Why are so many children being diagnosed Bipolar?

Early onset Bipolar Disorder.

By David Joel Miller.

Bipolar Disorder

Bipolar Disorder.
“Image courtesy of FreeDigitalPhotos.net”.

Bipolar diagnoses in children have increased 40 fold in the ten-year period from 2000 to 2010.

What is behind the increasing number of children and teens who are being diagnosed with Bipolar Disorder?

We are learning more about the risk factors for early onset all the time. Still as we learn about what may be causing this increase in the number of cases of early onset Bipolar Disorder, the picture of how to treat or prevent early life Bipolar Disorder is getting less clear.

If we could detect symptoms of Bipolar Disorder early, presumably we should be able to treat those symptoms and reduce the incidence of Bipolar Disorder or at least reduce the severity of the disorder.

Unfortunately there is often a lag of ten years or more from the first symptoms until the child has a manic or hypomanic episode that qualifies them for a diagnosis of Bipolar.

I have written in past blog posts about how many of the things that cause people to think of someone as Bipolar are in fact not necessarily symptoms of the disorder. Being moody does not make you Bipolar.

What does help define the Bipolar condition are the ability to sleep only a few or no hours per night and still have plenty of energy. That along with excessive energy, being driven to do things and being impulsive are the hallmark features of Bipolar Disorder.

Here are some of the possible causes for the increasing number of Bipolar diagnoses in children.

1. Taking Stimulant ADHD meds or antidepressants can set off a manic or hypomanic episode.

One huge risk factor for developing a Manic or hypomanic episode, the key factor in a Bipolar Disorder diagnosis is having taken either a stimulant or antidepressant medication.

Having been treated with a stimulant ADHD med seems to correlate with developing mania. Not all children treated for ADHD develop Bipolar and not all people with a Bipolar Disorder diagnosis were first diagnosed with ADHD but the overlap is disturbing.

In one study of adolescents with Bipolar Disorder 98% had been diagnosed with ADHD and treated with stimulant meds first.

This points to the need for psychiatric diagnosis to be reviewed by psychiatrists and in children by a child psychiatrist.

2. Abusing substances increases the risk of developing Bipolar disorder.

Over 40 % of children who receive the Bipolar Disorder diagnosis have been abusing substances. In their life time 60% of all people with Bipolar Disorder will develop a substance use disorder.

This is not limited to just stimulant drugs. There is a high overlap between Bipolar Disorder and alcohol abuse as well as developing problems with excessive use of Marijuana.

3. Being the victim of physical or sexual abuse or neglect.

Abuse or neglect increases the risk of developing Bipolar disorder. This also accounts for the difficulty in many cases of distinguishing between Bipolar disorder and Borderline Personality Disorder. It is possible for people to have both illnesses.

There is also an overlap between trauma induced problems, stress disorders like PTSD, dissociation and the like and Bipolar Disorder. We would like to think the boundaries between genetic disorders and those that are the result of life experiences were easy to find. In practice those lines are blurry.

4. Poor diet and lack of exercise are risk factors for Bipolar Disorder.

Poor diet, particularly diets deficient in some vitamins and minerals can increase the risk of getting a Bipolar diagnosis. Hard here to tell which came first. People with depression or mania, both symptoms of Bipolar Disorder neglect their diet. Poor diet increases the risk and around the circle goes.

Lack of adequate exercise has resulted in an explosion in weight related problems. There is the thought that this lack of exercise and poor diet is also contributing to the increased prevalence of Bipolar Disorder.

5. Genetics is a Bipolar Disorder risk factor.

If you have one parent with Bipolar Disorder the risk you will develop Bipolar Disorder is 33%. Two parents with Bipolar Disorder and the risk goes up to 70%.  Add to that the difficulty that parents who have an emotional problem have in parenting and you can see how the interplay of genetics and environment increase the risk dramatically of your grow up with a Bipolar, substance abusing parent.

