Manic depressive questions, if anyone with experience can answer...

[jedbel]

I know a close family friend who is bipolar. About 20 yrs. ago as a young unmarried man he became a member of the church my father pastored (is that even a word:tongue_smilie:) and we have really seen first hand what a struggle it is to live with this illness. I am surprised to find out through this board discussion that there is a way to manage this illness without medication.:confused: This has not been our experience at all! Every time this friend stops taking the medication we have to take him in to restart them because of severe symptoms that slowly begin to show up. He is now happily married and his wife is great at helping him stay on the meds. The only down side is that the meds make him feel tired/sleepy and cause hunger which has lead to weight gain. He has to live with these side effects and it is hard.

The symptoms you describe do not sound like the kind of bipolar our friend has at all. HTH!

[NCMom]

Actually, that is a hallmark of Borderline Personality Disorder (BPD), not Bipolar (BPAD).

 

Think of it this way: In BPD, thought becomes action. In BPAD, action becomes thought.

 

There is a great deal of (conflicted) research currently occurring, but it is generally agreed (for now at least) that BPAD is a physical, genetic illness; a disruption at the molecular level. The mood swings involved appear to be the result of too much or too little of particular chemicals in a person's brain.

 

BPD is generally seen as the result of damage to one's psyche. eg: A child who grows up with abuse may learn dysfunctional coping mechanisms to deal with "normal" moods. Hence, the "changing the attitude depending on the person/target" concept.

 

If anyone has questions, I'd be happy to answer them.

 

asta

 

I agree. My mother has Borderline Personality Disorder and her behavior is much more like what you are describing than the two people we know that have Bi-polar. Umm yeah, especially the lying about what the doctor said parts...:glare:

 

Georgia

[KidsHappen]

This is so very hard for me to answer right now as I am bi-polar and currently going through a mixed manic state. My reflection and ability to articulate is not as clear as it usually is. I'll start with answering your questions and then add whatever I can remember that I think maybe helpful.

 

1. Can manic depression be managed without drugs?

 

In my experience, no. I have read here of some who say yes, but I have never seen or heard of it in real life or on any of the sites that deal with mental illness in general or bi-polar in particular. Both my dm and one of my dds are also bi-polar and none of us can function well without proper medication.

 

Is there natural ways someone can manage it through diet, exercise, sleep?

 

Once again, in my experience no. I certainly tried: exercise, biofeedback training, relaxation training, chiropractic, acupressure, message therapy, vitamins, minerals, herbs, homeopathic, natural supplements, amino acids, diet. I have tried all of the natural anti-depressants and almost every natural calming med including GABA, valerian, Kava, melatonin for sleep and fish oils. I found absolutely none of it to be any help what-so-ever in dealing with bi-polar. Marijuana works very well for calming the manic state but is not a legal option in this country.

 

2. How much tolerance is appropriate from family members?

When the behavior is harmful at what point is it unexcuseable? (is that a word?) I guess what I'm asking is if you are manic, what do you ask of your family to help you? If you deal with manic behavior, what is your breaking point?

 

I do ask that my family help monitor my moods and show concern and mention it if they notice my moods starting to shift. My hubby seems to notice when I am heading towards a manic state before I do and my oldest teen seems to notice depression before others do. I would expect my family to step in if they thought I would do harm to myself or others and to be able to have a somewhat realistic grasp of when that is.

 

We have never had to deal with these issues but they would certainly be inexcusable and need to be dealt with immediately (and maybe even against the patient's will): drinking problems, drug addiction, abuse, extreme shopping, infidelity, self harm or mood swings and erratic behavior that would be scary to the family and make them feel unsafe, certainly any serious threats of any kind of harm.

 

Is it reasonable to ask a person with manic depression to manage their illness? What if they don't want to medicate?

 

It is reasonable to ask but not possible to make them. If a patient is somewhat sane and does not want to medicate, there really isn't anything that you can do about it. It takes a lot to have someone committed against their will. You have to take them where they are and then make a decision about where you want to be in relation to where they are.

 

Does a manic depressive need someone to run their life for them? Take care of all of major responsibilities? (For example, manage finances, take care of home care- anything that requires a focused effort?)

