Understanding Bipolar

Bipolar Disorder

The bipolar disorder illness affects the lives of many individuals. Not only those who have been diagnosed but family members and others in continual close contact with sufferers will be well familiar with the trials and tribulations of life with bipolar disorder. However this mental illness also known as manic depression can be treated, and people can lead full and productive lives. Many are exceptionally talented individuals, famous celebrities and top achievers in their fields.

What is bipolar disorder

Bipolar disorder is a mood disorder. In some individuals a chemical imbalance occurs in the brain affecting mood, energy levels and ones general ability to perform normally. Exactly why and how this happens is still under review but there seems to be both heredity and environmental components. Characteristic of bipolar is the oscillating between opposite ends of the mood spectrum. The severity duration and consequence of the mood swings allow for numerous variations within the bipolar spectrum the most well known of which are bipolar 1 and bipolar 11. From the manic highs through the milder hypomania to the depressive lows there are many in-betweens.

We all have periods of elation and despair, a natural part of living but different from these normal ups and downs, the bipolar symptoms are severe and the ramifications can be widespread and potentially damaging to the individual, their relationships, job or school performance etc.

Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms of depression 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. Bipolar disorder is a long-term illness that must be carefully managed throughout a person's life. The risk of suicide including teen suicide is high in untreated cases.

The bipolar disease does not seem to discriminate on the basis of gender, age, race ethnic groups or social classes. However there seems to be a genetic component as bipolar runs in families. Most sufferers having other close relatives with either unipolar or bipolar depression.

Some things in life we don’t get a choice in like whether or not we are genetically predisposed to bipolar disorder but there is an awful lot we do have control of which can have a very beneficial effect on the outcome. There will be aspects of day to day living complicated by bipolar but certainly not insurmountable and there will also be many benefits from the exceptional gifted abilities of many bipolar disorder individuals.

The aim of this site is to provide those interested with the knowledge of potential pitfalls. If you know what might happen you and your loved ones working as a team can put coping strategies in place in advance to minimize any damage.

Living with bipolar disorder

Living with a bipolar disorder individual in the home can be a stressful problem for the family as they witness their loved ones engulfed in episodes of mania and depression.

The same factors that would pose threats to peaceful family life for any family pose greater risks when living with a bipolar individual. Alcohol and drug abuse, lies, reckless spending, rage, depression, hypersexuality, suicidal inclinations, and hallucinations all have the potential to upset family peace and integrity.

To minimize risk family, friends and sufferer need coping mechanisms. This usually boils down to rather more in the way of routine, organization, forward planning and a sense of humor than normal. There is no disputing the power of laughter to improve ones sense of wellbeing to elevate the mood and help keep things in perspective.

It is important to know that few bipolar patients are dangerous so there is no need to feel physically threatened. Assuming they have been correctly diagnosed and are monitored by health professionals the disruptions to normal family life will be minimized.

Disruptions are more likely if the person has not yet been diagnosed, or misdiagnosed, or for whatever reason doesn't take the prescribed medications.

The best course of action for any support team is to seek help as soon as possible if the behavior of the individual is beyond what could be considered reasonable or normal even if the individual denies there being anything wrong and sees nothing unusual in their behavior.

Identify triggers i.e. stressful life events that are likely to spark the episodes of mania or depression. These might be memories of events like deaths, anniversaries, traumas, or the like. Keep a record of such events in your journal and learn to insulate your bipolar family member from them.

Living with bipolar disorder requires fighting not only your own irritation but also, and more importantly, the fears of the bipolar person. They have a craving for being in control of situations which is rooted in their fear of losing control and the attention of the family. With a lot of patience love and care family and friends can help abate these fears and provide help and support in social situations.

Manic episodes with psychotic features like hallucinations (voices, sounds etc) can occur with bipolar 1 individuals. What seems real to the patient might be construed as nonsense or bipolar lying to others. It is important to understand that "reality" is different for the sufferer who is simply recalling the experience as perceived. Acceptance of this relativism of reality goes a long way to curbing anger in such situations

Bipolar divorce
Incidence of Bipolar divorce

Bipolar divorce occurs in an alarming 90 percent of marriages in which one partner is suffering from bipolar disorder. The most obvious reason for this disintegration is the substantial social morbidity that results from the bipolar individuals maladaptive behavior. Serious social drawbacks associated with reckless behavior like abuse of alcohol or drugs, accidents from excessive risk taking, financial burden from over spending, inability to remain gainfully employed are have the potential to unravel even the most loving of relationships.

