More detail about Bipolarism

Hi all,

I know someone suffering from bipolarism, and I have spent several years researching it, but I find that the information is often conflicting. I was wondering if anybody could help with some questions? I have suffered from several bouts of depression but never bipolarism, btw, so I have some amount of empathy but I would like to know more.

1) Can your environment trigger an episode of depression? ( I have read that it doesn't).
2) Can your environment make your depressive phrase worse? (I have read that it doesn't).
3) Are you much worse around some people than you are around others during the same depressive phrase?
4) At what age did your symptoms start?
5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease?

Let me answer qu (5) about my experience with *depression*.

I believe that mental disorders should be treated the same as dying of cancer. If I was dying of cancer, I would not act all entitled expecting someone to ignore their needs and attend only to mine all the time. I would hope for a ton of emotional and physical support, but I am aware that the other person has their own physical and emotional needs, too. Also whenever I see that someone is affected emotionally by my behavior, I apologize. I try not to be selfish. The other person's feelings have equal validity to my own.

1) Not I, though I believe there's some variation to this.
2) For me, it isn't really that the environment makes it worse, it's more like certain events will cause me to do things that I'll later regret. I may need to rephrase that... I have a lot of "if X happens then I'll do Y" thinking. So I've really already chosen to act out. I'm just waiting for something to set me off.
3) I pretty much shut everyone out during depressive phases, to the point that my original DX included Schizoid.
4) Bipolar itself, or everything together? It's actually hard to pin down for me... The mood disorder got bad enough to warrant professional help mid to late 20s. I had what very well may have been a psychotic episode early 20s. I had some behaviors in my teen years that might have indicated it was going on back then. If you want other DXes the first indication was autism at 3 with speech delays (which was misdiagnosed as deafness...)
5) I was going to say that I don't handle it but I've already indicated that I separate myself. I don't think I've ever apologized for anything. I remember trying to explain to people that it wasn't about them. If I see a behavior that effects someone I care about, I take steps when I'm somewhat sane to prevent that behavior from reoccurring. My mom has MS. One of the things about that disorder is that it can effect her emotions. Should I expect an apology if she acts out because of her MS? I don't think so. You just have to deal.

1) Can your environment trigger an episode of depression? ( I have read that it doesn't).
please note I am also talking about manic phases, not as a direct result but through triggers such as excessive stress and lack of sleep.
that said things like diet are also directly applicable to stability. so while your environment may not have direct bearing on your state your predicament within that environment does, at least to the stage of lessening or exacerbating the severity of swings. so the short answer is no and the long answer is yes but.

2) Can your environment make your depressive phrase worse? (I have read that it doesn't).
simply no with the exception to the above clause. if your environment is causing depression it's most likely normal reactive depression which everyone gets from time to time but if someone is already fragile then this may make a larger or more noticeable impact on them.

3) Are you much worse around some people than you are around others during the same depressive phrase?
no, but. there are people that everyone knows that will irk or otherwise negatively affect them. these people can make it seem that the phase is worse though it's more just that you have
some people do make it harder to deal with the cycle, in either direction

4) At what age did your symptoms start?
depends on what symptom you measure by but I'd say the 'onset' was spread out from 12 to 17 with full completion by early 20's

5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease?
I seek space for 'time out' for periods during the episode this is mainly to protect them from me. but also so I have less distraction and can concentrate if my psychotic symptoms surface. in that case once I know it's not real I'm fine I just put it to the side. but if I'm dealing with someone then that distinction can be much harder as I may feel the false input is coming from or is related to them

Ultra-ultra-rapid cycling bipolar II with borderline traits here, medicated. Speaking solely about my case.

1) Can your environment trigger an episode of depression? ( I have read that it doesn't).
By all means yes, although not in a direct "someone died -> I'm depressed" way. When my boyfriend's mother was dying -- weeks of stress and despair -- I became terribly depressed which was obviously triggered by the events, the stress, the energy expenditure on travel (she was 2 hours away by train and we travelled every other day). But it was a slow process -- well, slow for my standards since it took two weeks, and it was going slowly down rather than waking up depressed and staying there.

2) Can your environment make your depressive phrase worse? (I have read that it doesn't).
Again, yes. I don't cope with stress well. Financial, emotional stress pushes me into depression (although when my boyfriend was diagnosed with cancer for some reason that made me manic). Once the stressor is removed and enough time passes, I slowly go back to "normal".

3) Are you much worse around some people than you are around others during the same depressive phrase?
Not really. I mean, when I am in a depressive phase I want to sit in my house, curtains closed, alone. A permitted variation is sitting in my house, curtains closed, with my boyfriend. So you could say I am worse with absolutely everybody else. But I don't think that's what you mean.

4) At what age did your symptoms start?
When I now look back I can see they started when I was a teenager, although it took until 2004 (when I was 27) for my depression to get bad enough that I needed medication.