6.  A changing environment may make Bipolar Disorder more noticeable.

Some of the characteristics that we today call Bipolar Disorder would have had survival benefits in the past. Fast processing speed and jumping to conclusions might save your life in the woods but can get you into trouble in the class room.

People with milder varieties of bipolar disorder enjoy the hypomania – for a while. Even full on Mania can be fun, until those impulsive decisions get you into trouble. Bipolar Disorders are often associated with over spending, excessive sexual activity and substance abuse. All things that damage relationships and can cost you your job.

The increase in children receiving the diagnosis of Bipolar disorder will continue to result in more adults with those labels as these early life cases age. If your child is having problems consider family therapy to help everyone find simple solutions to these problems.

If you or someone you know has Bipolar Disorder or another emotional problem that might look like Bipolar Disorder consider getting help. Therapy can be effective in helping you to learn how to control your symptoms. Medication can also be useful in keeping you moods within bounds.

People can and do recover from the symptoms we call Bipolar Disorder.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended books.

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The voices in your head – depression, anxiety and fear – they lie

By David Joel Miller

Should you listen to those voices in your head?

You know the ones I mean, the doubt, the discouragement, the thoughts of depression and anxiety. Those voices that tell you things will never be better. They say you can’t do this and you must do that. Those voices are maintaining you emotional and mental problems.

We all have those voices in our head at times. The ones that tell us we must do something or that we will never be able to do something. How we interpret those voices makes all the difference.

Those voices in your head and you do not need to be psychotic to hear them, they arise from all sorts of things. They can be the voices of negative people from your past. Remember that those adults that told you depressing, hurtful things, they may have had an emotional problem also. It is not unusual for a depressed parent to pass those voices of despair down to their descendants.

Not all voices in our heads are negative. Sometimes they are telling us valuable information, memories from our happy experiences. But remember other times what they say are outright lies. How can you tell the difference?

Frequently, that thing we call a voice in our head is our own thoughts, thoughts heavily influenced by our emotional state.  When we are in a bad mood, down and dejected, those voices talk of doom and gloom, the tales of the depressed.

Some people take this to be the devil on one shoulder and an angel on the other. Our thoughts are telling us we should or shouldn’t do or think a particular thing.

If you are more philosophical than religious you might frame this as a conflict between your conscience and your desires. If that voice in your head is telling you to go ahead and do it, you can get away with it this one time. That is probably your desires. If the voice says that what you are thinking about is wrong – that might be your conscience. But there are exceptions.

Others of us will interpret those “voices” in our heads, those thoughts that sound so convincing that they must come from somewhere else, as messages from God or our higher power.  If you get that thought, be careful to check out this message with your spiritual adviser. The God talking to you may be a function of your emotional problems.

Another source of those “voices in your head” is things you have been told in the past. Under times of stress, and most of life is stressful, memories of what we have been told come back.

What we constantly need to ask ourselves is – are these voices telling the truth?

Believing that because you have a sudden thought, that you must do a particular thing, can result in a lot of problems.

More cognitive humans might interpret these “voices” as automatic thoughts. Over time the things we tell ourselves and are told become so a part of us that we think these thoughts as if they were facts. Those ideas are our automatic default ways of believing even when they do not match the facts of the current situation.

These voices in our heads become problematic when we lose the ability to dispute what they are saying. We do not need to believe everything that we think. What we tell ourselves may only be true because we say it.

If you find that those voices will not be silent even when you command them. If those voices take on a personality of their own, then it is time for professional help and probably medication.

But short of a true psychotic experience, we all have those recurring thoughts that might at times sound like voices telling us things. Whether those voices are the memories of what you were told as a child or are your own imaginings, remember that sometimes the voices lie.

Not only is some of our self-talk lies but what those old voices in your head are telling you, that may be lies also.

What has your depression, bipolar, anxiety or other emotional problem been telling you? Are your internal voices telling you the truth or has your depression been telling you lies again?

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Is it the Bipolar or is it me? Confusion and self-doubt.

