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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

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