Bipolar Disorder*

This is a place for those who have Bipolar Disorder to discuss the torment of living with this condition and also for those who love someone who has Bipolar Disorder to find information and support on how to deal with your loved one.

From high to low. From mania to depression. From recklessness to listlessness. These are the extremes associated with bipolar disorder, a mental illness characterized by mood instability that can be serious and disabling. Bipolar disorder is also known as manic-depression or manic-depressive illness — manic behavior is one extreme of this disorder, and depression is the other.

The deep mood swings of bipolar disorder may last for weeks or months, causing great disturbances in the lives of those affected, and those of family and friends, too. Today, a growing volume of research suggests that bipolar disorder occurs across a spectrum of symptoms, and that many people aren't correctly diagnosed. Left untreated, bipolar disorder generally worsens, and the suicide rate is high among those with bipolar disorder. But with effective treatment, you can live an enjoyable and productive life despite bipolar disorder.

Bipolar disorder symptoms are characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of signs and symptoms can vary from mild to severe. There may even be periods when your life doesn't seem affected at all.
Bipolar disorder symptoms reflect a range of moods.Bipolar disorder symptoms reflect a range of moods.

Manic phase of bipolar disorder
Signs and symptoms of the manic phase of bipolar disorder may include:

* Euphoria
* Extreme optimism
* Inflated self-esteem
* Poor judgment
* Rapid speech
* Racing thoughts
* Aggressive behavior
* Agitation
* Increased physical activity
* Risky behavior
* Spending sprees
* Increased drive to perform or achieve goals
* Increased sexual drive
* Decreased need for sleep
* Tendency to be easily distracted
* Inability to concentrate
* Drug abuse

Depressive phase of bipolar disorder
Signs and symptoms of the depressive phase of bipolar disorder may include:

* Sadness
* Hopelessness
* Suicidal thoughts or behavior
* Anxiety
* Guilt
* Sleep problems
* Appetite problems
* Fatigue
* Loss of interest in daily activities
* Problems concentrating
* Irritability
* Chronic pain without a known cause

Types of bipolar disorder
Bipolar disorder is divided into two main subtypes:

* Bipolar I disorder. You've had at least one manic episode, with or without previous episodes of depression.
* Bipolar II disorder. You've had at least one episode of depression and at least one hypomanic episode. A hypomanic episode is similar to a manic episode but much briefer, lasting only a few days, and not as severe. With hypomania, you may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine and functioning, and you don't require hospitalization. In bipolar II disorder, the periods of depression are typically much longer than the periods of hypomania.
* Cyclothymia. Cyclothymia is a mild form of bipolar disorder. Cyclothymia includes mood swings but the highs and lows are not as severe as those of full-blown bipolar disorder.

Other bipolar disorder symptoms
In addition, some people with bipolar disorder have rapid cycling bipolar disorder. This is the occurrence of four or more mood swings within 12 months. These moods shifts can occur rapidly, sometimes within just hours. In mixed state bipolar disorder, symptoms of both mania and depression occur at the same time.

Severe episodes of either mania or depression may result in psychosis, or a detachment from reality. Symptoms of psychosis may include hearing or seeing things that aren't there (hallucinations) and false but strongly held beliefs (delusions).

How do you get motivated to get things done around the house?

Do you dread going to bed at night or just enjoy staying up all night? I love the night time because everything is so quiet and peaceful. Daytime makes me nervous there is just too much going on.

I'm fighting depression right now. Don't know what I hate the most, the mania or the depression........

How to love someone who is Mentally Ill

The short answer, of course, is: love someone who is mentally ill as you would love anyone else—unconditionally, with all your heart—but don't expect that love to be reciprocated, and don't expect everything to just "get better" one day, because it probably won't.

Mental illness can come in all shapes and sizes; trying to maintain a relationship with someone who suffers from mild depression is a walk in the park compared to trying to work things out with an individual with schizophrenia or bipolar disorder. So there is no silver bullet, no panacea...each relationship has its own parameters and its own rules—the most important being that those parameters and rules are subject to change at almost any time.

