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Bipolar Disorder

Bipolar Disorder

Living with Someone Who is Bipolar

Living with someone who has Bipolar Disorder can be difficult

Living with Bipolar DisorderI try (like many others I am sure) to keep Bipolar Disorder from wrecking my family.  I don’t always succeed.  In a lot of cases, it comes down to taking my medication on a regular basis (which historically I have not always done).  Even at the best of times, living with someone who has Bipolar Disorder can be difficult.  In some ways, it is probably harder to live with someone who is Bipolar than it is to be Bipolar yourself.

Having Bipolar disorder is just part of who I am.  It isn’t “good”, it isn’t “bad”, – it just “is”.  There are good days and bad days, but I expect that.  Just because someone else thinks I am having a “bad day” doesn’t mean that I experience it that way.  I don’t really know what it is like to live with someone who is Bipolar.  I only know what they say and how they seem to react.

InsaneLong before I was diagnosed, a roommate said to me, “living with you is like walking on eggshells”.  That kind of made me mad – and my response was something like “Well at least I wash my clothes”.  This had nothing to do with anything – except that she didn’t wash her clothes.

My husband once said, “Living with you is like waking up with a rabid animal.”  My thought was, “Then don’t talk to me when I wake up”.  In either case, I still believe that I wasn’t doing anything particularly wrong – unpleasant for them maybe – but normal for me.
There are some things that you can do to help yourself deal with a household member that is Bipolar.  Know these hints will not solve the problem, but they may make things better.

•    Don’t say things like, “I am not putting up with this Bipolar shit!”  First you will make them angrier than they already are. Second, you obviously are putting up with it, and they may feel compelled to remind you that you both live there, which will make you angry.
•    Do keep an eye on whether they are taking their medicationNormal and MiserableIf you can check on it in a prominent manner – do so, but likely you will have to sneak around them.  You can’t easily force them to take their meds, and subtle reminders will probably create an explosion. But you have to decide if the explosion is worth it – or just be prepared in case it is not.
•    Educate yourself so that you can see what “the disease” is, and what the person is.  Know that the disease is also a significant part of a person. Also, know that a lot of what you like about them is because they are bipolar.  While Bipolar Disorder makes things difficult, it also makes things interesting.
•    If you can watch for disruptions, try to be there to compensate.  Meaning; make sure children and other responsibilities are taken care of.  It does not mean that you must do all the work but remember you aren’t necessarily doing it for “them” but for the others that depend on them.
•    Try not to be angry at them for being who they are.  Again, part of what makes them interesting is the disorder and for a lot of use – we like who we are most of the time.  If you don’t like us, then leave.
•    Lastly, and most importantly – if you can, be there to pick up the pieces when it breaks – because with most of us, it usually will.

Whether it is a spouse, child, a sibling or roommate, you will have to make a decision.  If you can put up with the mental disorder, that’s great.  You can help them, but you can’t change them.  They can’t change being Bipolar, and criticism never helps.

Melissa

Living With Someone Who’s Living With Bipolar Disorder:

Living with someone who is living with bipolar disorderA Practical Guide for Family, Friends, and Coworkers is an essential resource for anyone who has a close relationship with a person who has Bipolar disorder.
This book provides a much-needed resource for family and friends of the more than 5 million American adults suffering from bipolar disorder. From psychotic behavior that requires medication to milder mood swings with disturbing ups and down, this book offers a warm and often humorous user-friend guide for coping with bipolar loved ones, colleagues, and friends.

The book includes Guidance for identifying bipolar disorder symptoms and how to get the diagnosis confirmed Strategies for dealing with rants, attacks, blame, depression, mania and other behaviors. The book includes crucial information on medication and its effectiveness, potential side-effects and techniques for dealing with attempts to self-medicate with drugs and alcohol.

How many people with bipolar disorders can care for themselves, get help, feel supported and go on with their own lives? This important book contains real-life illustrative examples and a wealth of helpful strategies and coping mechanisms that can be put into action immediately.

Bipolar II – Really?

Is it Bipolar II – or just plain Bipolar Disorder not yet recognized?

Google “Bipolar” on the “news” tab and see what you find.  It is astounding how many semi-celebrities have come out and said “I have Bipolar Disorder”.  Unfortunately, the story is often about Bipolar II, which somehow makes it “better”.

