Bipolar Disorder:

[Loretta Ann]

Hi all,

Something that I have found very difficult to understand is the thinking problems associated especially with this disorder. I have known quite a few people with this problem, one who was successful in committing suicide. It breaks my heart to see them struggling so. I am hoping to learn something here that will enable me to provide something beneficial for my family member who is afflicted with this disorder.

I just came across the following and am saddened by the degree that these people must be suffering. I know that if they could see things differently there life would be better.

Ideas… anyone?
Darlene


Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives. More than 2 million American adults, 1 or about 1 percent of the population age 18 and older in any given year, 2 have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life. It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.
Signs and symptoms of mania (or a manic episode) include:

* Increased energy, activity, and restlessness
* Excessively "high," overly good, euphoric mood
* Extreme irritability
* Racing thoughts and talking very fast, jumping from one idea to another
* Distractibility, can't concentrate well
* Little sleep needed
* Unrealistic beliefs in one's abilities and powers
* Poor judgment
* Spending sprees
* A lasting period of behavior that is different from usual
* Increased sexual drive
* Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
* Provocative, intrusive, or aggressive behavior
* Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with 3 or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, 4 additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:

* Lasting sad, anxious, or empty mood
* Feelings of hopelessness or pessimism
* Feelings of guilt, worthlessness, or helplessness
* Loss of interest or pleasure in activities once enjoyed, including sex
* Decreased energy, a feeling of fatigue or of being "slowed down"
* Difficulty concentrating, remembering, making decisions
* Restlessness or irritability
* Sleeping too much, or can't sleep
* Change in appetite and/or unintended weight loss or gain
* Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
* Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if 5 or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer. Some people with bipolar disorder become suicidal. Risk for suicide appears to be higher earlier in the course of the illness. Therefore, recognizing bipolar disorder early and learning how best to manage it may decrease the risk of death by suicide. Findings from gene research suggest that bipolar disorder, like other mental illnesses, does not occur because of a single gene. It appears likely that many different genes act together, and in combination with other factors of the person or the person's environment, to cause bipolar disorder. Finding these genes, each of which contributes only a small amount toward the vulnerability to bipolar disorder, has been extremely difficult. But scientists expect that the advanced research tools now being used will lead to these discoveries and to new and better treatments for bipolar disorder. Brain-imaging studies are helping scientists learn what goes wrong in the brain to produce bipolar disorder and other mental illnesses. New brain-imaging techniques allow researchers to take pictures of the living brain at work, to examine its structure and activity, without the need for surgery or other invasive procedures. These techniques include magnetic resonance imaging (MRI), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI). There is evidence from imaging studies that the brains of people with bipolar disorder may differ from the brains of healthy individuals. As the differences are more clearly identified and defined through research, scientists will gain a better understanding of the underlying causes of the illness, and eventually may be able to predict which types of treatment will work most effectively.

Treatment:

* Lithium, the first mood-stabilizing medication approved by the U.S. Food and Drug Administration (FDA) for treatment of mania, is often very effective in controlling mania and preventing the recurrence of both manic and depressive episodes.
* Anticonvulsant medications, such as valproate (Depakote®) or carbamazepine (Tegretol®), also can have mood-stabilizing effects and may be especially useful for difficult-to-treat bipolar episodes. Valproate was FDA-approved in 1995 for treatment of mania.
* Newer anticonvulsant medications, including lamotrigine (Lamictal®), gabapentin (Neurontin®), and topiramate (Topamax®), are being studied to determine how well they work in stabilizing mood cycles.
* Anticonvulsant medications may be combined with lithium, or with each other, for maximum effect.
* Children and adolescents with bipolar disorder generally are treated with lithium, but valproate and carbamazepine also are used. Researchers are evaluating the safety and efficacy of these and other psychotropic medications in children and adolescents. There is some evidence that valproate may lead to adverse hormone changes in teenage girls and polycystic ovary syndrome in women who began taking the medication before age 20.14 Therefore, young female patients taking valproate should be monitored carefully by a physician.
* Women with bipolar disorder who wish to conceive, or who become pregnant, face special challenges due to the possible harmful effects of existing mood stabilizing medications on the developing fetus and the nursing infant.15 Therefore, the benefits and risks of all available treatment options should be discussed with a clinician skilled in this area. New treatments with reduced risks during pregnancy and lactation are under study.

