Q:   Is There a Personality Type Associated w/Bipolar Disorder?

Just out of interest - is there in your opinion a personality type that is associated with bipolar disorder? I recently attended a bipolar lecture given by a psychiatrist and he said that most people with bipolar disorder are outgoing and extroverted. I have bipolar disorder - but i am certainly not considered an extrovert - i would describe myself as very sensitive, shy, but adventurous, with lots of drive and also very creative and imaginative. I can be extremely 'social phobic' at times - but then again - with people i feel comfortable with, i can be quite lively. Is it a myth that those with bp are typically 'outgoing' and extroverted?


Dear Emily –

One particular psychiatrist has spent much of his research career trying to answer your question. actually, he is done a vast amount of research on many aspects of bipolar disorder, but “personality type” (which we might refer to using the official jargon term, “temperament”) is one of them.  I refer to the work of Dr. Hagop Akiskal, and colleagues.  He is a professor of psychiatry at the University of California at San Diego, leader of their international mood disorders clinic.

For example, searching PUB MED , the National Library of Medicine website, using the search term temperament bipolar. the first article was by a colleague of Dr. Akiskal’s, and the second was authored by a team including Dr. Akiskal himself. In other words, there is someone whose opinion on this is informed by a lifetime of research – as opposed to the psychiatrist you heard from recently (perhaps he was just making an off-the-cuff remark.)

Here’s my interpretation of Dr. Akiskal’s work in this realm: true, some people with bipolar disorder have “hyperthymic temperament”. when they have manic symptoms, they tends to be of the euphoric/grandiose type. other people with bipolar disorder, however, have “irritable temperament”; when they have manic symptoms, these tend to be irritabile and dysphoric ( and, according to his December 2008 paper, a higher likelihood of suicide as well). Another group of people who have bipolar disorder have been recognized to have “depressive temperament”.  As you can imagine, the dominant shift in their mood is toward depression.  Finally, there is “cyclothymic temperament”, in which people have relatively unstable mood/energy that seems to go up and down more than average.

Importantly, people can have these temperamental traits and not have bipolar disorder at all.  Think about it: you know some people who are just “up” people, bubbly and energetic and full of ideas and charisma.  This is hyperthymic temperament. Such people are more likely than others to have a bipolar relative. In other words, there is thought to be a genetic connection. But that’s as far as the connection goes. It’s true that people with classic, manic-depressive pattern Bipolar I, the folks who have classic euphoric manias, commonly have hyperthymic temperament. But there are numerous other temperaments that can show up in bipolar disorder, reflecting the many different variations of this illness.

Dr. Phelps


 

Published February, 2009