Today I have the pleasure of interviewing Bruce Cohen, M.D., Ph.D, who is Director of the Harvard University McLean Psychiatric Hospital and Professor of Psychiatry at Harvard Medical School. He is also the coauthor, with Chelsea Lowe, of the recently released book Living with Someone Who’s Living With Bipolar Disorder: A Practical Guide for Family, Friends, and Coworkers. Cohen lives in the Boston area.
Question: I have always maintained that the best thing a person can do to support a bipolar loved one is get educated. But if you could offer folks a crash course, what are the five most important things you think a loved one should know about bipolar disorder?
Dr. Cohen: Getting educated is good advice. Here are five important things everyone dealing with bipolar disorder should know:
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The emphasis on education and family support is key. No one wants to be different or sick and most people have trouble accepting a diagnosis of bipolar. The task of helping the person to accept the diagnosis and take the appropriate steps to deal with bipolar frequently fall to the family or “significant others.”
I was diagnosed Bipolar 5 years ago. It took me a year to accept the diagnosis, I refused to believe it. But I still took the prescribed medication.
It took about 2-3 years to find the right medications for me, the right “cocktail”. But for the last 2 1/2 years have been happier than I could have imagined 10 years ago. I’m comfortable to be single, happy, and stable. Much of my life, excluding the last 5 years, so for 25 years I went undiagnosed, had 3 failed marriages, couldn’t stand to be alone, and was failing school after I previously went to Nursing school when I was 28 and getting a 4.0 GPA. This disease grabbed me by the throat and practically throttled me to death. I didn’t know what was wrong with me, and nobody could tell me. It wasn’t until after moving and finding a “good” doctor, that I was diagnosed.
On the side: SLEEP matters–a whole lot.
I have BPD, and that wasn’t helpful at all…sorry
I know this post is long, but there is a “family history” that is part of it.
My daughter was diagnosed with ADHD at 6.5 years old and then with Bipolar II at age 9 (that was later changed to I due to the auditory hallucinations that led me to take her to the Psychiatrist in the first place. Apparently a change in criteria concerning psychotic features required this change.) I was then diagnosed with Bipolar II after a 3 year battle with “Major Depression, Dysthymia and good old Borderline Personality Disorder” that kept getting worse and worse on SSRI’s. A year later they finally figured out I had ADHD too. (My Bipolar II was also changed to I because of visual hallucinations that got ignored previously.)
Anyway, my daughter is now 18.5 and recently decided that becoming sexually active with a boy that she doesn’t even have feelings of love for would be an okay thing, despite our (and usually hers) moral and church standards. She stopped taking her meds for two weeks because of a “fear & psuedo” symptoms of pregnancy. Now she tells me she doesn’t need her meds & that she just “wants to be herself.” She’s more irratable, even less focused and even more down on herself. She has to be badgered constantly to do any chores (this has been an ongoing issue – it’s just worse now). Her college classes are really suffering, even though she’s only taking one with a lab. She got incompletes in all her classes last semester because she ended up in a Psych hospital thanks to a toxic relationship with another boy that had lasted 1.5 years. She’s not putting forth any effort to work on those classes and doesn’t seem to care that if she doesn’t complete them, she’ll fail and have to pay back financial aid money.
Her therapist said the sexual thing was even likely a manic episode. When she was in the hospital they changed a med, but I wonder about it’s efficacy or if the dose is high enough now.
She’s made comments about moving out, but she has no job nor the maturity to handle those responsibilities of living on her own. (I managed to do it out of necessity due to a horrible family situation. I was in the Naval Reserves, had a full time job, a regetable roommate and in college. My Navy career ended 6 years too soon because of this mental health stuff, but I held it together enough to do well and make it that long.) This girl won’t be able to do that. I love my daughter dearly and have never tried to baby her. I’ve tried everyway I know how to boost her self-image and have tried to be strict enough, but not controlling like my father. I also didn’t let her run wild. She has taken enourmous amounts of my time being the center of attention and I have made that sacrifice at my own expense and even the expense of other loved ones/friends at times. I know I made mistakes with some consistancy issues on chores, but this stuff now is ridiculous.
I know some kids are able to stop the ADHD meds as adults, but research is showing that it doesn’t really go away. I’m living proof. If they had only known way back when I could have been an even better student. Unfortunately, motivation in school has not been this child’s strong suit since 4th grade when she ended up with a crappy teacher. Homeschooling didn’t help either.
I haven’t heard of Bipolar resolving. Is it possible?
Does anyone have any suggestions? I don’t want her to end up back in the hospital or worse yet, in trouble with the law as ofte happens whe Bipolar patients do when they stop their meds. I haven’t noticed signs of mania, more depressive type symptoms.
{Oh, another stone in this soup is that her father left our family when she was twelve and got himself another family 6 years ago that doesn’t have the medical/mental health issues. They do have baggage from an abusive father in that woman’s first marriage. They have been living together for a large portion of the time since he left us. My daughter didn’t like that at first because of our moral values, I guess she has come to grips with what she can’t change. My ex did propose to his girlfriend three years ago, but she won’t set a date. Oh well.
I remarried 4 years ago so it’s not like my daughter has been without a father figure. She hasn’t always accepted the idea, but she did eventually develop a bond with my husband. Here recently though it seems only when it’s convenient for her.
