Family & Friends of Bipolar Support Group
This community is dedicated to parents, siblings, grandparents, other relatives and friends of someone who is Bipolar. The purpose of this community is to help families and friends develop greater patience and understanding, as well as maintain a positive, caring relationships with those diagnosed as Bipolar.
I wanted to write something for those people that are looking to support their partners and loved ones. I see a lot of people, both in this community and bipolar who are looking for help when someone close has been given a diagnosis of Bipolar. The purpose of this mini essay is to give some initial guidance and pointers.
Nature of the disease
Bipolar is a mental illness that tends to be episodic. People have periods where they are either depressed or manic and times when they are normal.
You can think of the two poles as up and down, but sometimes it is more appropriate to think of it as fast or slow.
Most people have some idea what depression is like, that is characterised as slow.
Hypomania or mania presents itself as a speeding up, thinking faster, lots of ideas, becoming scattered thinking, inability to concentrate on one thing. Speech can become faster and disjointed. People over estimate their abilities. Sleep is disturbed. Anxiety is common. At this point some will tend to use inappropriate coping strategies, self medicating with alcohol or street drugs, gambling, spending, risky behaviour. There is also something called hypersexuality which increases libido and decreases inhibition which can lead to affairs, unsafe sex etc. So far this falls into the category of hypomania, literally below mania.
For some people hypomanias bring a feeling of euphoric, for others it is an uncomfortable negative feeling (dysphoria).
Mania is the any/all of the above with hallucinations and delusions (believing something that is generally regarded as untrue, e.g your neighbour is Satan, that kind of thing).
There are also mixed states which a mixture of depression and mania.
A hypomania or mania might be only once in a few years or even longer. It can last a few days, or weeks or months if untreated. Typically a depression follows. People differ in the frequency of episodes and how long those cycles take.
What causes bipolar?
The direct cause of bipolar is a disruption of normal brain function probably due to fluctuations in brain neurotransmitters. That there is an extremely high level of incidence in certain families and statistical analysis in twin studies etc points towards a genetic origin. There may also be an element of triggering which seems to be after childhood. This includes bereavement, childbirth etc.
Types of Bipolar Disorder
Bipolar 1 . Full blown mania and major depressive episodes
Bipolar 2 Hypomania and major depressive episodes
Cyclothemia Hypomania and depressive episodes
Bipolar NOS a collection of rarer types
Schizoaffective combination of bipolar and schizophrenic symptoms.
Is it permanent?
Yes. It cannot be cured currently but it can be managed.
Treatments
The main treatment is via medication. The principle ingredient would be a mood stabilizer (it does exactly what it says). Lithium, Valproate and Lamotrigine are common ones.
Anti-depressants are sometimes prescribed but with caution as they can trigger (hypo)mania.
Also sleep meds because lack of sleep can trigger (hypo)mania.
Anti-psychotics may also be prescribed even for those that dont have psychosis, partly as a limiter for hypomanias.
Side Effects
Read the labels. But weight gain is a common one. Also libido loss (some psychiatrists regard this as acceptable collateral damage). People often feel fogged or zombified. This fogging and tiredness can be extreme to start with but should go after a few days/ weeks.
See www.crazymeds.us
What can you do?
Apart from the usual some specific points.
Learn to separate the bipolar from the person. If they are having a bad day and they are not behaving so well bear in mind this might be the bipolar. However, sometimes BPs will blame bad behaviour on their BP, so this works both ways.
Remember that bipolar is episodic. If something is a constant the chances are that its not coming from the bipolar.
Ensure they get appropriate and regular sleep. Sleep disturbance is both a trigger and symptom of Bipolar episodes.
Alcohol and drugs dont help bipolar and can prevent the meds from working.
Because there are some persistent side effects and we are not bipolar all the time, sometimes we are tempted to give up the meds when we are stable. That in itself can trigger mania and that mania is likely to be harder to control. Keep them on the meds.