 

It really depends on how functional/disabled they are and what they want. Many bi-polar people are disabled to the point of receiving disability and really can not take care of themselves. Others are fully functional and able to manage on their own. Most are somewhere in between. When well medicated and balanced, I am able to function normally as long as the equilibrium remains the same. I do not tolerate extreme stress very well and I do not know that I could manage long term without support systems. I do need someone to take care the big things (finances, home and car repair and maintenance, etc.) and even some small things (I can not make phone calls for instance). I know and accept this. However, most of the time I can handle life: the cooking, cleaning, teaching and so on. If the person does not want help, once again there is nothing you can do about that.

 

What if the manic depressive person refuses treatment or management?

 

Nothing you can do about that until they reach a place where they are deemed committable. Most bi-polar people are very sensitive about other people making decisions for them, probably more so than your average person. Our decisions, experiences, memories, everything is questioned in relation to our being bi-polar.

 

One more thing I wanted to add was the spectrum of moods a bi-polar person can experience. Imagine a line with extreme mania on one end and extreme depression on the other.

 

On the manic end you have delusions, paranoia & hallucinations, almost schizophrenic behavior. For the most part these people are non-functional. They are frequently committed or at least admitted for observation.

 

Then there is your average mania. This is where the extreme shopping, drinking, drugs, sexual escapades, and weird spur of the moment activities come from. There is also another variant in which people are just extremely agitated, irritable, anxious, angry, driven, fits of rage and such. When people are in this state they just want to be left alone. The presence of other people is painful. It is probably just as well because people don't want to be around them then either. The problem comes when they are forced to interact with other people.

 

Then there is the hypomanic stage. Everyone LOVES this stage and if you could stay in it all the time life would be grand. This is when you are euphoric, charming, witty, fun, etc. You are on your game, in the flow, on top of the world. You can get so much done. This is when books are written, works of art are created, you house is cleaned, decluttered, rearranged, painted. This stage never lasts very long and is almost always followed by a manic stage. This is when people are most likely to go off medication because they want to feel this way.

 

Then there is normal & balanced. This is the point we are always trying to reach. And it can be done with proper medication and life management but it is like walking a tight rope and you can be knocked off of topple over only too easily.

 

Heading towards the other end is dysthymia. This is a chronic low level depression in which life is blah, You have no energy, motivation, desire. You are just stuck and really have no ability to do anything about it because you don't have enough energy to try. You start withdrawing. You don't want to go out of your room, your house. You don't want to interact with people because once again it is painful. This almost always leads to worse depression.

 

Then there is severe depression. This is so bad, you don't eat, can't sleep, cry all the time, you can suffer from catatonia. This is where suicidal ideas can start to happen or unfortunately the desire to hurt others. People in this condition are the most dangerous and it needs to be treated as an emergency (thing Yates). People in this state can also be committed or at least admitted for observation.

 

 

I tend more towards the manic stage myself as does my dd. We fall in the extremely agitated, irritable, anxious, angry, driven, fits of rage and such. This requires pretty serious meds to control. My dd rarely if ever suffers from depression. I do sometimes but more in the dysthymic range. I am currently suffering from a mixed state in which I am having my level of mania and depression at the same time. I have only had this happen a few times in my life. It is much more painful and difficult to deal with than either of those alone. It is also much more difficult to treat and medicate and it takes longer to pull out of.

 

My mother was more of a depressive bi-polar but her swings into mania were extreme. Shopping (thousands of dollars), trips, nights on the town and much more. One episode lead to her leaving my dad for no good reason. I found her perplexing and scary but I never knew why she was the way she was until I was older and then unfortunately I understood only too well. As I look back on it now, I realize my mother and my moods were tied together just as my dd and my own are.

 

This is my experience of being bi-polar and of interacting with bi-polar people. I am sure that my vision of living with bi-polar people is skewed or colored because I am seeing it from inside looking out. Other people probably have a better perception of living with bi-polar people than I do. I have asked my hubby to read this thread and see if he can offer anything from his point of view.

 

Jessica, I wish you this best of luck as you work through this difficult period in your life and I hope that everything works out the best for you and your children. :grouphug:

Edited February 27, 2009 by KidsHappen

[Lovedtodeath]

 

The symptoms you describe do not sound like the kind of bipolar our friend has at all. HTH!