Of course, the daily interactions of manic-depressives can be a threat to any social relationship, including marriage, as bi polar people have trouble containing their emotions. Their response to a usual joke might be shockingly unexpected (an extreme of elation or depression). A word of mild reproof can bring thoughts of suicide. And so, it is not difficult to link bipolar disorder and divorce. Living with someone having the condition is very stressful and teeming with misunderstandings and conflicts. That is why diagnosis of a spouse with bipolar disorder has been called diagnosis for the couple.

Undoing the link between Bipolar Disorder and Divorce

To break the bond between bipolar disorder and divorce, the healthy spouse has to play the key role. Firstly the partner must believe that it is worthwhile to save the marriage (and the partner). The primary requisite is to understand that the manic-depressive cannot control their feelings. The caring spouse must be prepared to expend high doses of patience, understanding and support to protect the marriage against bipolar divorce.

Well managed long term control of the bipolar symptoms by qualified healthcare professionals can diminish the frequency and severity of manic and depressive episodes and stabilize behavior thereby greatly enhancing the quality of life of the bipolar person, spouse and family. The healthy spouse can contribute enormously by ensuring that treatment is sought whenever necessary and that medication is taken regularly. Any suicidal thoughts, remarks etc by must always be taken seriously and reported to the psychiatrist who may suggest some effective drug treatment.

The caring spouse should be a willing listener to partner's hallucination accounts without fear or judgment no matter how gruesome or unrealistic the details. One important way to lessen the risk of bipolar divorce in a marriage is to learn as much as possible about bipolar disorder or manic depression to be aware of what stresses are attributable to the partner being bipolar and how these could lead to divorce if not adequately managed.

Reminding the suffering partner that he is being loved and cared for helps a lot. Identifying events that trigger episodes of mania or depression is also important. Preventing these triggers would reduce the frequency of episodes and hence result in less social tension. To plan beforehand how to deal with a possible episode will help reduce the embarrassment on both sides. Ongoing emotional support and encouragement in treatment will eventually bring down the connection between bipolar disorder and divorce.

When reality doesn't meet our expectation with bipolar and relationships its easy to apportion blame but no matter how bad the situation, changes are possible from both sides if the commitment is there to do so. Generally changes for the better from one partner will inevitably bring improvement from the other. Often what is missing is the "what" and "how to" knowledge. Amazingly our preparation for adulthood instills in us the sanctity of marriage but does little in the way of teaching how to hold it all together when things don't go according to plan. Bipolar divorce prevention strategies are sadly missing from our education.

Bipolar relationships

Are Bipolar relationships different

The success of relationships including bipolar relationships depends on whether the needs of both parties are met and this is where bipolar depression makes it rather more challenging.

Look at any thriving relationship and most likely you will find both partners are working actively at keeping the relationship alive and vibrant. Whether still in the dating stage or way down the track effort is put into finding great date ideas for special quality time together.

Many partners have no desire to dominate in the relationship. Such a partner in a bipolar relationship would be more tolerant, comfortable keeping the peace, walking the tightrope and essentially doing all that is necessary to keep outbursts to a minimum. The bipolar partner with the dominant personality and big ego happily takes control, runs the household like a business manager delegating often useless tasks right left and center, and feeling very important in the process. However it's not uncommon even in this scenario for the bipolar relationship to unravel over the long term, as the kids grow up without similar tolerance levels or the desire to pander to the unreasonable demands and often intolerable behavior.

Breakdowns in Bipolar relationships are a common consequence of the illness. The likelihood of divorce amongst bipolar individuals is twice that of the general population.

Any relationship breakdown whether it be with family, friends or work colleagues is likely to have an adverse effect on bipolar symptoms. Even with normal individuals it can be extremely stressful and play havoc with ones moods, how much more so with someone already fighting continual mood swings.

Often with poorly controlled bipolar disorder, those closest to the bipolar individual like parents siblings or children spend so much of their time and energy trying to keep the bipolar person happy. They get worn down to a point where they can no longer cope, or are no longer willing to tolerate the situation. Inevitably they drift away leaving the bipolar individual further isolated and vulnerable to regression of symptoms.

