Bipolar disorder, by definition, is a mental disorder that involves changes in mood. Bipolar individuals have alternating depressive and manic periods (bipolar disorder used to be called manic depression).
Bipolar Disorder Defined
Bipolar disorder is a mental illness categorized by cyclic periods of extreme euphoria and activity (mania), most often followed by periods of extreme depression. Since moods are oftentimes up and down for most people, to be diagnosed with bipolar disorder rather than normal mood swings or traditional depression, the patient must experience four or five symptoms of mania for at least a week.
Classifications of Bipolar Disorder
There are currently four main classifications of bipolar disorder, including Bipolar I, Bipolar II, Bipolar NOS, and Cyclothymia:
- Bipolar I is diagnosed if the patient has one episode of extreme mania, with or without a depressive period.
- Bipolar II is diagnosed if the patient has a less extreme manic episode, called hypomania, followed by at least one major depressive episode.
- Cyclothmia is a milder form of bipolar disorder and causes hypomania (milder than mania) and mild depression. During cyclothmia, a person has less extreme cases of mania and depression, but they are both experienced in a cycling of moods, changing back and forth on a consistent basis.
- Bipolar Disorder (NOS), meaning "not otherwise specified," is the classification used when bipolar disorder is diagnosed, but does not fall into one of the three previous categories.
Bipolar disorder also can be "rapid cycling," which is when the moods of mania and depression cycle back and forth. Many people with bipolar also suffer from mixed mood episodes, or mixed states, which include clinical depression and mania, resulting in anger, belligerence, delusional behavior, insomnia, fatigue, suicidal thoughts, and many other behavioral symptoms.
Symptoms of Bipolar Disorder
Symptoms of mania can include rushed speech, short attention span, sleeplessness, racing thoughts, impaired judgment, and unusual behavior. Oftentimes when people are experiencing mania, they will engage in substance abuse, increased and unsafe sexual activity, and display aggressiveness and grandiose, delusional ideas about themselves. In later stages of mania, the patient may experience psychotic delusions, hallucinations, and rage.
Symptoms of depression can include deep sadness, fatigue, isolation, guilt, hopelessness, and anxiety. Depression may also cause a loss of sleep, sexual drive, interest in normal activities, and appetite. Depressive states are often accompanied by social anxiety, chronic pain, and lack of motivation. In later stages, those experiencing a depressive state may become suicidal and psychotic.
Symptoms of bipolar disorder usually first occur in childhood or late adolescence. Studies suggest that there are many factors that contribute to the disease, from early childhood environment, neurobiology, and genetics. The disease is diagnosed after other illnesses are ruled out. It is treated with counseling, therapy, and medications such as antipsychotic medications or mood stabilizers. Lithium is the most common medication for bipolar disorder.
Is Being Bipolar a Disability?
Bipolar disorder is a listed disability in the Social Security administration's impairment listing manual. This means that applicants with bipolar can automatically win disability benefits by satisfying the criteria in the bipolar depression listing. Alternatively, they can prove they can't perform their past work or even any other unskilled work to get a medical-vocational allowance. (If an individual's mental residual functioning is so restricted that he or she is unable to meet the demands of simple routine repetitive work activities, or if their functional capacity is so restricted that they are not able to perform or be trained to perform other jobs, a medical-vocational disability allowance is possible.)
Bipolar Disability Listing
Social Security's disability listing for bipolar disorder requires that you have had severe episodes of both depression and mania, and is quite complicated. To qualify as mania, you should have experienced three of the following during a manic episode:
- high energy and activity
- rapidly changing thoughts
- fast, frenzied talking
- decreased sleep
- high self-esteem
- easy distractibility
- risk-taking behavior, or
- paranoia, delusions, or hallucinations.
To qualify as depression, you need to have had four of the following symptoms during a depressive episode:
- decreased energy or activity
- loss of interest or pleasure in activities
- difficulty concentrating or thinking
- poor appetite or weight gain
- too much sleep or too little sleep
- guilty or worthless feelings
- suicidal thoughts, or
- paranoia, delusions, or hallucinations.
Lastly, you need to have had recurrent, lengthy episodes of worsening bipolar symptoms or serious problems with social functioning, focusing, or activities of daily living (ADLs).
If you don't currently have the above symptoms, you could qualify for benefits if your bipolar disorder has lasted at least two years and is being managed with medication, support, and/or assisted living, but still limits your ability to work because of the likelihood that a change in environment or job stress could cause you to have episodes of decompensation.
Evidence of Bipolar Disorder
Claimants with bipolar disorder should remember that disability claims are approved or denied mostly on the basis of medical records. You should strive to maintain a consistent and ongoing schedule of treatment. Ideally, this means having a history of treatment with a qualified psychiatric professional. This way your doctor can be recording the symptoms and limitations you experience during episodes of mania or depression so that the SSA can see if they match the SSA's criteria, above.
Qualifying for Disability on a Medical-Vocational Allowance
If the SSA decides that your condition isn't severe enough to meet the requirements for bipolar disorder, above, it must consider whether you can do unskilled work with your symptoms. If your symptoms ruin your ability to follow instructions, remember details, focus, or have appropriate social interactions, the SSA is supposed to grant you disability benefits via a “medical-vocational allowance.” Learn more about med-voc allowances for mental conditions.
It can be difficult to get a medical-vocational allowance for bipolar disorder, so if you are turned down at the initial state, consider hiring a disability lawyer to help you appeal. Having an experienced disability attorney can greatly increase your chances of winning benefits.