Sunday, December 13, 2009

Questions/Answers

You asked.....I answered. Well, to the best of my ability. Again, keep in mind I am not a doctor, I am only answering these questions from my personal experience.

-Is Manic depression is different than bipolar disorder?
No, "Manic Depression" is the old (no longer used) name for "Bipolar Disorder". Bipolar Disorder was found to be a more accurate description of the disorder.


-I’m feeling better since taking my medications, which means I probably don’t need them any more, right?
Wrong, wrong, WRONG! The reason you are feeling better is because the medication is WORKING. Unfortunately this is one of the worst problems with Bipolar (and all mental illness) patients-they assume that because they feel "back to normal" they no longer need the medication. Psychiatric drugs are not like Advil; you can't just take them when you feel like it. They must be taken as prescribed, for as long as prescribed (often for the rest of your life). That's just part of the illness. Often a patient will think they are "cured", come off their medication, and crash. And then they have to go through the whole process of going back onto new medications and becoming stable-it ISN'T worth it!


-Is Bipolar "curable"?
No, it's "treatable". For now at least. Let's hope there's a cure in the future-that's why exposure is so very important.

-How is bipolar disorder diagnosed?
Bipolar is usually diagnosed during the teen years (I was 17). Usually a Bipolar patient will go through a manic episode and crash and attempt suicide (and thus end up in the hospital), where they will be diagnosed.. Usually there is a genetic history. The family doctor will refer the patient to a psychiatrist who will evaluate the patient over a length of time.


-What are the two types of Bipolar?
  • Bipolar I defines patients with the classic form of this disease: Recurring episodes of mania and depression.

  • Bipolar II defines those who never experience severe mania but instead the manic episodes are milder, and alternate with depression.

-What causes Bipolar?
The cause of Bipolar is still unknown, but science is getting closer to determining it daily. It is generally thought that the neourtransmitters serotonin, norepinephrine or dopamine have a great impact, as does genetic factors. Stress also plays a major role in relapses.

-Are Bipolars dangerous to others?
When Bipolars are manic, they can become very reckless and dangerous. That's one of the reasons why it is important for Bipolars to recognize their own "triggers" and realize when they are starting to slide in "manic mode" (as I call it). Family members and friends can also help by keeping an eye out. The Bipolar patient should head straight to their psychiatrist as soon as they feel "off".


-What is "hypomania"?
Hypomania means, literally, "mild mania."

-What is "Rapid Cycling"?
Rapid Cycling is officially defined as "experiencing 4 or more bipolar episodes within 12 months". I am an extreme rapid cycler-often expericing cycles in a couple days or even hours. For some reason this is much more common in women.


-What can I do if my loved one is Bipolar?

Twelve things to do if your loved one has depression, manic-depression,
or some other mood disorder:

1. Don't regard this as a family disgrace or a subject of shame.
Mood disorders are biochemical in nature, just like diabetes, and
are just as treatable.

2. Don't nag, preach or lecture to the person. Chances are
he/she has already told him or herself everything you can
tell them. He/she will take just so much and shut out the rest.
You may only increase their feeling of isolation or force one
to make promises that cannot possibly be kept. (I promise I'll
feel better tomorrow honey; I'll do it then, okay?)

3. Guard against the "holier-than-thou" or martyr-like attitude.
It is possible to create this impression without saying a word.
A person suffering from a mood disorder has an emotional
sensitivity such that he/she judges other people's attitudes
toward him/her more by actions, even small ones, than by spoken
words.

4. Don't use the "if you loved me" appeal. Since persons with mood
disorders are not in control of their affliction, this approach
only increases guilt. It is like saying, "If you loved me, you
would not have diabetes."

5. Avoid any threats unless you think them through carefully and
definitely intend to carry them out. There may be times, of
course, when a specific action is necessary to protect children.
Idle threats only make the person feel you don't mean what you say.

6. If the person uses drugs and/or alcohol, don't take it away from
them or try to hide it. Usually this only pushes the person into
a state of desperation and/or depression. In the end he/she will
simply find news ways of getting more drugs or alcohol if he/she
wants them badly enough. This is not the time or place for a
power struggle.