Back in grad school, I dated a young woman who, as it turns out, suffered from bipolar disorder. I won't get into the gory details of the relationship, but suffice it to say that bipolar disorder can manifest itself in a billion different terrible ways, the most frequent of which being a pendulum that swings back and forth between "I love you, I can't imagine my life without you" and "I hate you, I can't stand you, get the hell away from me."

I don't want to generalize about people who have this particular disorder (because it does indeed manifest itself in different ways depending on severity), but it's not uncommon for bipolar individuals to have trouble with impulse control, to have trouble maintaining stable relationships, to fear commitment, and to intentionally sabotage relationships even when they're (miraculously) going quite well.

Loving an individual with a mental illness is tricky; it takes patience and a degree of self confidence lacking in most of us (including, apparently, your humble author). It's difficult not to get angry when your boyfriend or girlfriend tells you, "I love you," one minute and "I never should have left my last boyfriend/girlfriend" the next. It's difficult not to be crushed when you realize that you really care for someone and, meanwhile, they're doing fairly awful things behind your back.

The situation actually seems to be worsened if you understand the underpinnings of the disorder involved. I stayed in the relationship mentioned above way too long, despite all the lies and deceitfulness, despite the fact that I only felt she genuinely cared for me about half of the time. I stayed in the relationship because the excuse—you know I'm sick, honey...I didn't mean what I said—rang true with me. I spent a good deal of time in my undergrad years taking courses in psychology and the philosophy of psychopathology and I agree with the materialist point of view: we are very much the sum of our genetic code and our environment, and we have very little (if any) free will.

So who am I to judge? How can I really condemn a person for acting in a way that is very much a part of her nature, a part of her illness? Should she really be held accountable for things she can't control?

So when she apologized, it seemed genuine. And hell, I have no doubt that it was genuine. But what took me so long to realize was that apologies didn't matter, best intentions didn't matter, and, in this case, love didn't matter, either. Because every apology was followed by more thoughtless actions...because despite best intentions, we are who we are, and some mentally ill individuals (even when medicated) simply lack the capacity to see their own actions with any type of perspective or introspection. They don't mean to hurt people, but they do—and, often, they will continue to do so, because that's the nature of the disease.

Looking back on that relationship, I often ask myself: Why did I put myself through so much hell, just so she could hurt me, apologize, and then proceed to hurt me again and again, over and over? It seems like a stupid question. What, was I a glutton for punishment or something? Why did I hang around when I knew that any love she felt for me was fleeting at best—why did I hang around when I knew that she was never going to "get well?"

Ah, but therein lies the rub. Implicit in any relationship with any mentally ill person is often the belief that "one day s/he will get better, and everything will be okay." It's a stupid thing to believe, but we believe it nonetheless because it's human nature to believe perseverance pays off...that if you try hard enough, things will work out. This may indeed sometimes be the case, but with individuals who are mentally ill, it often just leads to heartache.

Put simply, the mentally ill often play by a different set of rules. We try to interact with them, to work things out with them, to maintain our relationships with them; but in the end, we're often inadequately prepared.

Sadly, my understanding of this subject runs deeper than memories of some failed relationship from years past. Mental illness has taken a toll on my own family, and loving a family member who is sick in this way can often seem like an impossible task.

I've written about my sister before. Life with a family member who suffers from mental illness (in this case, Borderline Personality Disorder) is stressful as hell, to say the least. With some Borderlines, you can trigger an episode just by saying something seemingly innocuous; life becomes an exercise in walking on eggshells. You can't treat the person you love the way you used to for fear of hurting that person's feelings, driving them away, or otherwise wrecking the relationship.

My sister and I used to be best friends. Now I view my relationship with her differently, in a way that is difficult to explain. I still love my little sis, and I'm sure I always will—but loving her has taken a back seat to making sure I'm prepared for whatever might happen next. I've lived through her drug abuse, her attempts at suicide, and her subsequent involuntary commitment to a mental institution.

