The three symptoms below represent the side of bipolar disorder we all know is there but rarely want to let the public know exists.
I know how important it is to protect the reputation of bipolar disorder in the general public. We don’t want people thinking we are dangerous, scary, crazy people who can’t be trusted. But I do feel we need to own up to the fact that certain mood swings DO cause the behaviors we want to sweep under the carpet. The three symptoms below represent the side of bipolar disorder we all know is there but rarely want to let the public know exists. This is only an opinion, of course, but I’m truly interested to know if you feel the same.
#1 Dangerous, Aggressive, and Violent Behavior in Bipolar Disorder
I work with parents and partners of those with bipolar disorder. In the majority of situations, people who are in a strong dysphoric manic episode can be dangerous, aggressive, and violent. Physical assault and weapons are not uncommon. Many men go to jail because of this behavior when they actually need psychiatric help. People who are mild-mannered and kind when well, both men and women, get superhuman strength along with the aggression—ripping a sink out of the wall, punching through windows, throwing chairs, and other dangerous behaviors are not uncommon.
Families and partners suffer in silence because they are scared to tell anyone about what really goes on at home.
I have violent thoughts when dysphoric mania is raging. I used to chase down cars if the driver flipped me off or made a strange face. It is not my goal to scare anyone reading this. It’s my goal that we are honest about these hidden and pushed-under-the-rug symptoms of bipolar disorder.
The solution is management. People with bipolar do not have these symptoms unless the mood swings are raging. Prevent the mood swings, and you can prevent the dangerous, aggressive, and violent behavior.
#2 Psychosis in Bipolar Disorder
I have rapid cycling bipolar II disorder, with psychotic features. I experienced undiagnosed psychotic symptoms from age 19 to 31, when I was finally diagnosed. I’ve had hallucinations and delusions all of my adult life. What scares me is that no one—and I mean no one—educated me about psychosis when I was diagnosed. It was as if the symptoms didn’t exist. When I learned the extent of my psychosis, I was appalled that I had lived with it for so long.
My symptoms were mostly visual hallucinations and paranoid delusions. I didn’t know that others didn’t have them as well! If you have bipolar I disorder, there is a 70% chance of full-on psychosis when you are in a full-blown manic episode. This psychosis can be very bizarre and mimic schizophrenia. The difference? People with bipolar disorder only have psychosis during a manic or depressed mood swing. There is no psychosis outside of depression or mania.
If a person experiences psychosis in between episodes, this is not bipolar disorder but another mental health condition. Do you or your loved ones have psychosis? If bipolar disorder is involved, psychosis could be involved as well.
#3 Cognitive Impairment in Bipolar Disorder
Many people find this scary. We already have bipolar, does this mean we have memory problems as well? Maybe. Cognitive impairment from memory lapses, forgetting appointments, being unable to remember information, and experiencing brain fog during certain episodes is common! If you have bipolar, you’ve probably felt the sluggish brain that comes with depression. If you have mania, you have probably tripped over your words, said things you didn’t mean, and had trouble thinking thoughts in order.
My cognitive symptoms visit me daily. I’m not able to remember dates and numbers, and I need help with calendars and appointments. Mine got worse after intense therapy I had for severe depression. It’s something I find distressing, but it’s easy to manage.
I want us to be open about cognitive issues. This is the only way we can get help! My cognitive symptoms tend to linger all of the time, but they get worse with mood swings. A perfect example of this: I was supposed to submit this blog by midnight. Yesterday, I reminded myself all day to submit it, but I still managed to go to sleep without sharing it on time. I have to live with these symptoms, and even though a few things slip through, I do control the majority of my minor memory problems with a good support system!
Here’s the Good News—Yes, There IS Good News!
Bipolar disorder is an episodic illness. We have all of our symptoms while in a mood swing. This means we are STABLE when we are not in a mood swing. The symptoms I list above usually go away when the illness is successfully managed. It can take regular monitoring for those of us who have daily symptoms. Others who have long breaks between mood swings may even forget the symptoms even existed. This is why we must have a management plan that can recognize the dangerous, aggressive, and violent behavior; psychosis; and cognitive impairment as soon as they begin.
I know we want to protect our reputation around this illness. We don’t want to be seen as different or “freaks.” But I ask that within our community, we get brutally honest about what really happens to those of us with the illness. It’s the ONLY way to stop the symptoms and make them stay away forever!
Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get It Done When You’re Depressed, and The Health Cards Treatment System for Bipolar Disorder. She is a columnist and blogger for bp Magazine, and she won the Mental Health America journalism award for the best mental health column in the US. Julie was also the recipient of the Eli Lilly Reintegration Achievement Award for her work in bipolar disorder advocacy. Julie is a bipolar disorder expert for ShareCare, a site created by Dr. Oz and Oprah. Julie is CEU certified and regularly trains health care professionals, including psychiatric residents, social workers, therapists, and general practitioners, on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People magazine. She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called "Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis, and Depression." You can find more about her work at JulieFast.com and BipolarHappens.com.
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