Bipolar Disorder is still a serious stigma – prevents people from getting jobs and such.  Technically, as Bipolar Disorder is considered a disability, an employer who did not hire or fired an admitted bipolar patient based only on that fact would be in violation of the American Disabilities Act, but few people are willing to go to the carpet on that.  Plus there is the little issue of being “able” to perform one’s job.  I can perform a job if I am taking meds.  If I am off of meds, I become highly unreliable with a lot of other liabilities – risky behavior that I have decided not to discuss.

Only a couple of years ago, I was warned by a well-meaning family member against posting too much on social media about Bipolar Disorder – and this in his mind included “liking” too many Bipolar pages.  He was concerned about my ability to obtain a decent job.  I don’t know if I have a “decent “job today – I have made my own way which works out better for me – no boss to annoy, no dress code, nobody else’s time clock.  For the most part, I don’t worry about social media – I don’t think I will ever have a “real” job again – no more frequent flyer miles for me.

Bipolar 2I was once diagnosed as Bipolar II – but really, both the doctor and the therapist thought differently – they both knew that I had regular Bipolar Disorder but wasn’t ready to accept it.  Actually, I am pretty sure my doctor tricked me into taking Lithium for the first time by telling me that it would help boost my antidepressant activity.

In retrospect, I am astounded that I believed him since I know so much about medication – but I took the medication.  How many of these people really have Bipolar I Disorder and just don’t say so.

It is much easier for people to say and accept that they have Bipolar II.  In my opinion (which is obviously vast and knowledgeable – just kidding, no really), Bipolar II is a way of sliding by the real diagnosis.  As in “I have Bipolar Disorder but not really”.  “I have Bipolar Disorder but I am not crazy”.  “I have Bipolar Disorder but I am not dangerous”.  “I have Bipolar Disorder but I won’t embarrass you”.
When it gets down to it…wasn’t that true for all of us at one time?  Or at least didn’t we believe it at one time?  I still fit some of the criteria – I am “functional”, “productive”, “hypomanic” – except when I am not.

I often confuse my doctor when he asks how it is going by saying “good enough”.  What I mean is that I am not manic exactly, I am not depressed.  Actually it works better for me if I am teetering on the edge of mania.  If I am just crazy enough that I know that I am crazy – then I will keep taking my meds.  Because I forget.

I originally sought treatment for severe depressiondepression bad enough that I had to decide whether to kill myself or study (I had a big exam the next day).  In retrospect, I was actually in a mixed episode with plenty of energy but in a really bad mood.  Oh, and then there was the slight issue of the hypnogogic hallucinations which I denied at the time.  See, even if I know that I have Bipolar DisorderManic Depression – I still forget.

It would be easier for me to say that I have Bipolar Disorder but it is “just” Bipolar II.  I thought that too.

Melissa

Bipolar Disorder and Risky Behavior

One of the most attractive facets of the “symptoms” of Bipolar Disorder is “risky behavior”

Even though this symptom irritates me, it is true. Actually, most of the medically described symptoms of the disorder irritate me.

Probably the reason this symptom bothers me is that like many others, I forget or wish to deny my own risky behavior.  I personally have wanted to think that I am, above all, that – and that my activities were justified which my therapist would say is oppositional behavior and really another symptom of Bipolar Disorder.

Not wishing to go into the specifics of risks that I have taken, I will say that upon honest examination, they have been many.  Because of Bipolar Disorder, I feel compelled justify them.  As a Bipolar, I could go on and write in circles about why I did what I did but really coming back to the same conclusion.  Technically, they have been justified, because I was ill.

Dangerious BehaviorExamples of risky behavior include things such as promiscuity, drug or alcohol abuse, shoplifting, gambling, excessive spending, infidelity, putting yourself in physical danger and others.  The obvious examples of this are celebrities who get into legal trouble because of risks they have taken – such as shoplifting, public exposure, public drunkenness, and drunk driving.  There is no logical reason for a celebrity to steal or shoplift as the things they steal “necessities” and that they can clearly afford to purchase.  There is also no reason for a celebrity to drive repeatedly drunk as they can usually afford a driver, and there is hardly ever a reason for public exposure.

Do I feel guilty for any of the risks I have taken?  Really, I don’t.  Were they against my moral values?  Really, they weren’t.  I certainly have regrets but no guilt.  I regret doing those things because of the trouble I caused and sometimes because they were things that others could judge me for.  Still today, even though I am well stabilized on medication, I am not sure they were against my morals.  Intellectually, I know that some of them were considered “wrong” or possibly illegal but that is the judgment of others, and my judgment system is different.