When I think of my sister, instead of thinking, "Gee, I sure love her," I find myself thinking, "Good god...what's next?"

The answer to that question came recently: she's moving to Dallas. After spending a few weeks with an ex-boyfriend of hers, she's decided to pick up her life and move in with him. No matter that this ex-boyfriend is diagnosed manic-depressive (and off his meds). No matter that this ex-boyfriend has been known to cut himself and abuse all kinds of drugs. No matter that their relationship already failed years ago. None of these things matter to the mind of a Borderline, who are notorious for having difficulty with impulse control.

She's moving hundreds (hell, maybe even thousands) of miles away, to a place where she knows no one (except the ex-boyfriend), to a place where she has no support structure to catch her if and when this latest scheme fails. The last time I wrote about my sister, I suggested that her killing herself was inevitable, that I was simply glad she hadn't done it yet. It would seem, however, that this eventuality is becoming more and more of a reality every day.

It won't be long now, I find myself thinking.

I'm usually not a fan of fatalism, but when you've exhausted all of your options (save calling her up and screaming at her and getting myself cut out of her life again), you suddenly realize that certain things are just going to happen in this world, and sometimes there's not a goddamned thing we can do about it.

A few weeks ago, karma debt and I had a very nice conversation via /msg regarding the similarities between my sister's situation and what happened with Hermetic. (I felt terrible, because at the time, I had no idea who Hermetic was, being a relative newbie to E2 and all.) karma debt was extremely supportive, giving me all kinds of advice and well-wishes, but one thing she said still echoes in my mind: No matter how prepared you think you are for it, when they actually do it, you're never ready. You're never prepared.

She's right, of course. I keep telling myself that I know my sister is probably going to succeed in offing herself one of these days; I know it's not my fault, and I say I'm not going to blame myself if and when it happens. But the truth is, I will. The truth is, no matter how much I've done to try to avoid this eventuality (and that's quite a bit), it'll never be enough...I'm always going to end up thinking that I could have done more, I should have done more, I should have been there for her in some greater capacity, I should have stopped her, somehow.

And yet here I am, present day, and nothing has even happened yet. Why am I not doing something now? Have I really exhausted all my options, or have I just exhausted myself? Have I given up on her prematurely? Is there some way I can (literally or figuratively) shake the bejesus out of her and get her to realize what she's doing to her family, to herself?

Enough explication. Enough backstory. Enough concern for things that haven't even happened yet. As the title suggests, this is supposed to be a how-to.

I wish I could just jot down "twelve easy steps for loving someone who is mentally ill," but it would all be tripe bullshit—and besides, as the anecdotes above suggest, I haven't quite yet mastered the skill myself. But I do have a few thoughts to share on the subject, thoughts that basically boil down to the following:

Don't withhold your love from someone just because s/he is mentally ill. First, there are varying degrees of mental illness, and certainly the kind of stuff I've been discussing in this writeup doesn't apply across the board to everyone who is sick. But even with the ones who aren't "mild" or "moderate," some of the most incredible people in this world are bipolar or borderline. Meet them, get to know them, and love them (if applicable). Not every relationship with a mentally ill person is doomed to fail.

But...

Don't let your concern for someone else's mental illness be an excuse for ignoring your own mental health. In other words, if your friends or loved ones are sick, give them some leeway. Give them your understanding. Give them your love. But don't let them use their disease as an excuse to treat you horribly. Don't let them use "I'm sick" as an excuse to hurt you and your family. In short, treat it as you would any other relationship: Understanding goes a long way, but if a person (sick or not) is continuously hurting you, for your own sake, you must distance yourself from that person.

That last part may seem like a difficult pill to swallow, but sadly enough, those feelings will develop by themselves over time. Don't get me wrong, I still very much love my sister—but at some point in my life (not so very long ago), I had to make a conscious choice to stop worrying so much about what she's going to do to herself next. I had to make a conscious choice to accept the fact that I am not my sister's keeper. She must live her life and I must live mine—and whatever happens...well, I'll just have to deal with that when it comes to pass.