By David Joel Miller.

The struggles to find you when you have Bipolar or another mental illness.

Self confusion

Who am I?

People who grow up with a mental illness have a difficult time finding out who they are separate from their disorder. The younger you are when the symptoms start the more difficult it is to find out who you are during those times the symptoms are at a severe point. People with other mental illnesses may experience this same confusion but it is easiest to illustrate by discussing the effects of Bipolar Disorder on self-doubt.

Youth with Bipolar disorder have a second set of tasks to navigate over and above those all teen’s experience. Finding you who you are is a necessary task of adolescence. Much of that sense of self is developed as a result of the experiences you have. For the person with Bipolar Disorder, the person who has those experiences changes depending on the severity of symptoms.

In the early stages of the disorder, the disease goes largely undiagnosed. The person who will someday get that bipolar diagnosis may spend 20 years or more struggling with out of control emotions before they discover that those unpredictable mood swings are a result of their disease, not some defect in who they are.

When you have symptoms, try to control them, but find you are out of control more than in, it is easy to begin to doubt yourself and to begin to hate yourself. Before receiving their diagnosis many youths with Bipolar Disorders have been led to believe they are “bad kids” and that they should be able to do things they find far outside their abilities.

The person with Bipolar Disorder will experience a large discrepancy between who they are supposed to be and who they are. Despite their best efforts, who they feel they are, will change depending on whether they are in a manic, hypo-manic, depressive or mixed phase.

The peak onset for Bipolar is between fifteen and nineteen years of age, precisely those late teen years when you need to establish who you are as a separate person from your caregivers and friends.

The earlier the onset of Bipolar Disorder the more difficult it becomes to define what is the disorder and what part of these feeling and behaviors are you.

Often the person with Bipolar will report that they don’t know how they feel. A given situation will make them feel happy one day and sad or angry the next. This creates extreme self-doubt.

Having a mind or body that betrays you can lead to self-hate. In the early stages of Bipolar Disorder, before the diagnosis, there is a high risk that you will come to hate yourself for having uncontrollable and unpredictable moods.

Clients sometimes report during a severe episode “This is not who I am.” They have the feeling that there are three or more of them, the depressed person, the manic person and sometimes there is that person that is them without the symptoms.

Someone with Bipolar Disorder may find that they shift between being an introvert and being an extrovert depending on the state of their illness. They can easily become confused as to which is the real them.

After a particularly manic episode or a really low depressive episode, the person with Bipolar Disorder may find themselves saying “That is not me, I don’t want to be like that.”

The result of all these conflicts in their self-image can leave a person in the early phase of Bipolar Disorder with negative self-beliefs. These beliefs are likely to persist into adulthood and then change slowly if at all. The person that they find themselves to be on medication or after therapy is a whole different person to the previous untreated person.

One risk for the undiagnosed person is the tendency to become a chameleon. Not knowing who they really are deep down they try to blend in and assume the roles of others around them. This results in an unstable self that is one way today and another tomorrow.

A common refrain is “I don’t like myself.” Or “I can’t do anything right.” Shaking these beliefs and sorting out who you are separate from your disorder is a difficult but necessary process.

Because of the mood swings between depression and mania the person with bipolar disorder faces unique challenges in finding who they really are separate from their diagnosis.

People with other mental and emotional problems will expertise these conflicts in varying ways. The key task is to learn that you are not your diagnosis and that your condition does not define who and what you will become.

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Where does the Bipolar spectrum begin and end?

By David Joel Miller.

Thoughts on Bipolar spectrum.

My understanding of the Bipolar Disorders, like many other “mental illnesses” has changed over the time I have been involved with this field. Not all professionals agree on some of these things so it is only fair I tell you some of my biases first.

When I first learned the technical part of diagnosis we had to study the diagnostic manual (the DSM.) The assumption here is that a really good clinician can distinguish between those with a mental illness and those without and further that those with a mental illness are in some specific way different from the normal ones.