What if both in the relationship are bipolar? In some ways it's likely to be even more dysfunctional but on the whole if both partners have well controlled bipolar and good support systems there is little reason why the bipolar relationship could not have a pretty good chance of success.

Bipolar rage

Why is Bipolar rage different?

Anger and rage are symptomatic of life. Everyone is prone from time to time to outbursts of anger and possibly even rage. It is hardly specific to bipolar disorder so why is bipolar rage an issue worthy of consideration.

Anger gives way to rage when one loses control, when the expression of anger becomes irrational, violent and manipulative.

Emotional extremes are symptomatic of bipolar so it is hardly surprising that bipolar disorder in children and adults should manifest itself in outbursts of rage.

Bipolar sufferers are often controlling personalities who feel inadequate by their own expectations or those of others. Rage episodes abusing others verbally and/or by physical violence are often in response to these strong emotions.

Briefly they gain control over those on the receiving end of the outburst, leading to a transient artificial sense of empowerment.

The outburst itself is generally not premeditated, its often triggered by some incident considered quite insignificant by observers but a climax to the build up of fear shame guilt or whatever strong emotion they are battling at the time.

As with most adverse bipolar behavior the recipients are usually those they are closest to, who love them dearly and by all accounts least deserving of such behavior.

If a pattern of bullying to manipulate and control others exists it's probably worth investigation and seeking medical help. Hurling crockery, plates of food or for that matter any object at others is unacceptable no matter what the circumstances. Smashing the windscreen of a car parked in a space considered yours is not normal.

Often the rage outburst is followed by remorse and the perpetrators themselves will realize their lack of self control and the need to seek help. Especially if children are on the receiving end its essential to remedy the situation before any long term damage is caused.

Rage management in bipolar disorder is part of the treatment and can radically improve the quality of life for all concerned.

Bipolar self injury is another area where the need for a sense of being in control manifests itself.

Bipolar and lying

The association between Bipolar and lying

It is not an uncommon experience for those living or frequently interacting with patients of bipolar disorder to become aggravated at lies told by the bipolar person. Lying and bipolar disorder seem to go hand in hand for most manic-depressives and this association is grounded in more than one source.

Lying Out of Fear

One obvious reason for the association between lying and bipolar disorder is fear. Almost every lie is rooted in fear- the fear of some possible punishment. It is a matter of fact affair to be punished for mistakes or wrongs done knowingly or inadvertently. Denying one’s role, when caught, is thus natural. Manic-depressives are more prone to commit mistakes like reckless behavior, promiscuity, and extravagance. Contriving lies for apology is thus natural for manic-depressives.

Attention Gatherers

Bipolar patients have a craving for maintaining control over situations, and among family and friends, this need often takes the form of lying. By making false statements to different people, the manic-depressive assumes he is the gatherer of people’s attention and in control of the situation, since they dictate what people know.

Loss of Self-Control

During episodes of mania or depression – but particularly in mania -- the patient’s conscious nervous system often loses control over what they say. In other words, a bipolar sufferer’s brain swirls out of rational control during such episodes. Whatever pops up in the mind is uttered, and hence the lies.

Hallucinations

Lying and bipolar disorder are linked by another fact. Bipolar patients often experience hallucinations. Mostly these are auditory hallucinations, that is, voices or sounds that no one but the patient experiences, and then tells others about. Certainly such stories are lies to those who hear them.

But other forms of hallucinations may also occur, like a manic-depressive complaining that some family member locked them in the kitchen, while the accused assuredly did no such thing. It is important to understand that in such cases, reality is different for the bipolar sufferer and they are simply telling what they believe they experienced.

Brain Chemistry

Certain chemical substances in the brain are known to induce mood swings. An important one of these is the neurotransmitter serotonin, whose low production can induce depressive episodes. Lovers of ice cream might recognize their cherished flavor as a mood stabilizer, because of the serotonin in the ice cream. Low serotonin in the brain of a bipolar patient is another reason for the connection between lying and bipolar disorder, as it triggers impulsivity in the patient and lies are a frequent result.

Whatever the reason lying can place a lot of strain on any relationship which is why bipolar and divorce is also not uncommon.