Because throughout this entire saga, I've learned one very important lesson: There's only thing worse than watching a friend or loved one destroy themselves, and that's allowing yourself to drown in their wake.

It sucks to watch someone you love spiral down the drain, and it's natural to offer them your hand to try to pull them out. But if they continuously try to pull you in with them, if they're more interested in bringing you down than allowing you to bring them up...at some point, you must stop offering them your hand.

Another View of how to love someone with Mental Illness

To love someone, in the real and unconditional sense, is something often confused with the idea of staying by someone's side and accepting all their behaviors, especially those behaviors that directly impact you as a person. To love someone who is mentally ill requires a different set of standards. You need to work to establish mutual respect, something a mentally ill person is often incapable of understanding and accepting.

A mentally ill person will also often have trouble understanding the need for personal boundaries and personal space, especially with someone they are in a relationship with. Based on my personal experience, I recommend making it possible to take long breaks from physical interaction. For someone with mental illness, the knowledge that you can leave at will but will always come back can be a powerful thing.

I've lived with and been in intimate relationships with two mentally ill women. The first was never really diagnosed, but she was suffering from the impact of a very powerful case of post-traumatic stress disorder. It was the result of a childhood where she was physically and sexually abused by her father, who ended up killing three of her siblings as a result of his abuse. She had an intense attachment disorder that caused her to treat casual relationships and friendships as being much more intimate, lasting and intense than they really were. She tended to imagine things happening to her that really weren't, imagining I was being abusive towards her at times, something that balanced out with her belief that we were destined to be together and had a "perfect relationship" that would never end.

Debra could not understand my need for personal space and boundaries. She tried to involve herself in every aspect of my life, treating my attempts to spend time alone as me having something to hide, usually an imagined affair. At times she would launch into a night of attacks against my person, trying to rip me apart using words she felt would wound me deeply, storming off in her car afterwards vowing never to return. In the morning I would wake up to a breakfast of bacon and eggs and Debra with a pleasant smile saying, "Did you sleep well, my love?"

Based on experience, both first hand and witnessed, it is impossible to have a relationship with a mentally ill person. A relationship requires some degree of stability and in most cases, with a mentally ill person, stability is impossible to achieve. To love them and care about them is one thing, and I work with the mentally ill because I love and care about them, but to love them in the way usually outlined by a romantic/physical/sexual relationship is not possible for any enduring length of time. You love the person, yes, but what your needs drive you towards is the hope that they will find the right path to treat, maintain and possibly cure their mental illness. This is a pipe dream. It is a self-defeating path. Once you are in this intimate relationship with a mentally ill person you become an enabler. It is unavoidable, no matter what lengths you go to try to convince yourself it isn't.

It is simple, really. Even in the case of a mentally ill person who knows they need treatment and ongoing therapy, being in an intimate relationship with someone gives them the sense that they can function normally. We consider being in this type of relationship to be the strongest sense of normality in our lives. Getting and keeping a job doesn't compare. Owning a home or paying the rent on time doesn't compare. Having another person love and accept you to the point where they are investing themselves wholeheartedly in a relationship with you is much, much stronger. And if this person has a job, a place to live and a car to get around in... suddenly it doesn't feel as if their mental illness means that much any longer.

Debra threw herself into intimate relationships and attached herself to men as if she was using a staple gun to do so. I wasn't the only one, and she is still doing it today. She did this because it allowed her to avoid the fact that she needed very serious treatment and therapy. She had incredibly unstable mood swings, imagined and believed in things that weren't really happening and for which there was no evidence whatsoever, and would stab herself with a knife to get attention when she felt people were ignoring her. Being in a relationship with a man allowed her to convince herself that she did not need help, that she was fully functional and normal.

