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Q&A: Bipolar Disorder and Sociopathy

QUESTION: I have A LOT of questions pertaining this one idea since I'm so determined to get the character's psyche right. I'm writing a story in which my character has un-diagnosed bipolar disorder.
  • How would this, if left untreated, affect a sociopathic character?
  • I know that bipolar disorder gets worse if left untreated, but how much worse could it get before the character is driven to suicide?
  • HOW, specifically, would the disorder get worse?
  • What would have to have occured in his childhood to spark the desire to kill?
  • What would prompt him to choose his victims? Is it just random or would a small force (specifically, accidentally insulting them) set him off?
  • Would the antisocial personality disorder account for the bipolar symptoms, or would they have two completely different sets of symptoms?
We have two different diagnoses going on here, right? Bipolar I disorder (the worst form of bipolar d/o) and Antisocial Personality Disorder (the official name for sociopathy).

Let’s make sure we get each one defined first. Bipolar disorder means your character has both devastating major depressive episodes and full-blown manic episodes. To be diagnosable, these episodes should cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

You also note that the character has not been diagnosed – in other words, no counselor or doctor has said “this is bipolar disorder” and suggested treatment.

The most notable way that bipolar disorder may affect sociopathic behavior is that during manic episodes, when the character’s judgment and impulse control go down, he may do things that are more hurtful to others than someone might otherwise. In other words, the manic episode exacerbates the sociopathic behavior.
I know that bipolar disorder gets worse if left untreated, but how much worse could it get before the character is driven to suicide? HOW, specifically, would the disorder get worse?
If bipolar disorder goes untreated, the character will begin to swing more rapidly between manic and depressive episodes, and the episodes may become more intense. “Rapid cycling” bipolar disorder means that there are at least two cycles a year (mania, depression, and then again, mania, depression). In other words, the character is cycling over months rather than over years. Ultra-rapid cycling occurs over weeks to days, and ultradian cycling happens over days.

Note that rapid cycling happens more as someone becomes older if the disorder is untreated. Also note that your character doesn’t have to be cycling ultra-rapidly if you want him to be moody. Since people with bipolar disorder have a mood “thermostat” that is easily knocked off balance by things like stress, he can be a mercurial sort even if he isn’t cycling rapidly from up to down and vice versa.

Suicide is not always a given with a mood disorder.  Many people consider suicide to try to escape the pain of such extremes in mood, but others do not.  And of those who consider it as an option, only some choose to act on it.
What would have to have occurred in his childhood to spark the desire to kill?
Okay, now we’re talking about the sociopathy. Typically there are a few different things that can trigger the type of dangerousness you’re interested in. The most common are abuse and severe neglect. Children who grow up around violence tend to learn violence as an acceptable way to deal with problems.

Some genetic mutations, brain abnormalities, and frontal lobe (of the brain) injuries can also contribute. You can probably get away with that generic info, but if you want more details, I suggest picking up a copy of my forthcoming book, The Writer's Guide to Psychology: How to Write Accurately About Psychological Disorders, Clinical Treatment and Human Behavior.
What would prompt him to choose his victims? Is it just random or would a small force (like, specifically, accidentally insulting them) set him off?
Most people with APD recognize that breaking the law will get them locked up if they get caught. So they’re probably not going to flip out on someone for something small…unless, of course, they’re in the middle of a manic episode, when their judgment is extremely poor.
Would the antisocial personality disorder account for the bipolar symptoms, or would they have two completely different sets of symptoms?
Definitely two different sets of symptoms! They’re two totally different disorders.

Need accurate and easy-to-understand information on bipolar disorder, antisocial personality disorder, or why villains act the way they do for your story? I've got you covered with lots of information on all of those topics in The Writer's Guide to Psychology: How to Write Accurately About Psychological Disorders, Clinical Treatment and Human Behavior at your favorite online bookstore today! Pre-order a copy now!


Remember, if YOU have a psychology in fiction question you want to see answered here, use the Q&A form on the Archetype site.

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