Category: Bipolar Disorder

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When Bipolar Disorder Brings Marital Distress

00Bipolar Disorder, Depression, Featured news, Marriage, Stress, Suicide July, 19

Source: Cristina Jiménez Ledesma at Flickr, some rights reserved

In a busy urban community church, Reverend John Tahir, a parish minister, enjoys many moments helping and advising members of his congregation. One of his more meaningful responsibilities is counselling young couples, providing marriage education to them with the hopes of preparing them for this new chapter in their lives. The importance of this task is not lost on Tahir, as he knows far too well that significant issues such as money, boundaries, and lack of communication to name a few, can result in marital challenges. The reality is that marriage can be a rather difficult journey. 

Dr. Gary Chapman’s book, The Five Love Languages, examines marital discord resulting from a lack of effective communication. The premise is that every person enters a marriage with their own definition of what love means. As a result of these inevitable differences, people have distinctive love languages. According to Chapman, problems in marriage arise primarily because people often expect their spouse to demonstrate love in a way that is compatible with their own love language.  

It is not hard to imagine that living with a spouse struggling with a mental health disorder only adds to the complexities of marriage. The divorce rate varies among mental health disabilities because each condition presents its own unique challenges. For example, those who have phobias and obsessive compulsive disorders have a much lower divorce rate than affective disorders such as bipolar disorder and depression. Though there are four different types, bipolar disorder is characterized by drastic mood shifts with either manic or depressive episodes. Those with this affective disorder can experience high, elated, and energized moods while experiencing hopeless and depressive ones at other times. It is interesting to note that the divorce rate of those with bipolar disorder is very high—approximately double the rate of the general population.

In an interview with the Trauma and Mental Health Report, Brian (name changed for anonymity) shares his experience of having bipolar disorder: 

“It’s been hell struggling with suicidal thoughts every day. I’ve lost a sense of joy and optimism.  I find it difficult to complete even regular daily activities.”

Brian’s struggles have taken a great toll on Christina, his wife. Spouses of individuals with bipolar disorder, like Christina, may be at increased risk of stigma, stress, depression, psychiatric symptoms and a decreased quality of life:

“My life revolves around my husband. I’ve taken on a lot of additional responsibilities and it has affected my physical and mental wellbeing.” 

Christina recalls being late for a recent meeting because she was afraid that her husband was going to kill himself: 

“I didn’t feel comfortable leaving him at home that day. I had my mother-in-law come over so that I could attend my meeting.”

The relational interaction between spouses, where one is a patient and the other a caregiver, can contribute to additional marital challenges. Research suggests that neither patients with bipolar disorder, nor their spouses were accurate in describing each other’s experiences and concerns when it came to the impact of the disorder on their lives. These differing perspectives can lead to marital difficulties because each partner’s thoughts and feelings are misunderstood and challenged. The issue speaks to a lack of effective communication, which Chapman believes can contribute to the breakdown of the relationship.  

Brian and Christina both emphasized certain themes that were important to themselves while neglecting other aspects that were important to the other. When asked to reflect on a specific experience related to Brian’s psychiatric treatment, the couple highlights different concerns:

Christina: “I feel frustrated and helpless due to the lack of support and guidance from medical professionals. I have to constantly fight for Brian to receive proper treatment.”

Brian: “I have first-hand experience as a patient. When I’m in the hospital, I feel like I lose my identity as an individual. I am treated as just one among many other patients with a mental illness.”   

Lack of effective communication appears to be a common theme in all marital problems, which becomes further impaired when coping with the difficult challenges associated with bipolar disorder.  

In his book, Chapman asks:

“Could it be that deep inside hurting couples exists an invisible ‘emotional love tank’ with its gauge on empty?…If we could find a way to fill it, could the marriage be reborn? With a full tank, would couples be able to create an emotional climate where it is possible to discuss differences and resolve conflicts? Could that tank be the key that makes marriage work?

—Young Cho, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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RUSH Prevention Program Helping Children of Bipolar Parents

20Bipolar Disorder, Emotion Regulation, Environment, Featured news, Health, Parenting, Stress, Therapy May, 16

Source: Rolands Lakis on Flickr

“It was just kind of not knowing what you were going to get every time. Emotionally when I was younger, I always cared about her. She was my mom. As I grew up, I kind of became disconnected because I didn’t know the real her. I only knew her from her diagnosis. I only knew her emotions. I didn’t know the real her.”

– Steven, child of a bipolar mother.

In 2004, the World Health Organization named Bipolar Disorder (BD) the seventh-leading cause of ‘disease burden’ for women between 15 and 44, a measure that combines years of life lost to early death and years lost to living in subpar health. Public Health Agency of Canada reports that BD occurs in one percent of Canadians, and their reported mortality rates are two to three times greater than the general population.

The disorder is marked by alternating periods of manic euphoria and intense depression. In a manic state, people experience elevated moods, racing thoughts, and sleeplessness, in addition to overspending and engaging in risky sex. The depressive phases make for overwhelming feelings of sadness, withdrawal, and thoughts of death and suicide.

Research has related BD to aggressive behaviour, substance abuse, hypersexuality, and suicide. But more recently, studies have been showing the kinds of challenges faced by children of those diagnosed with the disorder.

The Pittsburgh Bipolar Offspring Study reports that children of bipolar parents are 14 times more likely to develop bipolar spectrum disorder. Children of two bipolar parents are at an even higher risk.