Could you explain some differences?

[TraceyS/FL]

I can't tell you how helpful everyone's responses have been. I'm fairly certain I've been lied to or even the person claiming to be bipolar has been misdiagnosed b/c they are not manic and can change their demeanor instantly depending on who they are talking to.

I can relate to the change on a dime.

 

What about the person with bi-polar who abuses his family but is charming to everyone else? Have they been misdiagnosed, are they bi-polar and evil, are they bi-polar and BPD?

 

I hope this doesn't sound rude. I am really wondering. And does the answer to this change how we would react to this person?

I"m curious on this too. Family/me (and my mom when she lived here) is the only person mine is abusive too. No one else in daily life would think there was a problem.

 

Although, he did just flip on wednesday. BIG TIME - not abusive but made a really stupid decision.

 

Jessica - :grouphug:

[Pamela H in Texas]

Family/me (and my mom when she lived here) is the only person mine is abusive too. No one else in daily life would think there was a problem.

 

In the BP community, this difference is noted often. However, I have to say that I'd be surprised if they really do pull it off COMPLETELY with everyone else LONG TERM. I feel "normal" sometimes in some situations for a time. Then more and more history, situations and quirks show through. These aren't really things I try to hide, just that as you get to know ANYONE, more and more comes out and my things just are particularly not pretty.

 

Another difference might be that they act outside of normal but in a different way than they normally present to loved ones. For example, my son most certainly didn't seem "normal," but the issues were CONSIDERABLY different with the teacher at school (he attended for 2mo) than at home. However, treated appropriately (though not medicated), he is "normal" almost all the time now :)

[asta]

What about the person with bi-polar who abuses his family but is charming to everyone else? Have they been misdiagnosed, are they bi-polar and evil, are they bi-polar and BPD?

 

I hope this doesn't sound rude. I am really wondering. And does the answer to this change how we would react to this person?

 

There are evil bipolar people, just as there are evil euthymic people. A person's base personality doesn't change just because they're ill.

 

That said, it is possible to have a dual BPD/BPAD diagnosis - I have seen it very often. IME, the dual Dx people are easier to deal with then the straight BPD (borderlines) are, and the BPAD (bipolar) people are easier to deal with than either dual or straight BPD.

 

It all comes down to coping skills and level of manipulation in my book. I have dealt with both psychotic and suicidally depressed bipolars who were much more self-aware than the garden variety BPD.

 

Like I said, just my experience. KidsHappen's post on BPAD was excellent.

 

 

asta

[Guest shelly18]

My dad is a manic. Probably the most severe I've ever seen.

It's like a roller coaster. He's a very intelligent man and when he has his "highs" he's a terrific person to be with. I love my dad very much, but if he wasn't my dad I would not like him on bit. Because of the complications with his medication he has terrible mood swings. He's emotionally unstable at times. It's like walking on eggshells. I'm 18 and the oldest of 2 kids. I don't feel comfortable in my own house and everything that gets my dad upset and into his little "episodes" he blames everything that has gone wrong on me. It's a very difficult situation to grow up in and I'm still dealing with this today... Being bi-polar is not a joke. It's a very complicated and difficult illness to have and it's equally as difficult if not more on the family involved...

[LittleIzumi]

From what I've observed, there are degrees of bipolar-ness (is that a word?) It can go from being a small neuroses to full-blown psychoses. The full-blown psychoses is not pretty. A lot of outside factors can change our brain chemistry and exacerbate problems - lack of sleep, extra stress, physical illness etc. can make things worse.

 

 

:iagree::iagree::iagree: I am technically bipolar--diagnosed at a very young age plus there's a strong family history. However, it was a fairly mild case. I stopped taking my meds as an older teenager because it was very mild bipolar and the side effects were worse than any tiny bit it might have helped. Over the years my symptoms lessened and lessened and for most of my twenties the ONLY trouble I have at all is that I can't take any medication that has the side effect of being anti-depressant or it "tips the scales off balance" and I do get flung into a bipolar episode/maaaaaanic. Stimulants would probably have the opposite effect but I haven't taken them.