Neither of those assumptions is necessarily true.

In school, it was really important to learn to distinguish the niceties of the diagnosis. I spent a lot of time on things like the differences between Schizophreniform disorder, Schizophrenia, and Schizoaffective disorder. This is very important in school and in taking your exams for licensure. In the real world, it is not so important. Both the meds and the talk therapy are likely to be the same for all of these.

Some of our view of the “Bipolar disorder spectrum” is distorted by the need to rule people in or out and to state which things are normal and which are diagnosable. The ruler you use can alter the results. Our venerable rule books on diagnosis in the mental health field fluctuate between the categorical approach, putting people into pre-sized boxes, and the continuum approach where we line them up from well to sick. Here are my beliefs on this.

1. There are NOT two groups, the “normal” and the “mentally ill.”

With some medical disorders, you either have it or don’t. Mental illness is not like that.

We are coming to recognize that there are not two distinct groups, the well and the unwell, but in fact, there is a continuum between being well and unwell. Something bad happens to you, then you should be sad or anxious. All of us have some days we feel better and other days that we feel less well.

Most of the things we count as symptoms are in fact normal human behaviors. It is just that the unwell person has more symptoms or more severe symptoms than the less unwell person. When the symptoms add up to enough to make a diagnosis is largely a judgment call.

People do not move directly from a healthy weight directly to obese. The move comes on slowly one ounce at a time. The same thing happens with mood disorders. It is not just the number of symptoms but also the severity of symptoms that cause a professional to assign a diagnosis. Two different professionals and you may get two different diagnoses even in research studies using “strict diagnostic criteria.”

2. Counting symptoms is not an exact science.

Each mental health disorder has a list of symptoms that are believed to make up the disorder. The client needs to have some number of symptoms to get the disorder. Say a disorder requires the majority of the list of symptoms, 7 of 13 possible symptoms, look at all the ways we could add this up. The mathematicians among us will recognize this as a factorial problem, the number of outcomes of 13 things taken 7 at a time. Email me if you do the math and get a number. Take my word for it the number of combinations is huge.

So as the clinician talks to you he considers, do you have enough characteristics of a symptom to count that one? Then he adds them all up and if you get enough you win the diagnosis.

Lots of judgment calls in this process.

So what about the spectrum of Bipolar disorders?

I think this is a long spectrum and a lot of it does not deserve a diagnosis. The most severe cases can and should be diagnosed because if you have that many symptoms you need help.

Are birds Bipolar? Are other animals? I think they are a little. Every spring the days get longer, there is more daylight and they are awake more. They become interested in the opposite sex. Here in the northern hemisphere birds start looking for mates by Valentine’s day in February and by Easter, they have bred, created nests and are hatching out chicks. People do this same thing.

We humans, tend to fall in love in the spring and marry in the summer. It takes a little longer for the children, but not that much longer.

There is also a seasonal decline in activities for all animals in the winter. Bears eat all they can and then go sleep for the winter. In humans, we call this atypical depression. So some change from active, even hypomanic behavior occurs naturally with the seasons. These mood changes are normal human behavior.

We probably should not give every teenager a Bipolar diagnosis, though most of the time their parents are sure that their preoccupation with sex and their moodiness should qualify.

People who have diagnosable Bipolar disorder do not really have different symptoms. What they have is a difference in the severity of symptoms. They also have different outcomes.

With all spectrum disorders, we should not make our decision based on the presence or absence of symptoms, which alone is not enough. The key factor is what effect do those symptoms have on the person.

If the increased interest in sex during the manic or hypomanic phase damages their relationships, gets them fired for sexual harassment of causes other disruptions in their work and relationships then they get the diagnosis. Also if the symptoms of the mood swings become unmanageable and they upset the person with those symptoms, then they should be treated.

So yes there is a spectrum of Bipolar-like symptoms from almost unnoticeable to debilitating severe. The thing we professionals should be looking at is not our judgment of the severity of the symptoms, but how are these symptoms, these problems in living life, affecting the client.