Her dad is the “fun” parent and she’s always grouchy after spending time with him. He was up visiting this past weekend (he lives a state away) so I’m sure that was part of the reason for the flack I caugh this morning.}
I know even “adult” teenagers are selfish, but what is the difference between that and the Bipolar/ADHD symptoms when they aren’t on their meds or adequate dosage of meds?
Thanks for your time
I find this to be 20% helpful (the first one). It is almost trite. What do I do about a spouse who purposefully provokes episodes of dysphoric mania in me and insists the condition was not a disease? ANd these medicines…they are poison, producing zombie-like states, and others even provoke serious episodes of mania (SSRIs) or increase the risk of suicide! Not to mention the risks to organs like the liver, heart, kidneys. DOes no one care about our physical health? My unmedicated bipolar parents are in their 80s and still fighting it out every day.
Sorry, I had such high expectations from a Harvard man. This doctor really diappointed me. I like my unheralded little medical school much better. Who would have thought a Harvard psychiatrist could be so simple about such a complex subject? And for the record, I do take medicine.
Although I found the statements true, I didn’t find the article to be very helpful. I began to believe I was “manic/depressive” in High School and it scared me. I married at 17 and my doctors believed I was Bipolar. My husband didn’t believe that Bipolar was really an illness. In his opinion it was just something the doctors made up to steal “his” money. He chose to allow the doctors to treat me when he believed I needed it and then when he believed I was “cured” he wouldn’t allow me to see the doctor. This along with the stress he caused me made me much worse.
I finally left him after 20 years of marriage and divorced him. I saw a doctor that diagnosed me as bipolar and I was put on Depakote. That was a huge mistake. Depakote helped the moods, but it made me too sleepy to have any kind of life other than zombie. It also caused me to gain 100 pounds in one month, and caused my hair to fall out. The doctor tried many other medications but none of them seemed to work. He recommended that I find a different doctor that was more familiar with Bipolar Disorder.
I worked with a psychiatrist for the next 7 years. The first medication that worked was much too expensive and we couldn’t afford it. That doctor finally found another one that worked pretty good. He retired 3 years ago and I have been working with a new Therapist that I trust greatly, he also worked as a pharmacist before becoming a therapist. He didn’t like the medications I was on and weaned me off of those and started me on a new one. It has worked well for me.
My life is also much different. My new husband tries very hard to keep my life as unstressed as possible. I fall apart when too many new things are added to my life, and stress triggers my illness to become very bad. He doesn’t pick fights with me and he does his best to be supportive.
I never have slept well, that is a big concern with my doctors. If I get stressed I sleep even less. My moods get very disturbed if I can’t get any sleep. I agree with this doctor about sleep.
As for the information in this article I find it very vague and not very helpful.
Sorry but this was so generalized that it wasn’t much help.
One big problem I have had with my kids that are now grown, is that they feel I don’t take responsibility for the mistakes I have made in their lives. I was told I always blame the Bipolar Disorder. What finally got through to my son was when I came up with the analogy of: “If you are driving your car on an icy road and you start to slide and then over-correct, causing an accident, Is it entirely your fault because you over-corrected? or does the ice have something to do with it?”
Yes, I’ve made some really bad decisions in my life and I do take responsibility but damn-it! I can honestly die tomorrow and look God straight in the eye and say, “I did the best that I could!” All I ever wanted from my friends and loved ones was for them to acknowledge I did the best I could.
Hello all,
I have struggled to find exactly what gene has been identified as contributing to the possibility of bipolar. The identification of the human genome being influential in our physiology has been a true revelation. It has opened the door to so many possibility for future cures. But i think it runs the risk of being a red herring for so many other diseases and dysfunctions so feverishly questing for answers that have yet to manifest. I believe the field of mental health is at risk of being one of the biggest offenders.
I have read that the Slynar gene has been “linked” to bipolar. However the one study I read posted had found that only 10% of people with bipolar are found to have this gene in common. That does not consist of a trend bay any stretch of the imagination.
So far it appears to me that the most likely reason why mental dysfunctions such as depression, bipolar, borderline, OCD, and other like disorders are common in family history is due to a much simpler and much longer understood. The fact that we often seek to marry people like our mothers and fathers, and often are drawn to set up similar family structures are more to blame for our children having the same mental health issues. If women marry men who are distant and/ or abusive, the offspring are often susceptible to issues of anxiety. However, those same offspring are often equally susceptible to choosing spouses that are similar in character. (Or to try and mold the person of their choosing into that character.)
This situation occurs way more then 10% of the time. It is not a matter of genetic influence, but rather repetition of history. I would welcome comments that may shed light on why genetics are so often cited as an influence to these types of disorders.
Virginia,
I doubt very much that the person in yoir life deliberately porovokes episodes of Dysphoric mania. Why do yo fell that? It sounds as if you are not on the correct or adequate amounts of your medication. Just taking meds does not mean you will never have an episode , but will hopefully will reduce the likelihood, frequency and severity, but it is essential that it is the right one and the right amount. Maybe a combination is required. Does this person know your triggers. Perhaps it would help to take them along with yiu to therapy so they can learn what will help. I live with someon woth Bipolar Disorder so I know how easy it is to inadvertantly upset them, but especially if they are on the wrong meds as they do not want to discuss anything then, or in a reasonable way and that creates frustration fir the paryner whjo may want or need to discuss things.Difficulties and reluctance in communication can arise . It sounds as if your mood is not stabilized and that this is creating tensions. I would not blame your partner.People generally tend to do this because they are in a high mood.It is the illness. Good luck.