Bipolar and obesity

Bipolar and obesity connection

Many patients present with both bipolar and obesity. Obesity is a common comorbid (occurs together) condition which complicates the assessment and management of bipolar.

Bipolar is a disorder of behavioral extremes and during manic episodes excesses in many areas including calorie intake is not uncommon.

A significant contributory factor to the tendency to obesity in bipolar individuals is the weight gain directly attributable to the medication involved in the long term management of the disorder. This undesirable side effect may well self perpetuate the problem. The patient is less inclined to take the medication required to stabilize the mood swings and curb the compulsion to eat eat eat.

It is natural for anyone to turn to food when under stress and since bipolar and stress do not mix well the potential to turn to food for comfort is more probable.

A diagnosis of bipolar disorder generally occurs many years after the onset of the symptoms. Many do not realize or will not accept that their behavior is unusual so will not seek help and of those who do seek help some initially will be misdiagnosed. There will always be a number of individuals in the pipeline whose destructive eating habits are developing with time and who are already well on the way to obesity before the diagnosis occurs.

With obesity comes the increased risk of type II diabetes which is also one of the more common general medical comorbidities of Bipolar disorder. Not surprisingly the food consumed is usually the feel good stuff laden with the carbohydrates causing overloading of the insulin production process leading to insulin resistance or type II diabetes. The good news is that this form of diabetes is a result of diet and corrected by diet changes.

Both bipolar and obesity can be medically controlled and with help available there is no reason not to seek all the help you can get.

When are you considered obese?

Obesity today is classified as a BMI of 30 kg/m2 or greater. What's that in plain English? Well if you take your weight in kg and divide it by your height in meters squared and get an answer of 30 or more you are obese.

eg height 1.65m weight 100kg
BMI = 100/ (1.65*1.65) = 100/ 2.72 = 36.76 = Obese
or height 5' 4" (64") weight 120 pounds
BMI = [120/(64*64) ]*703= 20.59 = Healthy

For adults a BMI between 18 and 25 is in the healthy range, 25 to 30 is the overweight range and 30 plus indicates obesity.

Alcoholism and Bipolar

Alcoholism and bipolar disorder

Alcoholism and bipolar are a potent combination. Alcohol is the most common substance of abuse with bipolar disorder individuals.

Research indicates that both men and women with bipolar have a greater likelihood of alcohol misuse than the general population, that bipolar men are more likely than bipolar women to abuse alcohol and that there is more chance of a lifetime history of alcohol misuse with the combined alchoholism and bipolar.

Where alcoholism and bipolar co-exist whether as bipolar drug abuse during periods of depression or otherwise, the likelihood of non compliance with medication increases as does the risk of suicide.

Alcohol intoxication and mania and hypermania display similar symptoms as do alcohol withdrawal and depression. Concurrent alcohol abuse complicates the diagnosis, prognosis and treatment of bipolar individuals and often leads to heightened severity of bipolar symptoms, and poor treatment outcomes.

Numerous studies into the effects of alcohol with Bipolar disorder medications point to adverse effects and sometimes dangerous outcomes.

Bipolar and time zones

Bipolar and time zones connection

Is there a connection between bipolar and time zones? Changing time zones affects everyone but impact on people with bipolar disorder is amplified. It is not unusual for time zone changes to trigger an affective episode in some.

When we travel to different time zones our wake/sleep cycle (circadian rhythm) is upset and we suffer jetlag until it's back in sync.

The human body doesn't always take kindly to change. For optimum sleeping habits it responds best to consistent daily amounts of light and darkness and sleep deprivation can result if this balance is upset either by extended light hours or darkness. Generally we cope best sleeping at night while it is dark. Any disruption to the normal sleeping pattern is likely to result in adverse mood changes even in normal individuals but with bipolar getting too much light may trigger a manic episode while too little may trigger an episode of depression.

Recent studies at the university of Texas involving mice and a gene regulating circadian rhythm suggests a correlation between disturbed circadian rhythms and bipolar disorder. This would explain why bipolar and time zone changes are not a good combination.

Summer vacations are one of the joys of life but just be aware next time you take off to some far away exotic destination that time zone changes need to be factored into your management strategy for living with bipolar.

Bipolar and drug abuse

Bipolar disorder and drug abuse

Sadly bipolar and drug abuse often occur together. Drugs or alcohol abuse or dependency may occur at some stage in about half of bipolar disorder individuals and seems to be more likely with child or adolescent onset bipolar disorder. Substance abuse with alcohol, marijuana, amphetamines, cocaine, opiates is known to occur.