7. On the other hand, if excessive use of drugs and/or alcohol is
really a problem, don't let the person persuade you to use drugs
or drink with him/her on the grounds that it will make him/her
use less. It rarely does. Besides, when you condone the use of
drugs or alcohol, it is likely to cause the person to put off
seeking necessary help.

8. Don't be jealous of the method of recovery the person chooses.
The tendency is to think that love of home and family is enough
incentive to get well, and that outside therapy should not be
needed.

Frequently the motivation of regaining self respect is more
compelling for the person than resumption of family
responsibilities. You may feel left out when the person turns
to other people for mutual support. You wouldn't be jealous
of their doctor for treating them, would you?

9. Don't expect an immediate 100 percent recovery. In any
illness, there is a period of convalescence. There may be
relapses and times of tension and resentment.

10. Don't try to protect the person from situations which you believe
they might find stressful or depressing. One of the quickest ways
to push someone with a mood disorder away from you is to make them
feel like you want them to be dependent on you.

Each person must learn for themselves what works best for them,
especially in social situations. If, for example, you try to
"shush" people who ask questions about the disorder, treatment,
medications, etc., you will most likely stir up old feelings of
resentment and inadequacy. Let the person decide for THEMSELVES
whether to answer questions, or to gracefully say "I'd prefer to
discuss something else, and I really hope that doesn't offend you".

11. Don't do for the person that which he/she can do for him/herself.
You cannot take the medicine for him/her; you cannot feel his/her
feelings for him/her, and you can't solve his/her problems for
him/her; so don't try. Don't remove problems before the person
can face them, solve them or suffer the consequences.

12. Do offer love, support, and understanding in the recovery,
regardless of the method chosen. For example, some people
choose to take meds; some choose not to. Each has advantages
and disadvantages (more side-effects versus greater possibility of
relapse, for example). Expressing disapproval of the method
chosen will only deepen the person's feeling that anything
they do will be wrong.

-How can I explain Bipolar to others?

Stick to the basics. Most people can't retain everything about Bipolar; a lot of people don't want to. Just explain that Bipolar means you get mood swings, from elation to depression, and those mood swings have nothing to do with what is going on with their lives. It's caused by electrochemical abnormalities in the brain. Mania doesn't mean "crazy"-it refers to high emotions, fast talking, full of energy, not need much (any) sleep....etc. I'm a rapid cycler, which means that  I can be ultra-excited one day and deeply depressed the next, for no obvious reason. I get into what are called "mixed states" when I seem to have a lot of energy but at the same time am really down, angry or panicky. When I'm manic, I have particular problems with spending money and shopping. Inappropriate anger can be a symptom of bipolar disorder. I might say or have said hurtful things that I really don't mean - I'm sorry! Just keep it short and simple, otherwise it becomes overwhelming.

-How Often Do People with Bipolar Disorder Cycle?

It depends on the patient!

-What can a girlfriend/boyfriend do for THEMSELVES to stay grounded while trying to deal with the emotional and mental struggles of their significant other?

I think my hubby (and family) would probably be able to better answer this one, but I'll do my best. It's important for loved ones to stay strong, which means being able to give to support, but sometimes means stepping back too. Mental illness is exhausting for everyone involved, and everyone needs a break at some point. Loved ones have to realize that the mental illness has nothing to do with them; you cannot control it; it's beyond your power. You can make suggestions and try and give support to the mentally ill, but often they will push you away. Be patient. That is the best advice I can give. Eventually, we will either hit our "wall" or something will change, and we'll realize we need the help/support/whatever. Realize that when you get into a relationship with a mentally ill person, it's lifelong. It never goes away, and you (as a couple) have to fight it daily. I'm not saying it's not worth it; but sometimes (often, actually) I question why my hubby sticks around with all the crap I throw at him. But he loves me, and I love him. And that's what it comes down to. I never asked for this illness, I don't want it, but I have it....and I try and make the best of it-I take my medications always as prescribed, I always see my doctors when I'm supposed to-so my hubby sees the effort I put into staying healthy, and that means he'll let it slide when I do screw up. So there's no real easy answer here. It's a long, very difficult road (like any life long illness), but the best advice I can give to the loved ones-stay strong, stay healthy, get therapy for yourself if you need it, and don't be afraid to reach out to others-many cities have family and friend groups for the mentally ill!

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