To the extreme, The Former Muse, followed a very similar path, although she was always convinced every friendship and relationship she was involved in would fail. She was diagnosed with bipolar disorder, but over the last few months I knew her, the psychiatrist who met her when she was spending a few weeks in a psych hospital wanted to take her off her meds because he was convinced she was either borderline personality disorder or something quite different. The something quite different involved her absorbing the symptoms, habits, actions and diagnoses of the people she had worked with in her career in the field of psychology and adopting them as her own. It wasn't that she was faking her illnesses, but that she was genuinely absorbing them, as you could not fake her actions or her way of life. However, most of her symptoms and activities began only after she encountered them in others. She had always been deeply troubled in a way she could not define, and in essence she sought to define it by using tested models. Those that fit, such as bipolar disorder and cutting, she adopted. She only adopted suicidal behavior after I came to live with her. It wasn't part of her repertoire prior to my coming to live with her.

And the truth was, as it was with Debra, that it was not possible to love her and be with her in an intimate relationship. She sought to destroy the relationship and then praise it. She sought every means at her disposal to drive me away and then every means at her disposal to convince me to stay. I could either stay as an enabler or abandon her and validate her belief that all people would leave her, which was why I put her in the position of having to leave me.

You can love someone who is mentally ill. I maintain strong friendships with individuals who are mentally ill and I love them. I work with people who are mentally ill and emotionally unbalanced and I love them. You just cannot love them in the way that involves a lasting, intimate relationship because once they become convinced you are there to stay and you love them as they are, they will, in essence, stop trying to heal themselves because they have become validated by your love. The love cannot be unconditional. There must be a condition. They must continue to do everything they can to get "better" and to work hard to become the person they are. You must remind them constantly that you love them, not their mental illness and that you accept it only as a handicap to be overcome.

When things were good between us, The Former Muse would stop taking her meds. When things were bad between us she would start taking them again. When things were good between us, Debra would imagine things that weren't happening to sabotage our relationship and then attack me. When things were bad between us, she would work overtime to convince me she could function like a normal person and would go out of her way to make me happy.

You can't love a mentally ill person unconditionally. There must be a condition and the condition is the mental illness.

For almost a decade, I was in a relationship with someone who suffers from anxiety and depression caused by a condition that isn't often mentioned: Delusional Disorder -- in this case, the persecutory variety. Thanks to the original post, I also learned for the first time that the Delusional Disorder is just one manifestation of the larger Borderline Personality Disorder. While I was well-aware of the former, I was not aware of the latter, but in any case, I too neglected my own mental health in a long series of failed attempts to stabilize our situation so that I could finally convince him to seek long-term therapy.

I just want to interject here that if you suspect your loved one has Delusional Disorder, learn how to approach the situation. For starters, there is a good article on WebMD authored by the Cleveland Clinic. The key is that you must coax the sufferer into getting help for the associated anxiety and/or depression rather than just to "cure the delusions." Any hint of that will create resentment and resistance, while a symptomatic approach addresses the pain which is real to your loved one. Obviously, if the individual affected by delusions could separate what is real from what is delusional in his thinking, he wouldn't have the delusions. So trust me on this -- tell him that there is help for the anxiety and then go into treatment together so that you can both discuss the underlying reason(s) why he is feeling anxious. And don't be shocked when your therapist doesn't dismiss the delusions either. That's how the professional has to play it because it's the only way to get the patient to stick around long enough to make progress.

In case you're wondering, my former partner has never made any progress against his delusional worldview, and in fact still harbours the idea that a highly organized, technically advanced, powerful group of people with contacts all over the globe are intent on gunning him down, poisoning his dogs, destroying his interpersonal relationships, and causing his complete breakdown. Members of the conspiracy include total strangers, neighbors, acquaintances, (formerly) close friends who got tired of the cold shoulder, and probably now, even me. Delusional Disorder doesn't come with an ammo box full of effective medications, and the prognosis for complete cure is poor, but sufferers can learn to question their own conclusions and can at least know relief from the associated anxiety and depression through effective antidepressants.

Needless to say, he wasn't like this when we met, although there were warning signs such as alcohol abuse and financial irresponsibility. When he got sober early on (and stayed sober for all of our remaining time together) I thought our problems were solved. Well, a big one was solved for sure, but others were just beginning to manifest themselves. Delusional Disorder's median onset is at age forty, and sure enough, that was about the time when the underlying feelings begain to insidiously and progressively take over his life -- and mine.