Help them fight for appropriate treatment. If the side effects are too much (e.g fogginess, wight gain, loss of libido) support your partner in going back to the psychiatrist to make a med change. It often takes several goes to get it right.
Remember in the middle of the episode itnot about you. It unlikely you triggered an episode. But then its not much about them either.
Get educated. Look on the web, buy books.
This is a good one http://www.amazon.com/Loving-Someone-Bipolar-Disorder-Julie/dp/1572243422
Do all bipolars cheat?
No. Possibly more cheat than non bipolars when hypomanic. Medication reduces hypomania and therefore reduces that urge. Self awareness also means they can nbe more guarded about falling into old habits.
That said, some bipolars never cheat and have happy long term relationships. But then you dont hear so much about them.
Do all bipolars behave badly?
No. That seems to be becoming a media thing in the US. Bad behaviour = Bipolar and Bipolar = Bad behaviour. It seems more associated with alcohol or drug abuse. Again the risk is reduced with appropriate medication. Self knowledge again can help.
Again many dont and never have misbehaved.
Do 90% of bipolar marriages break down?
No idea. Dont think anyone else knows either despite the persistent repetition on the net. Ive looked and failed to find a proper source. I did find another assertion that bipolar divorce rate is two or three times that of the normal population, it then commented that the divorce rate is currently 50%.
I did, however find this from "Psychological Treatment of Bipolar Disorder By Sheri L. Johnson, Robert L. Leahy" It says there have been a lot of studies on unipolar depression (ie the normal kind) and marital functioning, but fewer on bipolar. It says "there is no evidence of divorce rates are higher with bipolar disorder than unipolar depression." Seeing as the incidence of unipolar depression is about 10% of the population it would suggest that actually it is not that much different from the general population.
I think my partner is bipolar, what do I do?
Ok, you CANNOT make a definite diagnosis yourself. Or by doing an online test. Or even by asking in the Bipolar Community. You need a diagnosis by a psychiatrist. Even a General Practitioner is not competent to do this, although a GP might be the first step to discount more obvious physical causes (see below for a few things that might look like bipolar).
So step number one is therefore to get your loved one to a professional. That might be easier said than done.
Things that look like bipolar.
They include certain kinds of poisoning, Borderline Personality Disorder, hyperthyroidism, certain tumours, ADHD. And of course alcohol or substance abuse. Thats just a list for starters, there are a LOT more. Trust me when I said they need to see a doctor/psychiatrist to sort this out.
Just in case you are interested there are 16 here http://www.emedicinehealth.com/bipolar_disorder/page2_em.htm
Comparison with Borderline Personality Disorder.
http://www.psycheducation.org/depression/borderline.htm
More info links
http://www.emedicinehealth.com/bipolar_disorder/article_em.htm
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/bipolarmanicdepression/bipolardisorder.aspx
More about Bipolar 2 and soft bipolar
http://www.psycheducation.org/index.html
Technical Diagnostics
http://www.fortunecity.com/campus/psychology/781/dsm.htm
Final Word
Still with me?
Despite all the media hype, all the horror stories from people who are convinced their partners are bipolar because they once saw a TV programme about it, or who have bipolar partners who are also alcoholicsmany of us are largely stable, productive, industrious faithful and loving. Just like other people really.
Nature of the disease
Bipolar is a mental illness that tends to be episodic. People have periods where they are either depressed or manic and times when they are normal.
You can think of the two poles as up and down, but sometimes it is more appropriate to think of it as fast or slow.
Most people have some idea what depression is like, that is characterised as slow.
Hypomania or mania presents itself as a speeding up, thinking faster, lots of ideas, becoming scattered thinking, inability to concentrate on one thing. Speech can become faster and disjointed. People over estimate their abilities. Sleep is disturbed. Anxiety is common. At this point some will tend to use inappropriate coping strategies, self medicating with alcohol or street drugs, gambling, spending, risky behaviour. There is also something called hypersexuality which increases libido and decreases inhibition which can lead to affairs, unsafe sex etc. So far this falls into the category of hypomania, literally below mania.