If the problems interfere with having a happy life then it has become severe enough we need to give it a diagnostic label and begin treatment.

Personally, I think there are a lot of people with less severe mood swings than what would be diagnosed as a Bipolar spectrum disorder that would benefit from some counseling. But as long as they can maintain the choice is up to the client.

Thanks to reader Dr. Charan Singh Jilowa for suggesting this topic. For more on this topic check the list of posts to the right or the post list on Bipolar disorder and mania.

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Are creative people anti-social?

By David Joel Miller.

Are highly creative people, writers, and artists, also anti-social?

Some occupations require lots of time working alone. Artists and writers, in particular, need to spend a lot of time by themselves. Do these occupations attract people who want to avoid people?

Is there a mental health problem or personality type that is over-represented in the creative fields?

From a counselor’s perspective, people who work alone or prefer to spend time by themselves are not anti-social. We reserve the label of anti-social as in Anti-social Personality Disorder for people who have no empathy for others. An anti-social person takes advantage of others because they don’t care. They are the ones who get the label of psychopath or sociopath.

People who prefer to avoid others may have some form of anxiety as in social phobia or they may have an attachment style that results in avoiding others but neither of those personality features involves harming others on purpose.

An avoidantly attached person does not expect others to meet their needs and seeks to get their needs met by solitary activities. A creative person might be avoidant and prefer to avoid all contact with people but that is likely to be rare. To be successful at a creative activity as an occupation they will need to go out and spend time marketing and promoting their efforts. Avoidant people are not likely to be willing to do that and are likely to believe that others will not like them anyway.

Someone with social phobia would like to be around others but because of fear, they are unable to be in situations that trigger their anxiety.

Anti-social personality, avoidant attachments and high levels of anxiety are not conducive to the risk taking the artistic person needs to genuinely create something novel.

But an artist and those of an artistic temperament are more likely to have one particular emotional issue. Many artists are moody.

One mental health issue does appear to be correlated with creative temperaments. Kay Redfield Jamison in her book “Touched with Fire” describes the connection between Bipolar disorder and creative endeavors. Those episodes of above average energy and times when the person is “in the zone” fuel creativity. Uncontrolled these episodes can turn into manic or hypomanic episodes and result in the creative person losing control and engaging in risky dangerous behaviors.

There are plenty of stories of famous artistic and creative people who had periods of high energy sometimes coupled with risky behavior followed by periods of deep depression. The energetic periods may fuel creativity but in the full-on manic episodes, the person is no longer able to stay focused long enough to complete projects.

The artistic fields have had a disproportionate share of individuals with mood swings who became alcoholic, addicted or suicidal. The really productive artists, in the long run, learn to manage their moods with or without help and they keep their emotions in bounds.

See also posts on Hyperthymic Temperament, Bipolar Disorder, and Mania.

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Bipolar Disorder or Borderline Personality Disorder?

By David Joel Miller.

Bipolar Disorder or Borderline?

There are several differences between these two disorders. But it is important to remember that it is possible for someone to have both problems which greatly confuses the issue.

The largest differences between the two are sleep and time. Ego strength and character structure also play roles in this choice of diagnoses. I have exaggerated the differences to make the distinction clearer.

Sleep matters.

To be Bipolar you must have had a Manic or Hypomanic episode. The key characteristic of those episodes is long periods (time) of above average energy and decreased need for sleep.

In hypomania, the person may be able to get by on a few hours of sleep, 3 or 4, and they feel fine. In full-out mania, they may even go all night without sleeping and still be just fine. At least they think they are fine. Others around them may notice they are irritable from lack of sleep but they think they are just fine.

Also in Bipolar when they are up they feel great, expansive. The same person may have episodes of depression and during those times they may sleep too much or too little but the telling point is that in the up times they will tell you they are on top of the world, full of energy and can just do so much without needing to sleep like lesser people.