5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease?
In depression I separate myself, apologise and feel guilty and terrible. But that's of course a part of what depression is. In mania I tend to not care and just expect others to do what I want, and I get angry if they don't.

By the way, I do consider bipolar to be a physical disease.

Hi

1) Can your environment trigger an episode of depression? ( I have read that it doesn't). I find that this is unusual for me but seasons definitely have an effect on my mood as does length of day - I dont know if that counts for you.

2) Can your environment make your depressive phrase worse? (I have read that it doesn't). Possibly in that it can be stressful if things are not good in 3D which can make things worse such as poor sleep but not really.

3) Are you much worse around some people than you are around others during the same depressive phrase? How I actually am does not change but how much I show to people might be different around different ppl depending on how much I trust them. This is only true to a degree tho as if things get worse it is difficult to hide.

4) At what age did your symptoms start? I have had symptoms of MI since I was a child and I believe I had an episode of full blown mania aged about 16. I was not diagnosed til aged 28 formally tho the idea was floated in my early 20s.

5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease? I am a big believer in personal responsibility to behave appropriately. I have had times which I think are exceptions to this - specifically full blown mania and psychosis/loss of insight. I think if things are this bad and due to the nature of those conditions, you are less able to take responsibility. but other wise you have a responsibility not to hurt others and if you do you need to apologise. I do however feel grateful when ppl I know realise that dealing with BP is not easy as this can help. Yes there is the thing about treating it as a physical illness but that does not excuse hurtful behaviour - as it would not excuse hurtful behavious in cancer either. it might explain hurtful behaviour but it does not excuse it imo.

Cracked

When we're talking about brain disorders, Alzheimer's, MS, brain cancer, and mental illness, that effect decision making processes, I feel it's important not to beat oneself up over past deeds. I agree with taking responsibility, but to me that means being proactive in treatment to prevent a re-occurrence.

My experience/opinions:
1) Can your environment trigger an episode of depression? Yes-ish... maybe not scientifically, but experientially. Most of my episodes come and go with a mind of their own, but I definitely feel strongly affected by triggers such as hot or cold environment, financial stress, emotional turmoil, deadlines or expectations, etc... but it's hard to distinguish which came first, the mood shift or the trigger.
2) Can your environment make your depressive phrase worse? Yes, again... at least experientially. I'd rather just stay home all alone and not have to cook or shop or work or anything, but if other people are around me or I have to function at all, my whole situation is impacted because now I also feel guilty and awful for being so pathetic, and doing such a bad job, etc etc, and I just spiral downward lower and lower. (Keep in mind I'm not medicated due to extreme adverse reactions.)
3) Are you much worse around some people than you are around others during the same depressive phrase? Yes, abso-freaking-lutely. My boyfriend is my only truly safe person. I can handle some friends for short periods of time, others I don't answer the phone or door. Others I avoid like the plague and don't even go on facebook. My super high danger people are, not surprisingly, my ex, and tragically, sadly, my own children, my brother, and often my parents. I withdraw for my own safety and theirs when I'm a mess.
4) At what age did your symptoms start? my very troubled teen years were chalked up to hormones. My first breakdown and 1st time seeking help was age 18, rehab at age 29, misdiagnosed as anxiety disorder age 31, correctly diagnosed Bipolar I age 42 (just 7 months ago). What hell I have lived, undiagnosed, unmedicated, all these years unable to understand...
5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease?
I definitely isolate as much as possible, I apologize profusely and feel absolutely awwwwwful about how I am, as if being depressed isn't bad enough, dragging others through it makes me feel even more terrible.
Having said that I will say, that as my awareness of my disorder has increased, I have worked harder to manage myself in regard to how I treat others. Having said THAT, there are times when I am so caught up in one phase or another that I lose touch with reality and am not sure I can even distinguish how I need to behave. Right now I am in a mixed episode, which makes ALL of it even more difficult and confusing.
It is definitely a very physical disorder, but that doesn't mean it doesn't hurt the people around us. If I expect the support and understanding from others of how this disorder affects me, then I better darn well be understanding of how this disorder affects those around me! Easier said, I know, but at least I can try.

1) Can your environment trigger an episode of depression? (I have read that it doesn't).

Yea absolutely, very often there's a trigger. Because bipolar is so unpredictable and neurologically ingrained sometimes it "just happens." Things like break ups, deaths, alcohol use (it is a depressant), etc can trigger depression. The tricky thing is people very often think they are depressed when they are grieving, and they are not the same thing. But people pre-disposed to depression, like people with bipolar, can get plummeted into a depressive episode. If you meant your literal environment, if you were somewhere or with specific people that bring back bad memories or you associate with a depressive period of your life that could totally bring it back.

