Reviewed by Aaron Horn, LMFT
The subject of this article is difficult to discuss because the answer depends greatly on the mental state of the person with bipolar disorder. Most of the time, most people with bipolar disorder have a sense of right and wrong that is equal to a “normal” person. However, people with bipolar disorder have their world view distorted during episodes of mania or depression and may have difficulty distinguishing right from wrong.
This question over discerning right from wrong pervades the world view of mental illness, and whether the sufferer can differentiate right from wrong is asked of many different types of disorders. This article will go over some of the background information, pertinent discussions of morality and hopefully fully answer this complicated question.
Bipolar Disorder As A Spectrum
It is vital to know that bipolar disorder varies in severity within each person. This means that someone can have severe bipolar disorder, while another person has a milder version. During times of the year they can become stabilized where they function like a neurotypical person. Also, while some people can experience psychosis, others with bipolar disorder never come close to losing control.
Someone with bipolar disorder can behave like a normal person when stable, and when very sick, that same person can have a total lack of control. The ways in which people with bipolar disorder could theoretically lose control is extremely varied, and this article will go over some of the major ways. First, there needs to be a brief discussion of bipolar episodes and their major symptoms.
Background Information On Bipolar Disorder
Bipolar disorder is made up of difficult episodes of highs and lows. Medical professionals refer to the ups and downs as mania and depression, respectively. Additionally, mixed episodes exist, which is diagnosed when bipolar patients have simultaneous manic and depressive episodes.
Bipolar disorder is also divided into subtypes, including Bipolar I, Bipolar II, and Cyclothymia. Bipolar I has mania, and Bipolar II has hypomania. Hypomania and mania are the same things, but mania is stronger and more severe. Cyclothymia has a milder form of episodes overall.
As will be mentioned later in this article, mania is most likely to have psychotic symptoms. Psychosis is one of the most dramatic ways in which people with bipolar disorder can lack the ability to see right and wrong. All forms of bipolar disorder are dangerous when untreated, but Bipolar I is the most likely to have psychotic features.
Below are symptoms associated with bipolar episodes.
Mania symptoms include:
- Elevated, expansive, or irritable mood.
- Increased energy, agitation.
- Lessened need for sleep. Energy levels stay similar or are raised despite the lack of sleep in mania.
- Forced speech. This is the difficulty of stopping talking.
- Uncontrollable, racing thoughts.
- Unable to focus.
- Symptoms last for at least a week, or hospitalization is required.
Depression symptoms include:
- Depressed mood. This can be defined as a general sadness.
- This is a loss of interest and/or pleasure.
- Weight loss. This does not include deliberate weight loss.
- Sleep problems. This can include insomnia and hypersomnia.
- Loss of energy.
- Loss of concentration.
- Suicidal thoughts.
- Symptoms last for a period of two weeks.
If you think you may be suffering from bipolar disorder or would like to know more, feel free to take a free diagnostic test at https://www.mind-diagnostics.org/bipolar_disorder-test. The results are confidential, and they may help you to learn something about yourself.
Bipolar Symptoms And The Bipolar Spectrum
Now that you know more about bipolar disorder, its episodes, and the symptoms of those episodes, it can be easier to understand the bipolar spectrum. This is crucial for this discussion.
For example, somebody dealing with the lower end of the impulsivity of mania may get into trouble by telling inappropriate jokes at a party. They may be annoying people or perhaps offending some, but it is mostly harmless.
Now, if that impulsivity becomes intense and out of control, that same person may attack or threaten another person or do some other incredibly inappropriate behavior. It is a matter of severity with many symptoms.
The same can be applied to the other symptoms of bipolar disorder. For example, you are technically dealing with insomnia if you toss and turn in bed for an hour. But, somebody dealing with extreme mania can be up for days, which could lead to dangerously irrational behavior.
People with bipolar disorder have the potential to live full, rich, and rewarding lives. Yes, they can say the wrong thing or make a mistake, but when the bipolar person is healthy, they fully understand right from wrong to the same extent that a neurotypical person does. However, people with bipolar disorder have the potential to become mentally ill where they may have difficulty understanding right from wrong.
If you ever meet a bipolar person who has lost control and is struggling to know right from wrong, you should view them as a sick person who needs to get help from a mental health professional. They are not bad, or purposefully intending harm; they may be an extremely ill patient who needs professional help.
Obviously, this article cannot detail every scenario in which a bipolar disorder may lose control. What follows is a few of the major examples of where a bipolar patient may struggle to see right from wrong.
Bipolar Disorder And Suicide
Suicide is probably the starkest example of a mentally ill person, not knowing right from wrong. First and foremost, if you have any suicidal thoughts, please contact the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline is available 24 hours a day, seven days a week.
Many suicidal people feel as though taking their own life is the only reasonable solution to their problems. It is not a solution, and suicide affects the friends, family, and everyone else associated with the lost person. It is a prime example of not knowing right from wrong as it negatively affects the entire community.
Suicide is present in mania, depression, and mixed episodes with bipolar disorder, and it is a major part of the disease. People with bipolar disorder are between 10 to 30 times more likely to commit suicide.
As suicide is never the answer, suicide is one of the most common and devastating ways in which a bipolar person can struggle to know the difference between right and wrong.
Psychosis And Lack of Control
Another way in which some people with bipolar disorder lose the distinction between right and wrong is psychosis. Psychosis is generally defined as an inability to recognize what is real in the world, often as a result of hallucinations or delusions. It is extremely dangerous, and psychosis is most often found during mania with bipolar disorder.
There are plenty of intense stories about people with psychosis doing all sorts of dangerous things. It is important to know that the person undergoing the event is extremely ill and needs medical attention.
Bipolar disorder can be diagnosed alongside a variety of disorders. In addressing a bipolar person’s ability to differentiate right from wrong, it is important to address this question on a number of associated illnesses.
For example, bipolar patients often have difficulty with food or substances in the form of an eating or substance use disorder. In these instances, the mentally ill person may be aware of right and wrong, but they feel compelled to do what they know is wrong. In essence, they cannot help themselves.
The same can be said for many other issues with personality, mood, anxiety, or other disorders. The mentally ill person can see right from wrong; they know that they are incorrect, but they just cannot help themselves.
As symptoms worsen, it is important for the sick person to seek help. There are many different solutions out there, and help is always available in one form or the other.
A loved one watching the other person’s struggle can be of assistance. One way is to understand that the mentally ill person is sick and not bad. Oftentimes, the two are misconstrued, and the person’s behaviors are considered immoral instead of needing medical attention.
This is a tough question to answer and a difficult topic to discuss. In short, people with bipolar disorder have a regular moral compass when they are in control of their illness. They may make mistakes, but they understand right from wrong as well as anybody else. Most people who adequately treat their illness can live healthy lives.
However, if bipolar symptoms and episodes become severe enough, people with bipolar disorder may have a warped view of right and wrong. If you or someone you care for is experiencing this severe of symptoms, please contact a medical professional.
This potential for erratic behavior can cause a great deal of difficulty and stigma for the life of the bipolar person. It does not have to! With the right treatment and guidance, people with bipolar disorder can live long, healthy, and fulfilling lives with full cognition over right versus wrong.