With those Bipolar manic episodes comes tons of energy. They like to go up in the attic and swing from the rafters. They might work all day then go to the casino and gamble all night only to go back to work the next day like nothing has happened.

Time.

People with Borderline have many moods within a day. The can be “touchy” easily set off and others may hurt their feeling without meaning too or even knowing why. People with Borderline Personality disorder are full of pain and rarely have a good day. They can be so bruised that a look or word can hurt them.

People with Bipolar have longer periods of up or manic feelings. When times are good for them they are really good. They may go weeks, months or even years when they are on top of the world. But eventually the crash comes and there will be long periods of time when they are depressed, possibly unable to get out of bed. Recurring episodes of depression is a common feature of Bipolar Disorder.

Ego strength.

Borderline Personality Disorder is pain based. Many borderlines were abused, neglected or deserted. They are needy in relationships but always distrustful that the person they are with will leave them.  Borderline may threaten to kill themselves if you leave them.

Bipolar people mostly don’t care what you think of them, at least not when they are manic. They know they are smarter than Einstein and better looking. They believe they can work miracles. This overvaluation of themselves and their abilities gets them in trouble a lot. The take excessive risks not because they want to hurt themselves like the borderline but because they really believe they will win.

Borderlines are anxious, Bipolar people could care less. Let this one leave and they will find another.

Sex.

People with Bipolar Disorder are often hypersexual. They can’t seem to get enough. This will lead to sexual indiscretions which ruin their established relationships. When manic they just can’t seem to stop themselves. When you’re manic the whole world looks good.

Borderlines are rarely secure in a relationship, fearful that if this partner leaves them, that confirms their fear, they don’t deserve a partner. They will stick with a partner, often an unworthy one, because they fear that if they were to break up they just could not take it.

Who loves their disease?

Someone with Bipolar disorder resembles a Vegas Gambler when they are on a winning streak they want to ride it forever. When the crash they hate themselves and can’t face the wreckage they have created. Bipolar people like being manic. They frequently quit taking their meds just so they can feel manic again. Mania is seductive like a new lover, but one who keeps treating you wrong. Still, you want to recapture that allure.

Borderlines are more like characters from a soap opera, bad stuff keeps happening to them and they wish the pain would end. They live in a world of pain and hurt. They wish they could find a way to get things to change. They are often angry and feel others don’t treat them right. Frequently they are correct. They have been mistreated by someone somewhere and they keep trying to find a way to make it right, to make the pain go away.

Do they ever not have symptoms? – Character structure.

Someone who has Bipolar disorder has a “Mood disorder.” They have specific times (Periods) when they have mania or Depression but other times they have no mood symptoms. These times of apparent “normal” behavior may last for months or years and then something kicks off another episode of mania or depression.

Someone with Borderline Personality Disorder has a “Personality Disorder.” The presumption here is that they learned to be this way and are like this most of the time. They learned to protect themselves, store their anger and release it in bursts and other survival techniques. The trouble is that the way they handle emotion makes them and those around them miserable.

The younger you were when you learned basic ways of being with others the harder it is to change. Most people with Borderline Personality Disorder continue to have some symptoms even after treatment, though with good care they can and do get much better.

Please check out my other posts on Bipolar disorder and Borderline personality disorder the list of categories is to the right.

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Does Depression go away suddenly if you have Bipolar Disorder?

By David Joel Miller.

Can people with Bipolar Disorder have a sudden remission of their depression?

Morning Question #23

YES, YES and More YES. It is common for people with Bipolar Disorder to rebound suddenly from a depressive episode. Taking antidepressants can cause that. So can a lack of sleep. Most likely these sudden recoveries for depression will not take you to “normal” whatever that is. They propel the bipolar person into Mania or at least Hypomania. I suspect that lots of other things can cause that leap from depression.

For more on Bipolar Cyclothymia, Mania or Hyperthymic personality see the categories to the right or check out the blog post – List of Bipolar related posts.  

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog, there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Thanks to all who read this blog.

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