This article is a continuation from Multi-Polar – The Many Moods of Bipolar Disorder part one.
Paranoia often accompanies delusions or hallucinations and is the perception that you are being persecuted. You may feel that someone is “out to get you” or someone is trying to humiliate you or be unfaithful. With these beliefs come accusations and suspicion of those around them for no reason. Even though paranoid beliefs have no basis in reality they feel completely real. You know that your girlfriend is cheating on you. You know that everyone is talking behind your back. Again, because this is part of a thought disorder (psychosis) it’s unlikely that anyone can shake these beliefs from the person suffering them.
Anxiety is like the free gift with purchase of many disorders and often occurs alongside other moods. (Anxiety disorders are the most common mental illnesses.) So it’s quite possible, and I might even suggest likely, to be manic and anxious or depressed and anxious. Anxiety might manifest as jitteriness, muscle tension, rapid heart rate, difficulty breathing as well as worrying thoughts, guilt, panic and feeling out of control among other things. Anxiety might be a fear attached to a specific thing or event or may simply exist from nothing.
Anger is a huge problem for some people with bipolar disorder. While everyone gets angry, some people with bipolar disorder get ANGRY. The rage can be extreme and completely out-of-proportion to whatever caused the anger. Extreme irritation can also occur. Irritation feels like being ANGRY at others for breathing your oxygen or for blinking so loudly. Anger and irritation often occur with mania, hypomania or depression and even euphoric (“happy”) manias can turn into fits of anger easily.
There are many examples of overwhelming overstimulation in bipolar disorder. “Racing thoughts” is one symptom of bipolar mania or hypomania and many people experience a flooding of thoughts so fast and furious that they can’t keep up. Another phenomenon that may be described as “crowded thoughts” also occurs when it feels like many different thoughts are all occurring simultaneously and ganging up on you – as if 50 screaming people were crammed into a phone booth. On top of that there is a physical feeling of overstimulation when the surroundings feel like they are “too much” and the very thought of acting is overwhelming. This feeling can occur when being physically stimulated or simply in response to an everyday situation like paying bills.
Suicidal feelings are a fact of life for many with a mental illness. Many won’t act on these thoughts, but many do with more than 50% of people with bipolar disorder having attempted suicide. Suicidal thoughts may stem from a hating of oneself, or from a desire to stop the pain of the disorder or seemingly from nowhere. These thoughts are more associated with depression but occur frequently (and dangerously) during mixed episodes too (below).
Mixed states are a combination of depression and hypomania or depression and mania. It was once thought these are only present in bipolar I, but we now know they happen in bipolar II as well. Mixed states are extremely dangerous as they can possess the energy of mania with the self-hatred and suicidal thoughts of depression as well as a raging need to act and thus result in a suicide attempt or other self-harming behaviour. Mixed moods are often the most troubling kind of mood – more than depression or mania – for the person with bipolar and mixed moods can be difficult to treat.
This two-part article was inspired by the chapter “Multipolar Disorder” in the new book Loving Someone with Bipolar Disorder (second edition) by Julie Fast and John Preston. No, I wasn’t paid to plug the book but I did get sent a copy of it by the publisher.