Vicki L Mayfield, M.Ed., R.N., LMFT Marriage and Family Therapy Oklahoma City If you would like to send a question to Vicki, email us at

Q. I think one of my co-workers is bipolar. She can be so nice and easy to work with then, unexpectedly she is mean and hateful. Sometimes it feels like I am walking on eggshells, unsure what might set her off. She does not maintain friendships. People try to stay away from her. Do you think she needs medication?

A. Your co-worker might be bipolar or she might have a personality disorder or she might have both. Frequently, the diagnoses are used together.
First let me help you understand bipolar. Before the diagnosis can be made the individual must meet the following criteria for a manic episode(as listed in the Diagnostic and Statistical Manual of Mental Disorders, DSM)
1. A distinct period of abnormally and persistently elevated, expansive or irritable mood lasting at least one week.
2.During the period of mood disturbance three of the following symptoms have been present to a significant degree: *inflated self esteem or grandiosity *decreased need for sleep *more talkative than usual/speech is pressured. *excessive involvement in pleasurable activities that have a high potential for painful consequences (i.e., unrestrained shopping sprees, sexual indiscretions, gambling)
Now lets look at some diagnostic criteria for Borderline Personality Disorder.
* A pervasive pattern of instability of interpersonal relationships, self-image, and marked impulsivity beginning by early adulthood and present in at least five of the following:
* A pattern of unstable and intense interpersonal relationships characterized by “I love you/I hate you.”
*Identity disturbance markedly and persistently unstable self-image.
*Affective instability….raging is the most profound of the borderline symptoms. Lack of affective moderation, the “zero to 100” is frequently seen.
*Inappropriate, intense anger or difficulty controlling anger (i,e,.frequent displays of temper, constant anger, mean/hateful comments about others
So now you have something to think about. Yes bipolar disorder can be pharmaceutically treated and people who stay on their medications can function very well. There is no medication that changes borderline personality. Therapy is recommended, although many do not make the commitment for the long term treatment.
It can be difficult to work with someone who is manic but not as difficult as working with someone who is borderline. I hope this information is helpful.