A Lovefraud reader sent the following question:

I have friend who is diagnosed as manic depressive. He displays or exhibits some of the traits of a sociopath, but I read that being manic depressives clouds whether someone is a sociopath. I don’t want to believe he is a sociopath, but I also do not want to be a fool. Suggestions or thoughts? I have one person telling me he’s a sociopath and I need to run away from him as fast as possible. That seems like the cowardly thing to do though. If we approached all people with problems that way, where would our society be?

People with bipolar disorder have sociopathic traits only while manic

Thank you for writing in with this important question. Many people with bipolar disorder develop exaggerated sociopathic traits while in the manic state. I first learned of this as a psychiatry resident. I had an outpatient I had followed for several months. He was a high functioning kind, compassionate, person. However, he stopped his medication and was admitted in a manic state. I did not know of his admission until the weekend, while on call, I was called up to an emergency on the inpatient unit. The emergency was the patient I thought I knew so well. He was agitated, aggressive and behaved in a very manipulative way. He was also disconnected from the treatment bond he had formed with me. He was clearly NOT the same man I had seen the previous month in my office!

Sociopaths often have “manic moods”

While sociopaths seem less likely to develop depression, they can show symptoms of mania. Mania is an expansive mood where the person seeks increased involvement in goal directed activities. Manic people are high energy and sometimes hypersexual. I often thought that my former husband seemed a bit on the manic side. His mind always seemed to be on the go. He liked to talk a lot, especially on the telephone. He was also somewhat arrogant. The arrogant, grandiose attitude of sociopaths and narcissists, also overlaps with the grandiosity of mania.

Since mania and sociopathy share many common features they are likely related disorders

Here is a list of traits/behaviors common to mania and sociopathy

1. Increased energy
2. Grandiosity
3. Talkativeness
4. Hypersexuality
5. Pursuit of schemes to make money, legally and illegally
6. Strong power/dominance motive with or without aggression
7. Poor impulse control

If you look at the list, you may notice that these traits/behaviors are also seen with cocaine intoxication. The reason for the commonality is that these disorders are caused at least in part by disturbed function of the mesolimbic dopamine reward pathway of the brain.

How can an untrained person tell the difference between sociopathy and bipolar disorder?

In cases in the extremes of both disorders the distinction is clear. That is the person with bipolar disorder develops and episode where he has the symptoms. Sociopathy is not episodic. It is a way of life! However, there are many people with bipolar disorder who are also sociopaths. The sociopathy is much worse when they are manic.

The key to recognizing a person you want to have as an intimate friend, is the Inner Triangle. Ask yourself if the person has developed Ability to Love. Is he/she affectionate, empathetic and concerned genuinely for the well-being of others? Does he she show appropriate Impulse Control? Does he/she have high moral standards?

A friend of mine asked me recently if I ever planned on an intimate relationship with a man again. I told her that I had come to realize that there is no room in my life for a partner that lacks a well-developed triangle. I hope you will think about this post and make the same choice.