Obviously, no two situations are the same (hell, no one situation is the same!) but in our case, my partner refused to admit that he was mentally ill at all. After a few weeks of months of depressive hell, he'd obtain a quick script for Wellbutrin SR, then brighten up considerably and would at least recognize the pernicious effects of depression. On the medication, he was able to gain insight and exhibit emotional memory. He was able to see how effectively the feelings of hopelessness and anxiety could be counteracted via self-medication via the Wellbutrin SR. But every time, he would decide that he no longer needed the medication for one reason or another (the latest being the complaint that it slightly raised his blood pressure). His newfound insight would lead him to confidently believe that he would just "know" when he needed to go back into the medicine chest, but of course, depression doesn't conveniently denote its next onset on the calendar, and within a short time he'd be in the quicksand again with the outcome always in doubt and me on the receiving end of sullen stares, angry intonations to "back off" and interaction so limited that I had at times a more satisfying relationship withe plumbing fixtures. So my point here is that unlike the situation in the original post, my partner wouldn't use his depression as an excuse for bad behavior until after he was feeling much better.

Even with the medication, though, the underlying problems -- the Delusional Disorder and Borderline Personality Disorder -- went unaddressed. There's a huge difference between serious therapy and a quick visit to the clinic for a fresh Rx of Wellbutrin SR. One is a visit to the gas station -- sometimes after the car has run out of gas -- and the other is a complete engine rebuild, to whatever extent that such an overhaul might be successful.

Nosprings' original post beautifully summarizes precisely the emotions I have felt throughout this roller-coaster ride. When I left, I gently told my partner that this was a separation and not a breakup, because I will not surrender all hope. However, I now no longer harbour any illusions. I recognize now that my heart was not ready to give up until now, and that I enabled his behaviour by allowing him to become a virtual recluse behind closed blinds, by paying all of our bills, and by keeping his secret from his family because HE felt like to tell them would be some sort of betrayal.

When I left, because he had become 100% financially dependent on me, I supplied enough money for him to get back to his mother's home, with additional funds to follow for about three months. She has a place ready for him and can offer a small inheritance recently received from his grandfather's estate. I made sure that she knows that he is deeply troubled and in need of immediate intervention. I didn't cut off his cellphone service right away, and I gave him our shared laptop because I had a spare, to ensure that he could communicate online. I'm detaching with love, but I am detaching.

I know that others will read this, and ask why I stayed in this relationship for so long? Anyone who has been in my shoes will understand, though -- you stay in it because the good times can be really good. My partner often lavished me with attention and spoke positively about my future and occasionally, about his own. He is artistically brilliant -- an extraordinary horticulturist and landscape designer whose talent seems to have been bestowed by Athena herself. Also, the bonds of love are actually, in a bizarre way, made more powerful by the understanding that if you bolt, this person won't just feel bad for a few days or weeks, but may actually end up in the street, dead, or both. In such a situation, one literally tears oneself in two even contemplating the idea of getting out. It's just unthinkable until such time that you can face yourself in the mirror and know that you've done all you can do. And yet, sometimes still, even now, I wonder. That's how powerful this bond has been.

I resisted leaving because I knew that accepting reality would result in a devastating tidal wave of raw, painful, wailing emotion accompanied by an avalanche of grief, heartache, sorrow, guilt and pain. I won't lie to you -- I got all that -- but I also tapped into my support network and gave myself full permission to grieve not just for him, but for the loss of our shared hopes and dreams. I am still grieving now, but every tidal wave subsides and every avalanche eventually comes to a stop.

The last thing I told my partner is that I could no longer try to save him. I told him that I was drowning and begged him to GET HELP, that it didn't have to be this way, that he deserved to find love and happiness and that he was still now and would always be my friend. I supplied specific information on free resources in our area for counseling and psychiatric therapy. I also shared one last hope -- that in the future, if in fact he becomes an indpendent person and if we both wanted it -- we could potentially explore recreating our future together. But really, that was just my way of offering both of us a shred of promise that all was not lost. It's not a false hope, but an honest hope, and there is a difference. I wished him, more than anything, peace.

