[medicalfox]

I have a close family member and she has a lot of problems. I always figured she had depression with a couple of personality disorders, but she denies that they are the most likely causes. She has severe anger issues and is easily triggered by almost everything which is why I never see her. She has a history of fighting other teenagers. What bothers me is that she blames her outbursts of anger for being bipolar. She isn't even diagnosed with having any kind of bipolar and I was telling her that people with bipolar disorder don't get angry all the time and over emotional, but she said I was wrong. I have never seen her manic and she is known to have depression. She self medicates and says that she will never take medications since it affects her drinking. She is also very narcissistic by viewing everybody wrong and seeing herself as a great person. What does this sound like to you? It sounds like bpd when it comes to the short fuse of horrible anger.

I really don't like her using her explosive anger as a excuse as being bipolar because this makes me look bad in my family. I don't want my family members to assume that people with bipolar disorder as always angry and over emotional.

[Zabine]

When I am in a mixed state I get very angry...raging if you will

[medicalfox]

She's angry all the time though, could she constantly be in a mixed state?

[Confusedinomicon]

You couldn't diagnose her until she sobered up. Substance abuse can mimic disorders.

Its also dangerous to mix medications with street drugs/alcohol.

The only way they wont make that assumption is if you talk to them.

[Zabine]

I remeber being angry all the time until I was put on a mood stabilizer. I wish I would have gotten on it in my teens, it would have saved me 15 years of anguish! However, you can't go around self diagnosing.....

[Resident Bipolar]

The angry outbursts to me sound like the effects of the alcohol, rather than anything else. Indeed, BPD is a lot more of a reasonable diagnoses for the angry outbursts than Bipolar Disorder but if she's consuming alcohol, that right there could explain not only the angry outbursts but also the depression that she's experiencing.

Of course if she was in a similar way before consuming alcohol, then there may be something else to blame. However I don't believe any qualified and experienced psychiatrist would diagnose a mental illness or personality disorder when there is alcohol in the equation.

Some psychiatric medications can also cause agitation and irritability, but psychiatric medications are obviously not a factor in this case.

Hang in there. It sounds really trying! I cannot stand it when people not only self diagnose but then use an illness they're not even diagnosed with to explain their unreasonable behaviour. Mental illnesses can often cause people to react in ways they wouldn't normally find acceptable behaviours otherwise, and in that case I can understand people using their disorder to explain their actions as it could indeed be to blame. Using a disorder you're not diagnosed with as an excuse is however, in my opinion, a very bad thing to do.



RB.

[Lillyleaf]

To be dxed the mood swings or symptoms can not be due or related or around any drug use or external factor. On the flip side many people with BP get into drugs and other bad habits to try to deal with their mood swings.

aka... :P It's an endless cycle.

I wish you luck!

[Victoria'smom]

Intermittent explosive disorder

[IndieVisible]

The real complication here is too things, she self medicates and drinks regularly. So it would be difficult if not impossible for even a pdoc to give her a real diagnosis. She would need to be clean for a 2-3 weeks to observe how she acts to properly diagnose her.

It could all be the drugs and alcohol. Or they contribute to whatever it is she has. How old is she?

[ultramar]

Yeah, being triggered into angry outbursts all the time doesn't sound like Bipolar Disorder (I assume even when not intoxicated?) -emphasis on 'triggered' and 'all the time.' I can see how her saying this to family could make you very uncomfortable as they may then get the impression that people with bipolar disorder are like this. This is one of the reasons that misconceptions regarding bipolar disorder really get to me sometimes: there's enough stigma without adding on behavioral issues that are not related, then people blame these on bipolar (diagnosed or not) and the misconceptions are proliferated, more and unnecessary stigma, and on and on. I'm thinking about that Dr. Phil episode someone mentioned here one time.

I remember interpreting for the mother of a teenage patient in outpatient psych who was seeing a pdoc for angry/rage outbursts. Her energy in that room practically put my hair on end, her demeanor was so aggressive. She hadn't been diagnosed, but when she said that she would stay up all night, the pdoc said "Well then, you may be bipolar afterall" (the mother protested, saying that she stays up all night sometimes because she's texting her friends).

In any case, the patient then turns to me and says, "Tell her [her mother]! See, it's not my fault!!"

Ugh. Maybe she does have BP, who knows, but the 'see, it's not my fault' really got under my skin: it was positively triumphant.

Doesn't look like she's going to seek help, so I have no advice on that front. But maybe you can explain to family what bipolar is and is not about (without necessarily mentioning the person you're talking about as this could end up being divisive). This sounds like one of those situations where some psychoeducation for family would be useful. Best of luck.

