Bipolar Answers

Bipolar Disorder is a diagnosis whose symptoms create an erratic and sometimes create gret chaos in the person's life who has the diagnosis but also in the lives of those who regularly come into contact with them.  What seemed fine two or three sentences ago can just as suddenly turn dangerous and lead to a hospitaliztion as you notice.  It can also just as quickly destroy the peaceful setting of a wedding and create forever negative memories of something that should be beautiful and wonderful.  It is, however, as you probably already realize something that is difficult to manage.  Setting boundaries is healthy but it can be difficult to navigate the emotions of another person who is hearing or receiving the boundary setting.  The timing of setting boundaries needs to be chosen with the greatest of care.  It seems that you have been managing this dilemma for a while and would like some guidance. It would be important for you to share how the person diagnosed with Bipolar Disorder has been affecting your life.   You say that this happened 3 years ago so I would ask that you prepare a time line of how she affected your life prior to the diagnosis and since the diagnosis.  No piece of information is too miniscule.  They are all very important to resoling your dilemma and determining how to begin setting boundaries.  Please be as specific as you can concerning any past interactions and attempts to work with her mental health symptoms.  What was successful and what was not successful?  Are you aware of the National Alliance for the Mentally Ill a/k/a NAMI?  There are many groups throughout the United States and they provide resources at their websites and meetings that are educational and supportive.  You can reach then at www.nami.org.  You may find that their availability is limited to or heavily internet or virtually focused today.  That would be a good resource whether virtual or in person.  Bipolar Disorder is best managed through a combination of counseling and medication.  Medication is going to be generally a lifelong situation as it is a chronic disease much the same as diabetes or heart disease.  She will decompensate from time to time so finding successful responses to her symptoms that you can use on a regular and steady basis.  This is likely to reduce the chaos and change for you.  Read a good book on Bipolar Disorder. The best writer I know is Kay Jamison who wrote An Unquiet Mind and who is a medical professional diagnosed with Bipolar Disorder.  You will find that a search of "Bipolar Disorder" on Amazon will produce family books for those who love a family member diagnosed with Bipolar Disorder.

Hi there. I'm sorry that you are struggling with the symptoms that you are experiencing. I can imagine that it is overwhelming and distressing for you. What I would like to do for your question is to give you a better sense of what BPD is in contrast with Bipolar Disorder. From what you described, it is highly likely that you have just BPD. BPD often mimics or appears like Bipolar Disorder. The difference between the two is with respect to the length of time and severity of the symptoms. For Bipolar Disorder, people often experience grandiose ideas, impulsivity secondary to those ideas, high levels of energy, and a decreased need for sleep. These symptoms occur together and are for a specific period of time therefore considered a "mood episode." With BPD, the symptoms are more pervasive and difficult to control in your day-to-day. The symptoms do include: difficulty with maintaining relationships because you go back and forth between "idealizing" to "hating" them; fears of abandonment; self-harming behaviors to help with alleviating emotional pain; frequent and intense experiences of suicidal ideation and/or gestures; impulsive behaviors (the goal being to alleviate emotional pain or to "fill the emptiness"); difficulty with managing your temper/anger outbursts; frequent and intense moodiness/mood lability; fleeting paranoia when you are under a lot of stress; lack of an identity/poor self-esteem (you often build your relationships with others by being a chamelion/blending in so that you are not rejected and feel like you belong but don't have a strong sense of self); and, chronic feelings of emptiness (which fuels impulsivity, self-harming and clinging to relationships even if they are unhealthy). Self-harming is one of the more "classic" or telling symptoms of BPD. When a person is experiencing bipolar disorder, they may become impulsive and also, during that episode, struggling with insight whereas when you are experiencing symptoms of BPD, you are aware of what is occurring but you have difficulty managing how you feel because it is so overwhelming. Can people have both? Absolutely, but there is generally a period of time when if Bipolar symptoms are under control that you are better able to see if BPD symptoms are still occurring or if they have stopped. I hope that this is helpful.

You have to remember with anything, that you can’t diagnose borderline personality disorder by yourself. My recommendation would be for you to find a psychiatrist or psychologist to obtain an evaluation as it would be important especially if you are considering medication as part of your treatment. BPD is often confused or overlaps with other conditions, so you need a mental health professional to evaluate you and make an accurate diagnosis. Try to find someone with experience diagnosing and treating BPD. As BPD is rarely diagnosed on its own because it often co-occurs with other disorders such as depression or bipolar disorder; substance abuse; eating disorders; and anxiety disorders. When BPD is successfully treated, the other disorders often get improve, too. But the reverse isn’t always true. For example, you may successfully treat symptoms of depression and still struggle with BPD. For the assessment, it is good to find out if you have any family members with any mental health issues to ensure that you are provided with an accurate diagnosis especially since BPD is caused by a combination of inherited or internal biological factors and external environmental factors, such as traumatic experiences in childhood. Although many people with BPD take medication, the fact is that there is very little research showing that it is helpful. What’s more, FDA has not approved any medications for the treatment of BPD. This doesn’t mean that medication is never helpful but if you suffer from co-occurring problems such as depression or anxiety, medication will address those problems. There is not a cure for BPD itself. In addition to a psychiatrist or psychologist, you need to find a therapist who is qualified in BPD treatment and recovery. Therapy may serve as a safe space where you can start working through your relationship and trust issues and “try on” new coping techniques. Dialectical Behavior Therapy (DBT) and/or Schema-Focused Therapy are helpful treatment modalities when addressing BPD. DBT treatment is a type of psychotherapy (talk therapy) that utilizes a cognitive-behavioral approach. DBT emphasizes the psychosocial aspects of treatment. Schema Therapy is an integrative approach to treatment that combines the best aspects of cognitive-behavioral, experiential, interpersonal and psychoanalytic therapies into one unified model. Schema-Focused Therapy has shown remarkable results in helping people to change negative ("maladaptive") patterns which they have lived with for a long time, even when other methods and efforts they have tried before have been largely unsuccessful.