What is not clear is whether the drug abuse is the result of having bipolar or whether symptoms similar to those of bipolar result from the drug abuse e.g. 30% of cocaine addicts fit criteria for bipolar disorder. Evidence seems to suggest that bipolar is at the root of the problem. Either way drug abuse comorbid with bipolar complicates the diagnosis and treatment of bipolar disorder.

There seems to be a link between chronic marijuana use especially in teens and increased risk of bipolar with psychosis.

Also there seems to be a connection between a family predisposition to mania and drug abuse and where this exits the drug abuse may precipitate an earlier onset of bipolar I disorder

There are suggestions that the drug abuse might be a way of self-medicating the unpredictable and uncontrollable mood swings characteristic of bipolar. Where treatment has not been sought either through ignorance or denial, the fact that there is an underlying reason for the symptoms is not known. The only problem with this argument is that if the drug abuse is supposed to relieve the symptoms i.e. stabilize the moods why the use of substances that worsen the situation like cocaine during manic episodes and alcohol during periods of depression.

Another explanation is that the behavior patterns symptomatic of bi polar disorder like excessive involvement in pleasurable activities, poor judgment etc make them more inclined to succumb to drug abuse.

Studies have also shown links between bipolar substance abuse and crime. Men seem to offend and get arrested more often than women, but the risk of being charged rises for females cocaine abusers. There is probably a connection here with another potential problem namely bipolar and money.

Here is a resource that offers light at the end of the tunnel for anyone with a drug or alcohol abuse problem. Especially if the abuse is a means of self medicating then a program offering a natural way of feeling good about oneself could prove a very beneficial alternative.

Here are a couple for those wishing to permanently kick the pot smoking habit by themselves or Easy Quit program .

Hypersexuality and Bipolar

Hypersexuality and Bipolar Disorder

Hypersexuality is not uncommon with bipolar and presents a threat to both the family and sufferer and can be particularly destructive in relationships.

For anyone in a relationship with a bipolar individual keep on the lookout for obsession with sex, compulsive sexual behavior, sexual addiction or whatever - essentially an abnormal increase in the desire for sexual gratification.

For many undiagnosed bipolar individuals this could be the first sign that something is not quite right and might well be the trigger for seeking medical help. Hypersexuality is symptomatic of mania in bipolar disorder and promotes an exceptionally vulnerable time for both parties in the relationship and if not recognized and properly handled can lead to emotional turmoil and family breakups.

Unsuspecting partners of normally sexually conservative individuals are often surprised at the onset of an affair, usually an entirely inappropriate one at that. Accompanied by words like "you're the only one I love but ..... its the sex dear" and that's it - you and the family are dumped for sexual gratification.

To those left behind its devastating both emotionally and financially especially if the absconding parent is also the sole earner.

Often the prime mover is in fact not the sex obsessed individual but seasoned sex predators on the lookout for vulnerable high earning individuals. They pounce with lightning speed satisfy the sexual needs and very little else, and often succeed in breaking even long standing happy relationships.

Bipolar disorder can be well managed with appropriate medication. Well controlled mania will handle hypersexuality and other emotional extremes like bipolar rage.

Bipolar and excessive money spending

Symptomatic of a manic or hypomanic episode with bipolar is excessive money spending, compulsive shopping and impulsive purchases.

Well how different is that from "normal" individuals. Probably the majority of people have at some stage indulged in these activities. How many of us possess collections of "must have" cookery books, diet books etc bought during periods of intense interest and rarely used thereafter. What is considered overindulgent by some might seem perfectly normal to others.

Not all reckless spenders are bipolar but for anyone with bipolar disease it can become a problem with serious consequences if precautionary measures are not in place.

During bipolar episodes there is often a lack of ability to link actions with consequence. This might in part be due to the feelings of grandiosity - totally inflated, unrealistic ideas of capabilities. Also the diminished ability to think and reason clearly no doubt contribute but knowing why is little consolation when the debts pile up.

There are some who have gone as far as forging signatures (usually of family members or friends) on credit cards, loan documents etc which seems to indicate the compulsion to reach the goal totally dominates the action. Possibly it's the misdirected creative ability of hypomania which is the driving force. The reasoning ability is clear enough to know that using their own credentials will not succeed but the compulsion to get what they want at that point in time overrides all else.