2) Can your environment make your depressive phrase worse? (I have read that it doesn't).

Pretty much what I said above. Also keep in mind that bipolar is wildly different between people and everyone experiences different triggers and severity and such. I get funeral mania, which is where I sometimes launch into a manic episode after attending a funeral of someone close. It's not very common but it does happen.

3) Are you much worse around some people than you are around others during the same depressive phrase?

Oh absolutely. There are some people I feel very comfortable around. Friends that come over to just spend time with me when I'm in such a down phase. I'm absolutely awful to be around, I've had a friend come over to study for an exam while I sat at my desk crying and studying for my own exam, but she did it because she cares about me. When I get really depressed it gets so difficult to be around people. Like I forget what it's like to be a functioning human being and I have no idea how to act around others. Just feeling severed from people and alone in a crowded room, so to say.

4) At what age did your symptoms start?

In hindsight, they started in middle school, probably around 12. A lot of times people can notice symptoms in childhood and there are unfortunate cases of childhood bipolar. I also know people who didn't show symptoms until after 50, due to traumatic events like death of a spouse and such. Again it's very unpredictable and people predisposed can show symptoms and different ages depending on a number of things, like events. Unfortunately we don't actually know what or why bipolar starts up.

5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease?

It's a tough thing really. When I'm depressed I seclude myself because I don't know how to function among people and I know I'm miserable to be around and drag people down. Depression also makes me feel awful about myself, which is true for just about everyone, and I feel like I have to apologize for everything. When I'm manic I don't realize it really and don't understand why people wouldn't want to deal with me or be around me constantly because I am the most hilarious and beautiful guy in the world (I'm also usually psychotic with crazy delusions like this haha). There will always be the debate about how people view mental disorders, especially those that affect decision making. Bipolar affects everyone. Most people don't experience periods like that and can't imagine what it would be like. It's impossible to imagine having occipital lobe damage and being unable to recognizes the faces of people you love. Similarly, bipolar affects the prefrontal cortex which is the primary component in decision making. People have done awful awful things after damage to that part of the brain. Anyway, enough anatomy talk but it's a very good demonstration of why it's not something you can just "get over."

Hi there,

I think that bipolar disorder is an illness which tends to be expressed in a highly individual way, and that in itself makes it quite complex and confusing. This is simply my experience:

1) Can your environment trigger an episode of depression? ( I have read that it doesn't).

I don't believe that my environment alone can trigger depression, as I've often become depressed even when, objectively speaking, my life was going very well. This has made it hard for people around me to understand, as it's not a direct response to external factors. However, stress is always a major trigger for my mood instability, so although my environment may not be uniquely responsible for the mood episode, it does have some impact.

2) Can your environment make your depressive phrase worse? (I have read that it doesn't).

Once the depressive episode has set in, then my environment itself can't really do much to either exacerbate or alleviate it. However, certain lifestyle factors such as a minimal stress, having a regular routine, a good diet and exercise can sometimes help to prevent the episode from taking hold, or at least slow down the rate at which it does.

3) Are you much worse around some people than you are around others during the same depressive phrase?

Not really, although I tend to isolate myself when depressed so it's hard to tell! I only feel comfortable around close family or my psychiatrist when in that state and tend to get very anxious around other people, being afraid they can tell I’m ill and will judge me for it etc.

4) At what age did your symptoms start?

They began to severely affect my functioning when I was 14, and at that point, I mainly had problems with depression and severe anxiety/panic attacks. However, I can see now that some symptoms started around 10 (with disordered eating, anxiety and OCD style rituals). I had my first full blown mania at the age of around 16, and was diagnosed then.

5) What do you do when your bipolar episode affects others who care about you? How do you handle it? Do you separate yourself from others, do you apologize, do you expect others to tolerate it no matter what, because bipolar ism should be treated like a physical disease?

I fully recognise the strain my bipolar causes for people around me- my family, in particular. When I'm well, I tend to feel very guilty about depending on them so much, and apologise about my past behaviour etc. However, when in an episode, it's all encompassing and I find it difficult to think about others. I do accept, though, that I'm often not in control of my own behaviour in an episode and my actions are very much out of character. This in theory diminishes the genuine responsibility I have but I still feel the need to make amends for my behaviour.

The question of whether it should be treated as a 'physical' illness is a complex one, as so little is known about the true causes of bipolar disorder. I personally consider it physical in the sense that it affects the brain's neurochemistry and functioning, but there are also so many environmental and genetic factors which may underpin this. I think the stigma and impact on outward behaviour/'personality' makes it difficult for many to genuinely treat it as a purely physical illness.
I find people’s inability to relate to, what for them, is such an alien experience, can be one of the most difficult and isolating aspects of living with bipolar.

I hope hearing different people's perspectives helps you to understand how the disorder can manifest itself x