[wildflowerchild25]

I hate when people blame their various dx for their unacceptable behavior. I get very angry sometimes because of irritability in mixed/manic states and I take it out on my family but I always feel like an ***hole afterwards. It is one I the things that drove me to seek help. I try to control it by taking deep breaths and things like that because just because I have bipolar does not mean I get to treat other people like s***. I get that having an MI causes certain behaviors and poor coping skills but eventually you have to take responsibility for your actions and seek help if you cannot control it. That is so aggravating for me! I hope your family member seems help eventually. Good luck!

[medicalfox]

Originally Posted by IndieVisible

The real complication here is too things, she self medicates and drinks regularly. So it would be difficult if not impossible for even a pdoc to give her a real diagnosis. She would need to be clean for a 2-3 weeks to observe how she acts to properly diagnose her.

It could all be the drugs and alcohol. Or they contribute to whatever it is she has. How old is she?

She's 18 years old. Even when sober she's aggressive and she's actually nicer when she drinks which is why I think she drinks so much. I don't think she will ever have a official diagnoses at her current rate. I was just wondering if this was bpd excluding the alcoholism.

[~Christina]

Well shes 18 where is she getting all this alcohol ? Yeah I know kids always find a way if they want too.

She could have any number of problems to be honest. But no way to determine it by a Pdoc until she is Sober. It is really upsetting to anyone that has Bipolar to hear someone just blame there behavior on " Bipolar".

Based on what info you gave us I would say Alcohol dependant and BPD or just a plain spoiled child that has been "allowed" to act this way and get away with it.

What a mess I'm sorry your have this person to deal with.

[medicalfox]

Originally Posted by ~Christina

Well shes 18 where is she getting all this alcohol ? Yeah I know kids always find a way if they want too.

She could have any number of problems to be honest. But no way to determine it by a Pdoc until she is Sober. It is really upsetting to anyone that has Bipolar to hear someone just blame there behavior on " Bipolar".

Based on what info you gave us I would say Alcohol dependant and BPD or just a plain spoiled child that has been "allowed" to act this way and get away with it.

What a mess I'm sorry your have this person to deal with.

She's a pretty party girl, everyone buys her alcohol and other things. She could be either those things (or both), but I probably will never know. I just dislike how she uses "being" bipolar as an excuse for her actions. Being bipolar doesn't mean you want to hurt every person that doesn't do what you want them to do 24/7.

[A Red Panda]

Why not give her some reading on the topic? She might get pissed at you, but hand it to her with a note going "Bipolar doesn't mean constant rage." Mail it to her or something if you don't see her often. She obviously needs to be educated on what bipolar is and isn't....

[Zabine]

Seriously she sounds just like me at 18 and through my 20's, check out my sig dx's………..just saying…...

[Resident Bipolar]

Originally Posted by medicalfox

She's 18 years old. Even when sober she's aggressive and she's actually nicer when she drinks which is why I think she drinks so much. I don't think she will ever have a official diagnoses at her current rate. I was just wondering if this was bpd excluding the alcoholism.

Alcohol can still be a factor despite this. In fact, when I was addicted to substances like alcohol I was a lot worse when sober than when intoxicated.

[bronzeowl]

Originally Posted by Resident Bipolar

Alcohol can still be a factor despite this. In fact, when I was addicted to substances like alcohol I was a lot worse when sober than when intoxicated.

I was thinking along the same lines. My mom self medicates with alcohol. She's been an alcoholic as long as I can remember... When drinking, she's pretty happy and talkative. However, separate her from alcohol for 3+ days and she suddenly becomes very explosive.

That's why it's so hard to figure things out when any kind of substance is in the equation...

It bothers me when people blame their behavior on a disorder. Regardless of what I'm told, I will NEVER blame my behavior on one. I can get a bit snippy with people I care about. I feel bad about it later, almost all the time. I think many of us here would agree.

Whatever is going on with this girl, she sounds like she does need some help. Even if it is merely a result of her dependency to alcohol, that alone would warrant needing help.

She sounds very much like me when I was 13-15, to be honest.

[Anika.]

Doesn't our individulal personalities , coping skills, learned responses, thought processes etc.. play a role in how we play out our mental illness....just sayin'. A lot of times someone with bipolar who gravitates to rage might because because they would gravitate towards that anyways. I gravitate towards tears and holding it in, but seldom in anger...because I was not allowed to display anger growing up and as an adult I never did end up expressing myself that way, and choose not to even tho I could choose to now. My tears can be on such a quick switch it can seem quite inappropriate at times. That however is my go to response. But has little to nothing to do with bipolar. Alas it does not go away with mania either or when in a normal state. And it is still something I can take some accountability for and work on.

