Wednesday, May 1, 2013

The Mania of Bipolar Disorder: What Goes Up. . .

Depression gets a lot of press, in books, articles, on talk shows. On the other hand, mania gets very little attention. In the various books dealing with bipolar disorder, there are lines, sometimes paragraphs, and very rarely, a few pages devoted to dealing with someone who is manic. Furthermore, much of what is written is counsel about hospitalization.

However, in this day and age, it can be very difficult to hospitalize anyone, particularly someone who is as clever and persuasive as a manic person can be. What, then, is a caring person to do, when someone important to him or her is in the full swing of a manic episode?

Dealing with a person who is manic is confusing at best. He or she is constantly testing everybody's limits, manipulating others' self-esteem, exploiting others' vulnerabilities, and projecting responsibility.

The people who love that person can get heaved off balance. They need resources for ballast. While the manic person is flying high, so full, so convincing, so strong, it does not seem possible that he or she will ever crash, especially if it goes on and on. However, eventually the mania will run itself out, and what almost always follows is a deep and dark depression. This is when the potential for suicide increases dramatically and is also when the support person will need a great reserve of strength.

Unfortunately, however, by the time the manic person crashes into depression, the family member is exhausted and lost, and may miss making appropriate decisions in response to their loved one. From a one-down position, powerless in the face of their loved one's mania, they are suddenly thrust into a position of needing to respond with direction and authority to their loved one's depressed passivity.

The resulting feelings of impotence, guilt, confusion, and self-blame can only weaken a caring person and make that person more susceptible to the impaired reasoning and countless accusations of the person who is manic. What follows are some thoughts and recommendations for how to survive the manic episode of a loved one.

1. A person who is manic can be quite persuasive especially about his belief that there's nothing wrong with him. You may find yourself with dangerous doubts about whether your loved one is sick at all. Remember that this is an illness, one with potentially fatal consequences

2. You must be solid within yourself and confident in the knowledge that you are dealing with someone who, although seeming in control, although insisting he has total command of himself, is in actuality quite out of control, if not of his present situation, then of the direction his situation is likely to take him. Remember that his judgment is impaired about what is best for him.

This can feel very disloyal, yet is probably the kindest, most responsible attitude you can have. With this attitude, when it becomes necessary, when your loved one plummets, you will be able to assume the responsibility needed. Believing him, trusting that he knows what is best for himself is like trusting a five-year-old to know that playing in the street is dangerous and can get him killed.

3. If you give in to your doubts, you may be drawn into your person's reality, which can only lead to your feeling more crazy and self-doubting. It is vital to remain shielded as best you can against such feelings. Knowledge and awareness are the best tools, along with professional guidance and support from people who care about you and understand what you're going through.

4. Do not try to deal with mania by yourself.

5. Find a psychiatrist who knows mood disorders, and form a strong alliance with that person.

6. Join a group for people dealing with the mania of someone they love. If your spouse or partner has bipolar disorder, find a group for couples who have dealt with the mania of one of them.

10. Read, go to lectures, and study bipolar disorder. Become a member of the Depression and Bipolar Support Alliance (DBSA) and the National Alliance for Mental Illness (NAMI) and receive their mailings.

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