[CJ]

Hi all,

Darlene,

That's a pretty fair assessment of Bipolar Disorder (which used to be called Manic-Depressive Illness). Where did you find this? Anyway, thanks for posting it; I'm sure it will be helpful.

As far as "any ideas" go, I can only suggest that we let the lab coats look for genes and chemical imbalances in the brain while we, as individuals, look for relief to the one fragment of your excerpt that caught my eye: in combination with other factors of the person or in the person's environment. There's always more than we can do to help ourselves than we think. Medication is an adjunct.

Love,
CJ

[Loretta Ann]

Hi CJ.

Thanks and your welcome.

Here is the link.

http://www.drugrehabcenter.com/bipolar-disorder.html

Love,
Darlene.

[Jennifer]

Darlene you have hit a topic that is close to home for me. My youngest sister (now 40) is bi polar and all the symptoms you mentioned we noticed in her but at the time no one knew what was going on. It wasn't until a brother died that she crashed completely and we realized that something was very wrong. We had her commited to a psychiatric ward in hospital for eight weeks to be properly diagnosed and it was tough on the whole family. Proper medication keeps her stable but she'll be on it for the rest of her life. If you want to chat about this please PM me.

[Carolynn]

Hi Darlene, and all. Hope your holidays were full of fun and relaxation.

Darlene, you've posted on a subject I have been thinking about, off and on, and wondering about it's relationship to some cases of GID. Five F2Ms and two M2Fs of my acquaintance have BP disorder (more do not!!) For some reason, it was much worse before they started transition, all spent at least a few weeks in a mental ward before starting GID treatment. For most, maintenance doses for the disorder have been decreased as other things related to their dyphoria have been treated, and one has not had an episode or needed adjustment now in five years and is on the lowest dose in his maintenance profile. I don't know if there is any relationship for sure, but it seems like the intensity of the BP disorder has decreased for all these people with GID treatment. I also do not know the incidence of BP disorder with GID. Now, I think I will ask my therapist next session.

Thanks Darlene, for initiating this thread.

Love, Carolynn

[Loretta Ann]

Hi All,

Thank you Jennifer and Carolynn for speaking out on this issue.

The part that I struggle with is that; my experience has been that those with this disorder, seem to want to hold others accountable for their well being. Specifically what I have heard from my relative is that if the mental health officials would say things differently they would not have the problem they have. It is like it is other people’s fault that they are like they are.

In the last relationship that I had with a Bipolar disordered person, she was only interested in how I would respond when she pulled her stunts, as opposed to becoming a healthy person herself. In other words she wanted a willing floor mat. A situation I was not willing to provide.

As an outsider looking in, I suspect this comes from a sort of surrender that the condition will not improve, but in my opinion it serves to reinforce that they will remain where they are dependent on drugs for the rest of their lives.

Drugs have side effects, and can cause other problems, which is why many of them look for other ways.

If you have some info that you think would be helpful Jennifer and would feel more comfortable PMing me please feel free to do that. But I have posted this here hoping that others (also) might have something to contribute.

Love Darlene.

[Aeryn]

Hi All,

Thank you Jennifer and Carolynn for speaking out on this issue.

The part that I struggle with is that; my experience has been that those with this disorder, seem to want to hold others accountable for their well being. Specifically what I have heard from my relative is that if the mental health officials would say things differently they would not have the problem they have. It is like it is other people’s fault that they are like they are.

In the last relationship that I had with a Bipolar disordered person, she was only interested in how I would respond when she pulled her stunts, as opposed to becoming a healthy person herself. In other words she wanted a willing floor mat. A situation I was not willing to provide.

As an outsider looking in, I suspect this comes from a sort of surrender that the condition will not improve, but in my opinion it serves to reinforce that they will remain where they are dependent on drugs for the rest of their lives.
Love Darlene.