The pain has been immeasurable, but at least now one of us will survive. I still have dreams, I still have hopes, but like Nosprings, I too recognize that the mold is indeed largely cast by environment, upbringing and personal experience. I've done my best, and I won't be afraid to express love and support, but I've given all the money and time I can spare. I had to save myself and allow him to meet his destiny on this earth. When our souls dance together across this universe, perhaps his gratitude will fill the extraordinary pain I feel with eternal joy and peace. That's my ultimate hope, and I shall never surrender it.

If you're in a situation akin to mine, or know someone who is, get professional help and join a support group for caregivers. Break the code of silence and let your loved one's family and friends know that you need help as well. Take care of your soul, learn to listen to your intuition, and never be afraid to be honest with your loved one or yourself. You're only human, though, and only you can decide when you'll have to save your own life, but for your own sanity do so in a way that lets you keep your head held high. You'll never regret that, and you'll always cherish the good times and never look back in anger.

Bipolar disorder, also called manic-depressive illness, is a type of depression characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual.

When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy, or agitated and irritable. A growing body of research recognizes a "bipolar spectrum" with symptoms of bipolarity occurring along a continuum.

Mania and hypomania often affects thinking, judgment, and social behavior. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state. See Symptoms of bipolar disorder.

Causes of depression/bipolar disorder
Because the symptoms, course of illness, and response to treatment vary so much among people with depression, doctors believe that depression may have a number of complex and interacting causes.

Research suggests that vulnerability to bipolar disorder results from both genetic and environmental factors. A serious loss, difficult relationship, financial problems, or any stressful (unwelcome or even desired) change in life patterns can trigger a bipolar/depressive episode. The hormonal system that regulates the body's response to stress also is overactive in many depressed people.

Treatment for bipolar disorder
Lithium has for many years been the treatment of choice for bipolar disorder, as it can be effective in smoothing out mood swings. Other medications have been found to be effective in controlling mood swings, including some mood-stabilizing anticonvulsants.

Join NAMI (National Alliance for the Mentally Ill)

http://www.nami.org/

This is a wonderful organization in good standing with the BBB. Thanks to them I was able to receive some much needed dental care this year for free.

Bipolar Disorder
What is bipolar disorder?

Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic and typically vary greatly over the course of a person’s life as well as among individuals. Over 10 million people in America have bipolar disorder, and the illness affects men and women equally. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in children. Most people generally require some sort of lifelong treatment. While medication is one key element in successful treatment of bipolar disorder, psychotherapy, support, and education about the illness are also essential components of the treatment process.
What are the symptoms of mania?

Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include:

* either an elated, happy mood or an irritable, angry, unpleasant mood
* increased physical and mental activity and energy
* racing thoughts and flight of ideas
* increased talking, more rapid speech than normal
* ambitious, often grandiose plans
* risk taking
* impulsive activity such as spending sprees, sexual indiscretion, and alcohol abuse
* decreased sleep without experiencing fatigue

What are the symptoms of depression?

Depression is the other phase of bipolar disorder. The symptoms of depression may include:

* loss of energy
* prolonged sadness
* decreased activity and energy
* restlessness and irritability
* inability to concentrate or make decisions
* increased feelings of worry and anxiety
* less interest or participation in, and less enjoyment of activities normally enjoyed
* feelings of guilt and hopelessness
* thoughts of suicide
* change in appetite (either eating more or eating less)
* change in sleep patterns (either sleeping more or sleeping less)

What is a "mixed" state?

A mixed state is when symptoms of mania and depression occur at the same time. During a mixed state depressed mood accompanies manic activation.
What is rapid cycling?

Sometimes individuals may experience an increased frequency of episodes. When four or more episodes of illness occur within a 12-month period, the individual is said to have bipolar disorder with rapid cycling. Rapid cycling is more common in women.
What are the causes of bipolar disorder?