Guilt is defined as knowing that you did something wrong.  Shame is a judgment that others impose upon you to try and make you feel guilty.

Recently I read that bipolar patients wish to avoid feeling, choosing instead to think.  I agree with that (and I feel compelled to justify my agreement) by also adding that I also think that this is because people with Bipolar Disorder also feel too much.

Fortunately, today I am stabilized on medication and usually don’t exhibit risky behavior.  I haven’t had an episode in a few years – since the last time I quit taking my medication.

Melissa Lind

Psychiatric Disorders and Geniuses

A lot of people like to think of themselves as geniuses.  Probably even more people with psychiatric disorders like to think of themselves as geniuses.

MichelangoWho can blame us – with examples such as Albert Einstein, Edgar Allen Poe, Beethoven, Michaelangelo, Charles Dickens, Ernest Hemingway, Winston Churchill, Charles Darwin, Isaac Newton… just to name a few.

As all of these stellar personalities are now deceased and most died before the advent of modern psychiatry, we can only surmise their disturbance – their genius however is clear.

Aristoteles, a Greek philosopher, once said, “There is no genius without having a touch of madness.”

Today, most who are diagnosed with a mental disorder– be it bipolar disorder, schizophrenia, borderline personality disorder, obsessive compulsive disorder, or even major depression, would be classified in previous times as “mad”.

A recent article in Psychiatric Times, by an actual physician – Nicholas Pediaditakis – attempts to link the occurrence of major mental disorders and geniusFreud called the difference in “temperament” of genius from that of “normal” people – “narcissistic neurosis”.

The basic theory as proposed by the author of the article says that people with certain mental disordersbipolar disorder, schizophrenia, and OCD in particular – ‘tend to “think” the world rather than “feel” it.’  He goes on to say that many are dysphoric and tend towards feeling a void and aloneness within themselves which can often lead to substance abuse and suicide – all too true.  His conclusion is that these illnesses cause an absence of adherence to social norms, not because you want to, but because you have to – but that it frees up parts of the brain for creative processes.

In addition, many artists, actors, comedians, writers acknowledge that much of their creativity comes from painpsychic pain not physical pain that is often experienced by those with mental disorders. This doesn’t seem to translate to genius in science, math, or other concrete areas, but the idea of a mind that has free space to concentrate on specialty areas does fit.

While I, personally, find offense in part of his statement (the part about wanting to think rather than feel) – I also find it true.  I, and those I know, would rather “think” rather than “feel”, but often we feel too much and cannot stop.

Aside from my bristling at the implication that mental illness is a choice – I find it amusing that science may be able to prove that there is a “mad genius” in me – someday.

Melissa Lind

A genius with a psychiatric disorder.

Bipolar Disorder and Adolescents

Symptoms of bipolar disorder in children and adolescents may look like other disorders

Traditionally bipolar disorder has been thought to first show in early adulthood – and more often in females.  Bipolar disorder was considered to be quite rare as few as 20 years ago, to be more exact. The first emergence came in the early 20s, mainly in females. But, our knowledge about bipolar disorder has grown rapidly in the last 20 years.

Instead of the single manic-depressive diagnosis – which included diagnostic criteria of both depressive periods, alternating with manic periods – described as “euphoria”?

Those who did not have clearly rhythmic, alternating periods of a “happy” and frantic manic phase with a classic depression period were mishandled, misdiagnosed, mistreated, or dismissed.

Bipolar ChildrenIn addition, it wasn’t really known that bipolar disorder could start in adolescence or even childhood, or that there are different types of bipolar disorder.  Today, it still isn’t “officially” recognized in the “psychiatric bible” – the Diagnostic Statistical Manual of Mental Disorders (DSM), but at least more practitioners do know that it exists.

Today, we don’t exactly know what causes bipolar disorder (only that there is a genetic link of some kind, and often some past trauma). But, we can at least identify adolescent and childhood bipolar illness.  We also recognize a variety of different types of bipolar disorder (Such as mixed manic episodes, rapid cyclers, people without a depressive phase, hypomania, dysphoria rather than euphoria and cyclothymia). We also have a “catch-all” type – Bipolar NOS or “not-otherwise-specified”.