Any major thought disorder (bipolar, schiz) has what are called positive and negative symptoms. The positive symptoms are the ones that are really obvious- hallucinations, delusions, disordered thinking. The negative symptoms are the ones most people see as "character traits"; hygeine, diet, attitude, etc.

Part of what you describe above may be the negative symptoms of bipolar.

It may also be simple frustration with the illness. Mental illness is hard to treat, it's not like having an infection and getting antibiotics or breaking a bone and having it set. So little is truly understood about how the brain works that it is difficult to find the right medication. Even then, it is difficult to regulate dosage. Add to that that what works for one person may not work for the next... I think you get my point.

Also, from my experience, many people with major thought disorders end up being enculturated to the mental health system. This means, in some cases, learning how to play the system. In playing the system, people often develop what are called personality disorders, or at least traits of these disorders. I have seen many people with major disorders slowly adopt the traits of other clients, undesirable traits, because on some level, they get something out of it.

[Loretta Ann]

Also, from my experience, many people with major thought disorders end up being enculturated to the mental health system. This means, in some cases, learning how to play the system. In playing the system, people often develop what are called personality disorders, or at least traits of these disorders. I have seen many people with major disorders slowly adopt the traits of other clients, undesirable traits, because on some level, they get something out of it.

Thanks Aeryn,

I am so glad I started this thread.

You have just given me a lot to assimilate. The problem I struggled with is that at one time I had the same major thought disorders, as my relative. Yet I was never bipolar or schiz.

What you have helped me with, is to understand that the reason I at one time would have taken the side of my relative is due to the fact that being raised in an abusive home forced me to learn how to play the system, in order to survive. When I left home that is all I knew how to do, and that does not bring one… the things he/she desires in the adult world.

As Leslie pointed out in another thread such things as character assassination serve to breed sympathy for the one whose character is being assassinated. The exact opposite of the goal of the assassinator, being as it also breeds contempt for the assassinator. The saying that; we can be our worst enemy has direct application here.

It is now my belief that anyone displaying these characteristics is witness of being raised in an abusive home, and yet being able to recover from the damage that has been done. Something that often takes years to accomplish.

Also I have been struggling with memories from my past (things I have done that I am ashamed of) hounding me. I do not expect that to be a problem now that I understand the reason I thought as I did at that time.

Respectfully,
Darlene.

[Aeryn]

What you have helped me with, is to understand that the reason I at one time would have taken the side of my relative is due to the fact that being raised in an abusive home forced me to learn how to play the system, in order to survive. When I left home that is all I knew how to do, and that does not bring one… the things he/she desires in the adult world.

It is now my belief that anyone displaying these characteristics is witness of being raised in an abusive home, and yet being able to recover from the damage that has been done. Something that often takes years to accomplish.

Respectfully,
Darlene.

What you describe above is so true. When one is raised in an abusive home, one developes a set of coping skills, that while effective in that environment, are not effective in society at large. If the maladaption is severe enough, it can lead to real problems. In mental health we call them Personality Disorders (antisocial, hystrionic, borderline, dependent, sure I am missing a few).

Personality disorders are tough to work with, the behaviors and faulty thinking processes have become very entrenched- they were, afterall, what helped the person survive a horrible situation.

I need to note that disorders such as schiz and bipolar, are not the same as personality disorders. Bipolor and schiz are caused by screwed up brain chemistry, while personality disorders are maladaptive ways of coping with the world. Bipolar and schiz require medication to control and personality disorders benefit from therapy (that's a quick kind of explanation). Although some of the symptomology may appear similar, the disorders are very, very different.

[Elizabeth]

Hi Darlene,

Having been raised in an abusive home also, I do beleive there is a direct connection. I have seen it in my brothers and sisters as well as myself. Luckily for me at the time I left home to go out on my own, I knew I was never going back, no matter what. I also knew that what happened in our home growing up was wrong.

I knew that lying, cheating, stealing, bearing false witness, putting others down, stereotyping people to become an object of critisizm, racism, drug abuse, alcohol abuse, were all wrong behaviors.

I tried to inform myself, and learn new coping skills as quickly as I could. However, it did not prevent me from having personality disorders, or depression. I knew there was something wrong, but was very afraid of being stigmatized if I were to seek mental health treatment.