And these children are also more vulnerable to psychosocial problems. A study by Mark Ellenbogen at Concordia University finds them at greater risk for problems with emotional regulation and behavioral control.

Ellenbogen and colleagues have explained how stressful home environments can alter biology to influence mood disorders in adolescents and adults.

In an interview with the Trauma and Mental Health Report, Ellenbogen stated that OBD individuals (that is, offspring of parents with bipolar disorder) show higher levels of daytime cortisol, a hormone that is released during times of stress. OBD are psychologically more sensitive to stresses in their natural environments.

“We have found that high cortisol levels in offspring may represent a biomarker of risk for affective disorders, particularly in vulnerable populations like the OBD. We believe that these changes in cortisol levels can be linked to stress, inconsistent parenting practices and disorganization in the family environment.”

Reducing the stressors in early childhood may help decrease elevated levels of cortisol, and ward off the development of BD and other problems.

Recognizing the need for early intervention, Ellenbogen initiated a pilot prevention program, Reducing Unwanted Stress in the Home (RUSH), which targets bipolar parents and their vulnerable children between six and eleven.

An assessment measures salivary cortisol, looks at the family environment, and evaluates the child’s behaviour. Then parents and children participate in weekly sessions.

With parents, the focus is on improving communication and problem-solving skills, and increasing structure and consistency in the home. With children, they teach skills for understanding and coping with stress through age–appropriate exercises and educational games.

“The goal of the RUSH program is to prevent the development of affective disorders and other mental disorders by intervening in families well before these serious mental disorders begin. That is, this is a prevention program for children at high risk of developing debilitating mental disorders.”

To date, children and parents have been responding well, but the research is ongoing.

Programs like RUSH aim to prevent the development of mental illness in vulnerable youth. And an ounce of prevention can mean a whole lot to quality of life down the road.

– Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Bipolar Disorder Makes For Up-And-Down Friendships

Bipolar Disorder Makes For Up-And-Down Friendships

00Bipolar Disorder, Featured news, Friends, Relationships, Suicide August, 15

Source: Farrukh/Flickr

Lauren and I have been friends for a long time.  More than once, she had mentioned to me that she had bipolar disorder, but I never gave it much thought.  It always seemed under control, and I knew she was getting help.  When we decided to move in together, I was not concerned.

But it became apparent immediately that she did not have her mental illness under control.  Long depressive episodes, where she did not talk to anyone, were followed by short manic ones (when she was great to be around).  As a friend, I had no idea how to help or how to help myself while living with her.  I was confused when she would suddenly get angry at me, and I worried about what to do if she hurt herself.  And if I were to call someone I didn’t know how she’d react.

Over the past year I’ve learned a lot about the disorder, how to deal with it; not as a psychologist or therapist, but as a friend.

Don’t take it personally

It is difficult to accept, but sometimes people in a depressed state don’t feel like talking, and not because they dislike you, or because they’re being rude.  Mdjunction.com tells readers that one of the “do’s” of dealing with a loved one is to “realize your friend is angry and frustrated with the disorder, not with you.”  I once asked Lauren why she would ignore me for days at a time and she told me that sometimes she doesn’t talk just to avoid crying on the spot.

Recognize triggers

Drinking made Lauren manic.  On the surface, mania doesn’t look all that bad.  The person is happy, exuberant, and outgoing.  But those with bipolar disorder who are manic often crash into a depression that lasts longer and is more severe than the mania.  I pointed this out to my friend, explaining that when she drank, her night usually ended in depression.

She responded, and cut down her drinking.  But some may not be as willing to take responsibility.  It’s impossible to force a friend to change, but pointing out triggers may give them some insight into their behaviour.

Talk to their family when necessary

Luckily, Lauren has a caring supportive family.  Her brother and I have exchanged phone numbers, and if something happens to Lauren where I’m in over my head, I can notify her brother and ask him to help.

Know when to call for help and own your decision

Once I had to call an ambulance for Lauren.  After finishing a bottle of prescription sleeping pills, she admitted to me that she wanted to die.  She could barely form a sentence and I feared the worst.  It was a difficult decision, I knew I risked losing Lauren’s trust but I called anyway.

Terri Cheney, author of, A Memoir and The Dark Side of Innocence: Growing up Bipolar writes “If someone you know or love talks about suicide, even jokingly or in a passing remark, stop and listen.  Ask if he or she has a plan….Above all, take it seriously.”

You don’t know how they feel

Don’t pretend to understand how someone with bipolar disorder feels.  Being empathetic and actively listening to what your friend has to say will go much further than telling them about that time you were sad and how it’s the same.  It’s not.  And most important, do not tell them to just “get over it.”  It’s not so easy.

Don’t put your friend’s needs before your own

Sociologist Jeanne Segal, author of The Language of Emotional Intelligence, writes that “Supporting your loved ones may involve some life adjustments, but make sure you don’t lose sight of your own goals and priorities.”

I used to invite Lauren everywhere.  I did enjoy her company; but on reflection, I think I was doing it largely out of fear.  I worried she’d hurt herself home alone.  Looking after her was emotionally draining.  I came to realize that not only did I have to learn to trust her alone, but I also needed my own time with friends, I needed to focus on my own life.

Having a friend or a family member with Bipolar Disorder can be complicated, and may require time and patience.  But the illness doesn’t have to define the individual.  Lauren is the same person I knew long before I knew of the diagnosis, and she is still a great friend.

But now I have learned to become more empathetic and accepting of people, whose moods I cannot justify…or even fully comprehend.

– By Anonymous, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today