For some people hypomanias bring a feeling of euphoric, for others it is an uncomfortable negative feeling (dysphoria).
Mania is the any/all of the above with hallucinations and delusions (believing something that is generally regarded as untrue, e.g your neighbour is Satan, that kind of thing).
There are also mixed states which a mixture of depression and mania.
A hypomania or mania might be only once in a few years or even longer. It can last a few days, or weeks or months if untreated. Typically a depression follows. People differ in the frequency of episodes and how long those cycles take.
What causes bipolar?
The direct cause of bipolar is a disruption of normal brain function probably due to fluctuations in brain neurotransmitters. That there is an extremely high level of incidence in certain families and statistical analysis in twin studies etc points towards a genetic origin. There may also be an element of triggering which seems to be after childhood. This includes bereavement, childbirth etc.
Types of Bipolar Disorder
Bipolar 1 . Full blown mania and major depressive episodes
Bipolar 2 Hypomania and major depressive episodes
Cyclothemia Hypomania and depressive episodes
Bipolar NOS a collection of rarer types
Schizoaffective combination of bipolar and schizophrenic symptoms.
Is it permanent?
Yes. It cannot be cured currently but it can be managed.
Treatments
The main treatment is via medication. The principle ingredient would be a mood stabilizer (it does exactly what it says). Lithium, Valproate and Lamotrigine are common ones.
Anti-depressants are sometimes prescribed but with caution as they can trigger (hypo)mania.
Also sleep meds because lack of sleep can trigger (hypo)mania.
Anti-psychotics may also be prescribed even for those that dont have psychosis, partly as a limiter for hypomanias.
Side Effects
Read the labels. But weight gain is a common one. Also libido loss (some psychiatrists regard this as acceptable collateral damage). People often feel fogged or zombified. This fogging and tiredness can be extreme to start with but should go after a few days/ weeks.
See www.crazymeds.us
What can you do?
Apart from the usual some specific points.
Learn to separate the bipolar from the person. If they are having a bad day and they are not behaving so well bear in mind this might be the bipolar. However, sometimes BPs will blame bad behaviour on their BP, so this works both ways.
Remember that bipolar is episodic. If something is a constant the chances are that its not coming from the bipolar.
Ensure they get appropriate and regular sleep. Sleep disturbance is both a trigger and symptom of Bipolar episodes.
Alcohol and drugs dont help bipolar and can prevent the meds from working.
Because there are some persistent side effects and we are not bipolar all the time, sometimes we are tempted to give up the meds when we are stable. That in itself can trigger mania and that mania is likely to be harder to control. Keep them on the meds.
Help them fight for appropriate treatment. If the side effects are too much (e.g fogginess, wight gain, loss of libido) support your partner in going back to the psychiatrist to make a med change. It often takes several goes to get it right.
Remember in the middle of the episode itnot about you. It unlikely you triggered an episode. But then its not much about them either.
Get educated. Look on the web, buy books.
This is a good one http://www.amazon.com/Loving-Someone-Bipolar-Disorder-Julie/dp/1572243422
Do all bipolars cheat?
No. Possibly more cheat than non bipolars when hypomanic. Medication reduces hypomania and therefore reduces that urge. Self awareness also means they can nbe more guarded about falling into old habits.
That said, some bipolars never cheat and have happy long term relationships. But then you dont hear so much about them.
Do all bipolars behave badly?
No. That seems to be becoming a media thing in the US. Bad behaviour = Bipolar and Bipolar = Bad behaviour. It seems more associated with alcohol or drug abuse. Again the risk is reduced with appropriate medication. Self knowledge again can help.
Again many dont and never have misbehaved.
Do 90% of bipolar marriages break down?
No idea. Dont think anyone else knows either despite the persistent repetition on the net. Ive looked and failed to find a proper source. I did find another assertion that bipolar divorce rate is two or three times that of the normal population, it then commented that the divorce rate is currently 50%.
