Bipolar mania can really foul up the family dynamic. One minute, your family is cruising along on autopilot, and the next minute you’re in a tailspin. It can begin innocently enough with a barely perceptible increase in irritability and criticism, and then quickly escalate into knock-down, drag-out conflicts, all of which contribute to worsening the mania.

13 Comments to
Bipolar Mania: A Vicious Cycle

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  1. “…various forms of therapy can help quell the mania.”

    Like what? Therapy has never helped my mania at all, it’s only helped with general stress/life management that all goes out the window during a manic episode. Mindfulness while manic? Ha! By definition that’s lacking.

    I’ve asked all my doctors and nurses and therapists about non-drug alternative treatments for mania and they all said nothing else helps. Googling had the same non-results. The drugs don’t help me a whole lot either.

    I totally agree that loved ones need to get support and disengage while I’m out of control.

  2. that diagram is interesting. the one thing I have been frustrated with my wife (who is bipolar), is that she tends to try to forget about the anger/rage afterwards, and downplay it. It took a really serious incident not long ago to wake her up and get her back into therapy.

  3. I have trouble with violent manias where I have explosive rage which often results in broken stuff and self injury. I used to get them several times/wk But now 6 yrs of therapy and 2 yrs of going through group therapy using the skills training manual for borderline personality disorder (BPD)by Marsha Linaham , I am much better. I still have issues, but have learned various ways to defuse myself before things go out of control.By being mindful, I have learned the warning signs and situations that tend to set me off. , and a bunch of other skill sets that normal people could use as well.

    This program has been very helpful if you stick with it and are open minded enough to learn.I was scared to death of being in a group but it actually was OK despite it being a revolving door with people starting and stopping, coming and going.
    Yes, there are times when I get mad and all my mindfulness skills go out the window, but it happens a lot less. Life is more worth living.

  4. I have been living with my bipolar husband for over 12 years. Lately it has become very very difficult for the family, and I have to really struggle to maintain my job, my sanity and to focus on the fact it is not me who is responsible for him. Everything is my fault, nothing is “right”. We have met with his therapist, who is very good (his lithium levels were so low as to be negligible as he was neglecting his meds). He now tells me that his therapist feels he is fine (his interpretation as his therapist has not increased his dosage). I am almost scared to call his therapist – i have permission to do so – for fear of the wave of repercussion that will follow. We have 2 young children under the age of 5 to boot. How long do I continue like this? Is it better to just ask for a separation? I fear that will only make him worse.

  5. Hi, Sad Mom-

    An article on NAMI’s website might help. It’s called “Setting Boundaries in a Marriage Complicated by Mental Illness,” by Kathy Bayes.

    Like most things, setting boundaries and consequences is easier in theory than in practice, but it may be a good place to start.

    The big problem at this point, as you well know, is in getting everything settled down to a level at which rational thought and discussion are even possible. Perhaps setting and communicating boundaries will convince your husband to get the treatment he needs and stick with it when he starts feeling better.

    I wish you and your family the best.

  6. I did separate and than divorce the bipolar man I still love. He is on different meds and they really helped but he was out of control until I left him. He now is better but drinking alcohol very heavily with the meds.

  7. I am a bipolar II patient. I have been stable, on meds (carbamazepine) and therapy for almost 5 years now. Unfortunately, I was also without any control for another 5 years, previously. Full-blown manias and depressions. Not pretty. Sadly, my now ex-partner was with me during this time, and she experienced all my manias and depressions. Manias seem to be harder for her to understand, and forgive. I dont think she ever fully forgave me for my actions, even though I tried so many times to explain they weren’t enrirely “MY” actions.

    I think Mania is harder to accept, understand, and forgive for people around bipolar patients. Like I always told my ex: “You tell me it was horrible for you, to stand through all my episodes. That, I understand. I’m sure it was. What you don’t seem to understand is that it was just as horrible for me. I don’t enjoy hurting people I love. I never intended to do any of the things I did during my episodes. I think it was just as hard for me as it was for you.”

    I clearly remember and will never forget how when I was on mania, I ended up screaming at my ex really bad, with our newborn present. I always ended up crying after my outbreaks of screaming. Now I understand why. It was hurting me to do so to my loved ones.

    Mania and bipolar in general are hard things. Not easy at all. But at the same time, they arent impossible to overcome. It just takes a lot of work, effort, patience, and persistance. But you CAN overcome it. Trust me, I did.