For the bipolar individual and those supporting them its best to accept the potential for inappropriate financial dealings exists and to put in place precautionary measures to curb the potential damage. Limiting access to credit cards is paramount. Any cash allowance should be spread over the period rather than provided all at once.

It's might be worthwhile quietly removing acquisitions, keeping receipts and waiting to see if they are ever referred to again. Very often it's the compulsive need to spend, regardless of the desire or need for the item, that the act satisfies.

The potential for bipolar and obesity is ever present so If overindulgence in food is part of the spending mix there is added incentive to take the necessary precautions.

Impact of Bipolar and stress

Increased stress is an unpleasant consequence of modern living with or without bipolar.

Stress is our response to unfavorable challenges that upset our rhythm. Everyone faces demands and obstacles during life that pose a threat to mental harmony. Often this results from unrealistic self imposed expectations or the expectations of others on our behalf. Whether we cant actually rise to the challenge, or our perception is that we can't makes little difference, either way we will encounter a degree of stress relative to the extent of the shortfall.

Stress sets off a chain of chemical changes in the brain which in the bipolar individual could potentially trigger both depression and mania so it is critical for bipolar individuals to strive for a stress free existence.

Bipolar disorder is associated with stress inducing behavior like the anxiety and irritability of depressive episodes or the excesses, risks and reckless behavior during mania. This can make it rather difficult to eliminate stress if there is no long term management of the disorder in place.

With many of the bipolar symptoms, being aware of the danger signs is half the problem. If you know the problem and can measure the effect then it is a lot easier to prevent the occurrence e.g. if you know your safe limits for sleep deprivation or alcohol consumption you can stay within those limits and avoid stressful situations. Its up to you to organize your life wherever possible to ensure your psychological and physiological needs are met. This is one area in which your needs should take priority. If your travel plans involve different time zones take this into account and plan accordingly.

Try to set realistic goals and make small incremental achievable behavioral modifications. Re-enforce your achievements rather than berating yourself for falling short on unrealistic goals.

Bipolar depression explained
Bipolar depression like any depression hampers ones ability to function socially, professionally and personally. hampers ones ability to function socially, professionally and personally. Depression and bipolar go hand in hand.

Depression is normally accompanied by feelings of sadness, loss of interest in normally enjoyable activities and a general ongoing feeling of hopelessness.

Bipolar disorder individuals fluctuate between periods of depression and elation sometimes with normal periods in between. With bipolar depression irritability and also agitation may be present. The depressive episodes are often shorter but the fluctuations into depressive states are more frequent and characterized by extremes in tiredness, food consumption and sleeping.

Depression alone can be managed with antidepressants but with bipolar depression mood stabilizers are an important component of bipolar medications. This is necessary to manage the swings in an effort to control the frequency and severity of the fluctuations. Antidepressants without mood stabilizers may activate mania or accelerate cycling between moods.

Long term management of depression with bipolar is vital. Risk of suicide is higher. The anxiety, irritability and hostility may lead to violent or suicidal behavior.

It is not unusual for bipolar disorder to be misdiagnosed as major depressive disorder, especially when the patient's moods swing more in the depressed direction. Frequently, the patient will only mention the depression to the doctor because the manic episodes do not seem like an illness from their point of view. Also behavior symptomatic of the manic stage like hypersexuality is unlikely to be seen as a problem by the patient.

Additionally, people with bipolar disorder can be normal for long stretches of time before suffering either mania or depression.

The Bipolar Disorder Anxiety Connection
Often people with bipolar disorder also have anxiety symptoms or anxiety disorders. Anxiety may be symptomatic of the depressed phase of manic-depressive disorder but it can also indicate a separate anxiety disorder. In fact anxiety without any underlying medical illness, i.e. as a psychiatric symptom commonly co-occurs with bipolar.

Anxiety is more prevalent with bipolar disorder than with unipolar depression and the incidence amongst the bipolar spectrum disorders is higher than those in the general population.

There are similarities between bipolar (a mood disorder) and anxiety disorders also referred to as the manic panic connection. Both display episodes of changed behavior. Anxiety or panic attacks usually occur in response to fear. With bipolar the altered behavior is reward orientated.