I did, however find this from "Psychological Treatment of Bipolar Disorder By Sheri L. Johnson, Robert L. Leahy" It says there have been a lot of studies on unipolar depression (ie the normal kind) and marital functioning, but fewer on bipolar. It says "there is no evidence of divorce rates are higher with bipolar disorder than unipolar depression." Seeing as the incidence of unipolar depression is about 10% of the population it would suggest that actually it is not that much different from the general population.
I think my partner is bipolar, what do I do?
Ok, you CANNOT make a definite diagnosis yourself. Or by doing an online test. Or even by asking in the Bipolar Community. You need a diagnosis by a psychiatrist. Even a General Practitioner is not competent to do this, although a GP might be the first step to discount more obvious physical causes (see below for a few things that might look like bipolar).
So step number one is therefore to get your loved one to a professional. That might be easier said than done.
Things that look like bipolar.
They include certain kinds of poisoning, Borderline Personality Disorder, hyperthyroidism, certain tumours, ADHD. And of course alcohol or substance abuse. Thats just a list for starters, there are a LOT more. Trust me when I said they need to see a doctor/psychiatrist to sort this out.
Just in case you are interested there are 16 here http://www.emedicinehealth.com/bipolar_disorder/page2_em.htm
Comparison with Borderline Personality Disorder.
http://www.psycheducation.org/depression/borderline.htm
More info links
http://www.emedicinehealth.com/bipolar_disorder/article_em.htm
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/bipolarmanicdepression/bipolardisorder.aspx
More about Bipolar 2 and soft bipolar
http://www.psycheducation.org/index.html
Technical Diagnostics
http://www.fortunecity.com/campus/psychology/781/dsm.htm
Final Word
Still with me?
Despite all the media hype, all the horror stories from people who are convinced their partners are bipolar because they once saw a TV programme about it, or who have bipolar partners who are also alcoholicsmany of us are largely stable, productive, industrious faithful and loving. Just like other people really.
-
I find myself going places in the car and not wanting to get out of the car. I come back home and I don't want to get out of the car. I think it's the only time I spend reflecting. Chronic tiredness from Long Covid plus the immunosupressing meds for my Crohn's is slowing me down but everything just seems a massive effort. I am dealing with the paperwork following my father's death but it's not...
-
Wow, it's the middle of the week already!Today is our 11 year anniversary, so we're going out to a nice dinner. I'm losing a lot of sleep these days, hence a wonky schedule and uncomfortable feelings. But I know it will pass, eventually.I hope all of you have a peaceful day, and may good things come your way!
Thanks again.
I particularly like the idea to seperate the BP from the person, I posted something early about seperating the drama from the BP.
Concise, to the point and clear. A very good staring point for anyone suffering because of this illness. Good job.
It is easy to feel the yo yo that is the rapid change of mood that leaves one getting very mixed signals that are hard to follow
and feeling hurt by what seems a personal attack coming from nowhere.
Thanks. Hugs to you for your help you gave and continue to give us.
Very informative and also I found to be very accurate.
Thanks-thanks........................................hugs
Thank you again!
But my basic answer would be..have you asked her why she drinks? Many bipolar's have a habit of self medicatating as a way of supressing/escaping all the crap that is often going on in their heads. This bad news for someone who is normal.
For bipolar it can make some of the behavioural problems worse, reckless behaviour, decreased inhibition from hypomania plus more of the same from the action of alcohol can amplifiy bipolar. It can also mask bipolar (because an alcoholic may present similarly to a bipolar even to the point of psychosis).
For someone who is on meds it interferes with their action and there can also be serious interactions.
My general counsel would be for her to get onto proper meds asap and stop the drinking.
Incidentally that would be the advice from 95% of the members of the BIpolar community. The remaining 5% are the unmedicatated members, they don't generally last long or transition to become part of the medicatated fraternity.