    Blessings to all bipolar patients out there, and of course, blessings also to all the people that have a bipolar in their family, or as a partner. Please try to understand it hurts us just as much as it hurts you. It really does.

    Camilo

  8. I am trying to understand, I hope someone can help me. I am a 54 year old woman, oldest of seven. My mother has recently been diagnosed with breast cancer and had a mastectomy. My Dad has a rare form of leukiemia that he is being treated for as well. Both of my parents are in their 70′s. I have a 51 year old brother that has battled his entire life with something, I’m not totally sure how to describe. When I read the childhood ADHD he was exactly that! That was before the medication “ridalin”. My mother always said my brother could scale a glass wall. They didn’t know what to do with him, and he was always in trouble. Spankins were acceptable back then, and believe me, he got more than his share. Now that he is older, he has an anger management problem. He is mean and very intimdating as he is a big man. My question is, how do I ask him to get a test done to see what is wrong. Recently he has moved back into my parents home, and none of the siblings will go to visit since he is there. IF they do go to visit, he (my brother) will slam things around and cause chaos while we are there to visit. This has caused tremendous problems in the family. HELP!!!

  9. Ooops after rereading I should also tell you that my brother has had several relationships with women, and has not kept any of them, not because he is abusive, but because he wants to control the woman’s EVERY thought. My parents will not throw him out because he has no job, no money, no drivers license. He did not pay child support, lost his license for that, as well as driving without insurance and owes $9000.00. Also he has been involved in drugs most of his adult life. He will not venture to ANY social events, and also missed grandparents and relatives funerals. Please Help, any kind of help would be greatly appreciated. Thanks!

  10. Hi, Robyn–

    Dr. Fink posted a piece some time ago entitled “Encouraging a Family Member with Bipolar to Get Help,” which probably doesn’t apply to your situation. It sounds as though your brother would not be at all receptive to any suggestions at this point.

    Dr. Fink posted another piece that may be more appropriate for your situation entitled “Can I Have My Manic Loved One Hospitalized?” on our other Bipolar Blog.

    By referring to these two articles, I do not want to discourage others from posting their insights. If you’ve been in a situation similar to the one that Robyn’s family is facing and found something that works, please offer your words of wisdom.

  11. Thank you Joe, I’m not sure if bipolar is the disorder is my brothers problem or not, but I am sure he has a problem. He cannot let go of the past, he is still mad, and won’t speak to family members or friends that he thinks have done him wrong 30 years ago! Oh my! He still brings it up… He also has an anger problem. Is this part of the disease? I know that if he would flip and do the things he says he’s going to, he would REALLY hurt someone. He has spoken of suicide as well. I’m just sick of my family being ALL torn apart and all the loose ends being trailed back to something he said or did. This is going to kill my parents….

  12. Robyn–

    You’re right, it could be something other than bipolar. And yes, anger can be a part of bipolar, although other things can cause irritability and anger too, including other health conditions.

    You and your family, including your brother, will probably never know the root cause unless some well-qualified person(s) can step in, defuse the situation, and then start sorting out what’s going on.

    I hate to see anyone’s family torn apart and suffer so much. I’m no expert in these matters, but I think your family would benefit greatly by pulling together and committing to resolve this unacceptable situation. Treat it as something that MUST be resolved.

    You have much to lose if this continues and much more to gain by resolving this. What a wonderful gift it would be for your parents and your family to have your brother back healthy.

  13. I went into a manic state a while back and managed to destroy two friendships that I’ve had for 10 years. I was so aggressive and impulsive that the slightest thing set me off and I responded (what I thought) accordingly; needless to say, I came down from it and was horrified at what I’d said and done.

    One of my friends understood somewhat and, though she said her trust in me was strained, tried to understand. She gave me an ultimatum though: Take your medication or we’re not friends. My doctor put me on lithium, which I hate taking for a number of reasons and though I’ve tried explaining them to her, she says that she worries about me too much and if I don’t and have another manic episode, she can’t support me.

    The other friend cut off contact completely, and honestly, I can’t say I blame her.

    The hardest thing to do is explain to other people that it doesn’t even feel like you afterward–it feels like some stranger hijacked your body, screwed up your life, and then you come back to yourself to realize that everything around you is strained or broken. From my experience, most people–even those who want to understand–tend to have this subconscious mentality that you were just being unreasonable, like a bad temper that you can control, or that somehow you’re just using your bipolar as an excuse.