While the exact cause of bipolar disorder is not known, most scientists believe that bipolar disorder is likely caused by multiple factors that interact with each other to produce a chemical imbalance affecting certain parts of the brain. Bipolar disorder often runs in families, and studies suggest a genetic component to the illness. A stressful environment or negative life events may interact with an underlying genetic or biological vulnerability to produce the disorder. There are other possible "triggers" of bipolar episodes: the treatment of depression with an antidepressant medication may trigger a switch into mania, sleep deprivation may trigger mania, or hypothyroidism may produce depression or mood instability. It is important to note that bipolar episodes can and often do occur without any obvious trigger.
How is bipolar disorder treated?

While there is no cure for bipolar disorder, it is a treatable and manageable illness. After an accurate diagnosis, most people can achieve an optimal level of wellness. Medication is an essential element of successful treatment for people with bipolar disorder. In addition, psychosocial therapies including cognitive-behavioral therapy, interpersonal therapy, family therapy, and psychoeducation are important to help people understand the illness and to internalize skills to cope with the stresses that can trigger episodes. Changes in medications or doses may be necessary, as well as changes in treatment plans during different stages of the illness.

It is useful to know whether the "mood stabilizing medication" prescribed has been approved by the FDA for use in bipolar disorder:

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What is Mental Illness: Mental Illness Facts

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD) and borderline personality disorder. The good news about mental illness is that recovery is possible.

Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.

In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups and other community services can also be components of a treatment plan and that assist with recovery. The availability of transportation, diet, exercise, sleep, friends and meaningful paid or volunteer activities contribute to overall health and wellness, including mental illness recovery.
Here are some important facts about mental illness and recovery:

* Mental illnesses are serious medical illnesses. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence. Mental illness falls along a continuum of severity. Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 Americans-who live with a serious mental illness. The National Institute of Mental Health reports that One in four adults-approximately 57.7 million Americans-experience a mental health disorder in a given year
* The U.S. Surgeon General reports that 10 percent of children and adolescents in the United States suffer from serious emotional and mental disorders that cause significant functional impairment in their day-to-day lives at home, in school and with peers.
* The World Health Organization has reported that four of the 10 leading causes of disability in the US and other developed countries are mental disorders. By 2020, Major Depressive illness will be the leading cause of disability in the world for women and children.
* Mental illness usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.
* Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives; The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States.
* The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
* With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.
* Early identification and treatment is of vital importance; By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized.
* Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.

To find out more about specific illnesses visit the By Illness page.

Some of the most common emails we received are from significant others of those who have bipolar disorder. These are from husbands and wives, lovers and friends, parents and children who just want to help, to be there for the person they love. But they don’t know how. Sometime ago a reader asked, "What IS helpful behavior? What does 'be supportive' really mean?" Members responded with How Family Members Can Help Someone with Bipolar Disorder.

Recently, Belinda wrote about her frustration in trying to talk with her girlfriend who is starting a manic upswing, but doesn’t think so. “I am so worried about my girlfriend. I see all the warning signs that she is hypomanic heading towards a full manic episode, but she disagrees. The thing is that my attempts to talk to her about this seem to be making it worse. When I’m nervous and upset I want to talk things out, but I’m driving her over the edge.”

Dr. Cynthia Last is a clinical psychologist in private practice who works with patients and family members routinely. She is also the author of When Someone You Love Is Bipolar and offers a couple of tips for talking to your loved-one during these times.

Don’t …

* Respond to the irritability
* Bring up touchy subjects
* Argue, even if you’re right
* Be a “Chatty Cathy”

Do …

* Speak calmly and slowly
* Use logic
* Give your mate breathing room
* Problem solve together

What have you found helps or exacerbates stressful conversations with your loved-one? If you’re the side of the coin with bipolar disorder, what ticks you off or smoothes things over?

Please pray for me. I got some bad meds and I've been really messed up for the last few days. Hopefully the new meds will work quickly to get me back on track.

I finally committed to going back on a mood stabilizer this week. Lamictal XR hope it works! Raised my Prozac from 40 to 60...... tweak tweak.