Adolescent or childhood bipolar disorder is official known as: “early onset bipolar disorder”.  In fact, childhood bipolar disorder can be more serious than a similar disease in adults and may have slightly different symptoms.

Symptoms of bipolar illness in children can often be more severe, and the cycling period may be more frequent.  Children also have more mixed episodes.  Children also have slightly different symptoms – so even the depression phase of the cycle may not be obvious.

Pediatric patients (children and adolescents) with bipolar disorder may have:

Bipolar Disorder in Children•    Abrupt mood swings
•    Periods of hyperactivity followed by lethargy
•    Intense temper tantrums
•    Frustration
•    Defiant behavior
•    Chronic irritability

These symptoms have to appear in more than one setting (school and home) and cause “distress”.

The problem is that many of these symptoms may look like other disorders.  They might be disorders such as ADHD, childhood depression, anxiety disorder, obsessive compulsive disorder, conduct disorder, premenstrual syndrome, oppositional defiant disorder and others. The danger might come from a misdiagnosis and improper treatment.

Bipolar disorder is treated with anti-manic agents (lithium), anti-convulsants (Depakote, lamotrigine) or atypical antipsychotics (Abilify, Risperdal).  In many cases, anti-depressant won’t be needed.  Treatment for other disorders like ADHD or depression may make bipolar disorder worse. Childhood bipolar disorder is something that desperately needs treatment as the distress caused to the patient, and the family can predispose the youngster to

•    Drug or alcohol abuse
•    Stealing
•    Involvement with law enforcement
•    Poor social integration
•    Poor academic performance
•    Suicidal tendencies
•    Premature sexual behavior

The Balanced Mind has a good self-check list of symptoms that can help a parent or a teen decide if bipolar disorder might be an issue.  Self-testing is not always accurate and should be discussed with a doctor, (preferably with test results in hand).  Not all doctors accept pediatric bipolar disorder. Parents may have to seek advice from more than one mental health professional and be aware that insurance may not cover the illness.

Melissa Lind

Ellen Forney – Bipolar Artist and Author

A bipolar book by the cartoonist Ellen Forney

Nearly 3 percent of adults in the U.S. have bipolar disorder – and that is known cases.  The question might be – how many people have it that don’t know about it?  Still, 3 percent is quite high, and the World Health Organization lists Bipolar Disorder as the “sixth leading cause of disability in the world”.

People with Bipolar Disorder face innumerable challenges – some personal, some professional.  Aside from the daily struggle to come to terms with the mental illness and manage symptoms, relationships and medicationbipolars often face stigma in the “regular” world.  Whether it is family members, friends or work associates, unless they have bipolar disorder, they are likely to have a skewed image and often little understanding.

Bipolar-1 Disorder - Ellen ForneyCartoonist Ellen Forney, of Seattle Washington, also a teacher at the Cornish College of the Arts released a graphic memoir – a graphic novel produced in a manner similar to her other published work.  In it, she describes what it is like to be bipolar from her perspective and how she struggled to find the right treatment.  Forney, along with her book; “Marbles: Mania, Depression, Michelangelo, and Me: A Graphic Memoir” were recently featured in the Huffington Post.

Being of an odd combination of scientist and artist – and particularly nosy. (some would call it inquisitive – but I prefer just nosy)

I have read a lot of books on bipolar disorder. I have read professional journals, research papers, self-help books, and books written by people with bipolar disorder – most of which were supposed to explain the illness, how to treat it, or tell what it is like to be bipolar.

Some of the books were well written, some were sadly misguided.  The most famous book by Kay Redfield Jamison, “Unquiet Mind” is considered “THE” book by many people, professionals and patients alike.  Though it is well-written, educational, and true – it doesn’t always fit, and many who are bipolar probably can’t read it when they need to.

Ellen Forney’s book is different.  It isn’t a manual; it isn’t a self-help book, it is simply a terrific depiction of bipolar disorder and even if you aren’t bipolar yourself, you should check it out. It is worth a look.

Melissa Lind

“Sex in Comics:” The bipolar Ellen Forney and R. Crumb

•    “My own BRILLIANT UNIQUE personality was neatly outlined right there, in that inanimate stack of paper.”
•    “My PERSONALTY reflected a DISORDER…”
•    “… SHARED by a group of people.”
•    “This sank in like the sun had gone behind the clouds…”
•    “… like I`d been covered by a heavy blanket, like a parrot…”