And even though I knew it was destroying me, I hung on to that old way of thinking(that I could cope by myself) until I could hold on no more. Until I was actually forced to deal with my issues, or die.

I know many of my sisters out there probably have a lot of these same feelings. I can say this. Being on this forum has helped me more than all the mental health care providers I have been to, combined. However, mental health care providers were still pivotol in coming to terms with being a transgendered person. I strongly reccomend seeing a therapist.

While I don't have bi-polar myself, I do still have depression. And I still see the cause and effect now.

Love always,
Elizabeth

[Loretta Ann]

Hi all,

Hi Elizabeth,

Thank you for coming along side here. I think the Fibromyalga contributes to depression, due to its restrictive nature. I think what is necessary in order to keep it down to as minimum as possible, is being able to accept that is the way we are. And look for the benefits. On the one hand it is restrictive yet on the other hand it is freeing, as it enables one to enjoy cross-dressing nearly 24/7 being as we are no longer required to work. I know that has helped me.

And even though I knew it was destroying me, I hung on to that old way of thinking(that I could cope by myself) until I could hold on no more. Until I was actually forced to deal with my issues, or die.

I believe there are people who will read this that don’t have ears that can hear what you are saying, and will need to reach a place where they will actually be forced to deal with their issues, or die. I wish them a speedy and safe journey to that place which I refer to as hell. I like you Sis, have been there done that, and wish that others would not have to experience it like we have. But perhaps for them there is no other way.

Aeryn,

For me the personality disorder acts like a smoke screen. It prevents me from seeing beyond it to be able to understand the effects of the bipolar disorder. Do all bipolar; schiz disorders display the personality disorders?

I suspect that the personality disorders also act as a smoke screen for the afflicted as well. Probably; subconsciously…attempting to provide something to hide behind, creating a false scene of security. That may be the level, (that you have alluded to) that they get something out of it.

Love and Respect,
Darlene.

[Aeryn]

Darlene,

No, not all bipolar or schizophrenics display traits of personality disorders.

Personality disorders are in a way smoke screens because they do provide something to hide behind. But it is not a conscious decision. We all learn how to interact with our world through our experiences. Some of us learn appropriate ways and some learn innappropriate ways. The thing is, with PD, those innappropriate ways worked for them in some situation. In a sense, they were appropriate, in that one situation.

The following link provides a brief explanation of PD:

http://mentalhelp.net/poc/center_index.php?id=8

[CJ]

Hi all,

Great thread. To Aeryn's fine contributions, I'd only add that it's important to keep in mind that there's a difference between personality disorders and personality traits or characteristics. Disorders cause distress and are maladaptive whereas traits have to do with a person's idiosyncracies.

While many people can be obssessive about classifying, cleaning, and reorganizing their workshop or library, not all have Obssessive-Compulsive Disorder. While many people may have a hard time considering any emotional and psychological needs but their own, not all suffer from Narcissistic Personality Disorder. While many people may be considered drama queens, not all have Histrionic Personality Disorder. While many (if not most) people struggle in their interpersonal relationships, not all suffer from Borderline Personality Disorder. And so on and so forth.

Most people have some type of personality trait or other which, if taken to its extreme, can lead to a diagnosis of this or that Personality Disorder. Again, the issue here is whether or not such and such a trait causes the person who exhibits it significant and fairly chronic distress, at which point the trait becomes an ineffective, defective, and even harmful coping mechanism.

Maybe this is why Darlene (or anybody else, for that matter... myself included) has a hard time distinguishing between what, in another person, is a smokescreen and what is a genuine illness. Schizophrenia and Bipolar Disorder, on the other hand, can lead to cognitive impairments that have little, if anything, to do with personality traits or personality disorders (although here, too, there are, of course, exceptions).

May you all be well when you're well. Health is a precious, precious thing.

Love,
CJ

[Loretta Ann]

Thank you all.

[Kay(SO)]

CJ,

Brillian post. I have been silently following this threat, again not to get involved in any psych discussions because it's exhausting for me at this point, being in the field and all. Well said and thank you.

Kay(SO)