ASK Dr. LEEDOM: What is the difference between bipolar disorder and sociopathy?

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.

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14 Comments on "ASK Dr. LEEDOM: What is the difference between bipolar disorder and sociopathy?"

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Dear Tilly,

First off, I am confused about why you were “recently” (how recently?) “playing” this guy for “business reasons.”

It is also my understanding that gun ownership is prohibited in OZ so this must also mean he is a criminal.

Tilly, my dear, I am going to say this: NO MATTER WHAT gain you might get from any “business deal” with a psychoopath it is UNWISE TO EVER INTERACT WITH THEM…..”playing” them is like playing with a poison snake! Pretending to be just like them (especially the criminal ones with guns) is a good way to get yourself killed, which apparently they have threatened to do recently.

Tilly, in order to keep ourselves safe, and to use our good LF knowledge of what these people are capabale of for our benefit, pseudo-bonding with these people for a little “business deal” (or even a big one) is UNWISE to the LIMIT. Tilly, I’m not even inclined to “boink” you, I am STUNNED at you “playing with fire” like this. You have been through so much, WHY ARE YOU GOING BACK INTO THE BURNING BUILDING? What in that building is so exciting or valuable that you would do such a thing?

My personal opinion is that you need to take a good sit down and see what you got (outside of a “good deal”) in doing this dangerous thing. It sounds like it was “exciting” all right, is it the excitement you got from conning the con? I can definitely see why your son was frustrated with you dealing with these people. Tilly, you know I have great affection for you and that I pray for you, but keep in mind that “God helps those who help themselves.” God in my opinion can’t stop us froom destroying ourselves if we are determined to do so, and deliberately dealing with and trying to con a con is one of those SELF DESTRUCTIVE things.

I realize what I am saying may be hurtful to you, Tilly, and you know that my purpose is NOT to hurt you, but give you a heads up in what YOU are doing to expose yourself to this kind of person. You have to get through the class with the teacher for your own long term benefit, but dealing with criminals or people who exibit any signs of Psychopathy is TOTALLY NOT GOOD JUDGMENT OR WISE. (((Hugs)) and I always pray fo ryou.

Old post…new comment. Let me quote my statistician daughter before you start equating sociopathy with bipolar disorder…”Correlation does not imply causation.” Just because certain traits are seen to be common between sociopaths and those suffering from a bipolar condition does NOT mean they are related states. I am bipolar, and it was during a very severe manic episode that I became such easy pickings for a sociopath. My energy level and hyper-confidence made him take notice and my hypersexuality and total lack of impulse control made me easy prey. Yes, someone bipolar can be a sociopath and a sociopath can be bipolar. They do share several common traits, but I would argue against them being related conditions.
Just saying,,,,


Hi Bree,
thanks for bringing this up. I hadn’t read it.
It is hard to distinguish a spath at first because they know to display the inner triangle: ability to love, impulse control, moral standards. The key then is to recognize the red flags, particularly the three trick pony: charm, pity and rage.

That’s an easy one and they all use it, you just have to learn to recognize it.

I’m sorry that your bi-polar condition made you vulnerable. It’s possible that you would have been targeted either way. I’m not bi-polar but spaths zero in on me. I think they like how meek I appear to be. I’m Catholic and they assume they’ll be forgiven, especially since I wear a cross around my neck. Spaths look for anything they can to hook you.

As for the relationship between spath and bi-polar, I think Dr. Leedom nailed it: they both are about a brain function in the limbic system that has gone haywire. Bi-polar is temporary but spath is always messed up.

I’m glad you’re here healing with the rest of us. Learn as much as you can. Knowledge is protection. That’s what the name Skylar means! It’s why I chose it.

Thank you Skylar. You make a very good point when you say,”It’s possible that you would have been targeted either way.” This was not my first relationship with a spath – just the most destructive. I’m glad I’m here too. I feel like I’ve made more progress in these last few days than I would have believed possible. I spend time here every day now because it keeps me from trying to tell myself that it really wasn’t that big a deal. It keeps me from burying it in my subconscious and pretending that I’m not angry, that I’m not hurting and that I don’t need help.

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