Bipolar can make some people irritable etc.. how we express it has a lot to do with ourselves outside of the dx. People do need to own some of what they get up to, or seek help to learn how to deal with it more appropriatly....which leads to some accountability anyways.

When we start to eqaute all our behaviour to our dx we just become our dx and nothing more. Is all our good behaviour or behaviour we are proud of because of bipolar too... because people love to own up to that bit.

[ultramar]

Thank you for this post. I agree that how any (and I mean any) MI manifests itself in a given person will likely have to do with their 'psychology' (basically everything outside of whatever chemicals are or are not roiling in our brains, in other words, who we are, our histories, etc.).

Is all our good behaviour or behaviour we are proud of because of bipolar too... because people love to own up to that bit.

It bothers me a great deal seeing the attribution of what one doesn't like about oneself to bipolar. It can help with the shame/guilt, but certainly not get to the core of the (non-bipolar) psychological issues. People with bipolar disorder are perfectly capable of flying into rages outside of episodes, for example. It can -potentially- be a completely separate issue. I think if there were a magic wand to whisk away the shame that can ensue from bouts of rage (or x inappropriate behavior) then it would be easier, and more common, to recognize them as potentially not part of an episode (if this is the case).

I'd love to attribute my faults and any poor behavior on bipolar disorder, but alas, life happens, *I* happen...

I think, to some extent or another, we can all agree on this. And it's part of the whole struggle with determining what 'mood' or 'behavior' is and is not bipolar. Recognizing/acknowledging/facing all that goes on outside of our illness, which, unless you're literally constantly cycling, is going to be mostly 'ourselves' I think is a lifelong project. This is one of the reasons why I'm such a big believer in therapy in the context of bipolar disorder -that's where you can face and deal with the psychological and behavior issues that medication may help with to some extent, but not eradicate, and not help to understand.

[Anika.]

I think the shame and guilt can be changed, we percieve it to be shameful or guilt worthy. So we could change our perception and try to see it for what it is, just a human behaviour we have learned to use because of x, y or z. Whatever the reason is why we do it doesn't even really matter. How to change that into something healthier that helps move us to a place we would like to be matters. We spend a lot of time wondering why, why, why instead of how. That might just be human nature to, but sometimes it really is easier to skip the why, and mive to the how even if it doesn't seem easier at first. Our brains can be stuborn.

Humans are so complex, will we ever truly know which is a bipolar behaviour and which is not...and does it really matter? Bipolar might make it harder to maintain control and harder to always use sound judgment..but not immposible. I rely on the possibilities because they are endless, and give you a way to acheive what you want. Would be a horrible thing to not have possibilities to work with. I really believe we are all capable of that which we doubt in ourselves and that doubt is most of the battle.

Regardless of the cause ... Acting out in anger can get people into a world of hurt & trouble, therefore, I think the most important thing is to try to get them to see all the bad things that can befall them if they continue in it without even trying to get as much of a handle on it as they can.

To me nothing's worse than ending up homeless or in jail or prison because of mental health and addiction issues. Unfortunately - and sadly - society, law enforcement and the judicial system still have little to no empathy and/or compassion for those struggling with any of it.

So maybe if you could get her to understand how important it is to get help before all that happens then it will save her the heartache of all the added headaches and complications.

Of course, she may totally blow you off, and if that's the case, you've done all you can to try to help her, and the only thing left for you to do will be to let her learn her life story the hard way & without dragging you along for the ride.

[ultramar]

Originally Posted by Anika.

I think the shame and guilt can be changed, we percieve it to be shameful or guilt worthy. So we could change our perception and try to see it for what it is, just a human behaviour we have learned to use because of x, y or z. Whatever the reason is why we do it doesn't even really matter. How to change that into something healthier that helps move us to a place we would like to be matters. We spend a lot of time wondering why, why, why instead of how. That might just be human nature to, but sometimes it really is easier to skip the why, and mive to the how even if it doesn't seem easier at first. Our brains can be stuborn.

Humans are so complex, will we ever truly know which is a bipolar behaviour and which is not...and does it really matter? Bipolar might make it harder to maintain control and harder to always use sound judgment..but not immposible. I rely on the possibilities because they are endless, and give you a way to acheive what you want. Would be a horrible thing to not have possibilities to work with. I really believe we are all capable of that which we doubt in ourselves and that doubt is most of the battle.

Thanks, this has shifted my thinking a bit, given me a different perspective. Wise words.

[medicalfox]

I can try to educate her, but she's not a very nice person and I don't think she could take me seriously. I'm hoping when she's older she will realize that life isn't one big party and that violence is not the answer to her problems.