    Sorry for the lengthy comment!

  14. I didn’t realize that bipolar is a vicious cycle. I also didn’t realize that bipolar is thought to be a mental illness. I don’t like to think of myself as mentally ill. However, I’ve learned to think of bipolar as if I was diagnosed with diabetes. Once diagnosed with diabetes, you have to keep it in check or it could get out of control. The same thing happens with being bipolar. After I was diagnosed with bipolar, I went into denial and I lied to my family and told them that the doctor’s had made a mistake with my diagnosis. I then had a really bad episode after failing my teacher’s test and I was then kicked of of the teaching program that I was in when they learned about my being ADHD annd bipolar. I realized then that I had a problem like someone who is diagnosed with diabetes and that I needed to always take medicine in order for me to function normally. When I have forgotten to take my meds like I should, my family immediately notices. This hurts, but I love my family more and I don’t want to do anything that I might regret. After reading this, I decided that I want to try therapy because I am soon to be graduated from college and I am scared about what the future holds for me in the workforce. I worry about if I can maintain normality in the workforce and if I can function normally without being impulsive and careless with what I say and do. It took me seven years to get my Bachelor’s degree and now that I’m almost ready to attain this accomplishment, I am worried about what my future holds for me. I’ve also learned that you can not be open with people and tell them that you are ADHD and Bipolar, especially Bipoloar. People are not so understanding and they are naturally judgemental of others. I wonder sometimes if my bipolar is brought on from having been abused as a child and that it is not genetic. However, I have two sisters and my mother who have been diagnosed with Bipolar also. By the way, excercise has been helping me to clear my head along with the medication. Excercising takes self discipline, but I’ve found that it is worth it. So, when it feels like the meds aren’t working, excercising does.

  15. I’m the husband of a bi-polar wife. Her condition makes her virtually impossible to deal with. She is presently in a manic state, has resorted to drug abuse and tragically gone outside of our marriage. We knew the cycle was coming and went to see her Doctor 2 months ago. She felt anxious, nervous, and was bitter. The doctor changed her medication, however I was not aware she had resorted to illegal drug use as well. Now my families world has been torn apart. She has abandoned our children, and views me as her worst enemy. At this point is there any hope left for her? She is having numerous affairs, and posting photos of herself nude on the internet. This is really not the conservative mother of my children that I adored, loved, and married.

  16. I have to say how Bi polar is such a mean disorder.. My husband soon to be ex is a good man but doesnt think he has a problem. everything is my fault… i have been with him for over 20 yrs and i could and still can see the pattern. everything would be perfect for a small time frame then you could feel the tension the anger the spending the frustration and you knew it was coming the burst the break what ever you want to call it. And after it happened things would be ok.. for the longest time i thought i was going nuts.. any time there was any stress it would start and continue till the break. I have loved this man for so long but then the worst thing happened his dad was told he had cancer and that was it. it was like this wall went up and everything was my fault. he stayed out late..worked more started talking to other women at odd hours.. when confronted it would only make it bad..you could tell he was in a cycle. a few years prior he was told he was bi polar and put on meds which were wonderful a full year of the perfect life.. but then he decided he didnt want to be on the meds any more and that he was fine and he convinced the doctor that he was fine and that his life was perfect and didnt need the meds. the doctor felt that maybe she had jumped to fast and that it was more an anxiety issue and took him off the meds.. well shortly there after was when he found out about his dad and life changed.. found out he was seeing 2 women and lieing to me about his finances and 3 weeks after his dad passed he left the family… just walked away and went with his new girl friend.. he no longer talks to his mom brother or children. blames me for his life and that he is happy…but hes not hes spending money like there is no tomorrow and the sad thing is the girl friend loves the fact he spends moeny shes also 14 yrs younger then him and 10 yrs older then our daughter. All of his friends cant figure out what is going on with him. nothing is right hes angry and doing things that are so not him but there is nothing i can do and i hate it!!! we went to counciling and she said yes hes bi polar and needs meds but she cant do anything till he asks for it just like the family doctor she said the same thing… what do you do???? he is destroying everything we had and he doesnt see any of it. all of it is my fault… the last thing i ever wanted was to divorce him he was my prince. my everything my best friend..but i dont know this person and he is so lost.. please if anyone reads this please pray for him.. that he wakes up and gets help… i will alway love him but i dont know what to do for him other then to walk away…uuuggghhh

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Candida Fink, M.D. and Joe Kraynak are authors of
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