Symptoms of anxiety are evident both in body and mind. Where the fear response is out of proportion to the threat as in anxiety disorders the body response may include chest pain, heart beating faster, sweating, reddening of cheeks and neck, dizziness, fainting, ringing ears, shortness of breath, headache, blurred vision, diarrhea, fatigue and weakness. Psychologically the sense of reality of the situation declines and feelings of fear, horror, panic etc take over. Concentration decreases, thinking becomes disorganized and the adrenalin rush intensifies the senses leading to sensory flooding.

Living with bipolar and anxiety disorder requires special treatment taking both into account. One ever present problem to be avoided is antidepressant-induced mania or cycling so generally mood stabilization is addressed before the anxiety symptoms.

Self Injury in Bipolar Disorder
Self injury amongst bipolar individuals certainly exists. Whether it be self harm, self abuse or self-damage the compulsion is there to inflict immediate damage on themselves.

Often it takes the form of cutting, usually the skin, and for the duration of the action empowers the cutter with a sense of being in control. This self inflicted bodily harm originates from emotional turmoil, feelings of powerlessness etc which are amplified in bipolar individuals.

Non bipolar individuals often abuse their bodies too with alcohol drugs junk food etc but these are indirect and painless at the time and whilst they might occur with full knowledge of long term possible consequences they do not involve deliberate compulsive acts to cause instantaneous tissue damage.

To family and friends bipolar disorder self injury is one of the most stressful hazards of the disorder. Because of its recurrent nature round the clock vigilance is necessary which inevitably puts one in a policeman like role further exacerbating these feelings (perceived or otherwise) of powerlessness.

Unlike rage outbursts or alcoholism and bipolar which are very public, self injury normally occurs out of sight with significant effort expended concealing the act.

Where evidence of self harm exists it is best to seek help from mental health professionals.

ipolar Suicide
Bipolar Suicide Why?
Of all the problems associated with bipolar suicide is one of the most heartbreaking.

The annual suicide figures paint a very bleak picture. An outcome of suicide in males is 5 times more likely than females and suicide is a leading cause of death among young adults. With the incidence of bipolar disorder now on a par with that of diabetes there are millions of people worldwide struggling with bipolar so negative outcomes are likely to affect many individuals and families. Sometimes patients are trying to cope with other conditions also like bipolar disorder and MS.

The incidence of suicide amongst bipolar individuals seems to be higher than that of the normal population and within the affective disorders the suicide rate is less with bipolar than unipolar people. With unipolar the depressive episodes generally last much longer so the risk of suicide is greater.

Individuals on long term management programs are at less risk than those who are not. This is partly because bipolar disorder tends to be recurring and the duration between episodes tends to decrease leading to more time spent in the depressive state with the increased suicide risk.

Another contributory factor seems to be what activity the individual is engaged in at the time. Army service away from home understandably worsens the situation when the individual is under increased stress and removed from their familiar support group.

Bipolar and Borderline Personality Disorder compared
Sometimes an individual displays behavior symptomatic of both bipolar and borderline personality disorder. Whilst there are certain parallels there are also areas of difference.

Mood shifts between mania and depression are common to both but behavior during those episodes differ according to the condition. With bipolar disorder during depression the individual is prone to self criticism, feelings of guilt , low self esteem, and deriving pleasure from enjoyable experiences is often not possible. They are generally negative about themselves and pessimistic.

By contrast the often invented self assessment with borderline personality is not compromised during mood cycling. The ability to function normally remains intact.

With bipolar reckless destructive behavior tends to occur during mania. Manic episodes are the danger zones for behavior such as reckless driving, drug and alcohol abuse, compulsive spending, sexual activity etc. Where borderline personality co-exists this type of behavior is not confined to the manic phase. Mania also does not effect social and occupational performance unlike bipolar.

The delusional aspects of mania are common to both as is the unease etc that can be caused in social environments. With bipolar those close to the individual can easily identify such behavior and whilst it might hamper harmonious socializing and have an intimidating effect on those caught unawares it is not harmful. With borderline personality disorder there is more of an underlying purpose associated like goal driven manipulation without obvious loss of control.

Where another condition co-exists with bipolar it can aggrevate the situation. Especially in children this is seen in cases of ADHD bipolar disorder