriate in the other 60% of cases and that it was all bipolar disorder.  Does this seem reasonable?  I fear we are over-medicating people with powerful psych drugs.

Thank you for your response,

Jennifer

[HFHS MD-JM]

Jennifer,

        "Classic mania", euphoria, expansive mood, racing thoughts, distractability and impulsive behavior is present in about 40-50% of all bipolar patients.  Another 40% have mixed mania/depression.  Violent behavior such as punching walls and smashing phones is not typical.  Such behavior could be due to bipolar disorder but you are right ther is a differential diagnosis.  One must consider intermitent explosive disorder, antisocial personality disorder and a number of psychotic disorders.  Bipolar disorder is not over diagnosed.  Instead research shows that this disorder is not appropriately diagnosed
or treated in many instances.
         Pleases keep in mind that this information is intended for general educational purposes only.  Please consult your personal physician for specific health concerns.

Sincerely,

HFHS MD-JM

Keywords: Bipolar disorder