by Julie A. Fast
It’s hard for family members and partners to believe that a person with bipolar disorder can’t remember certain mood swings. I often hear the question, “ Doesn’t my husband (partner, child, sibling) see the damage he did when he was manic! Is he lying to me when he says he can’t remember? How is this possible?”
To answer this, I will start with a short explanation of the different types of bipolar disorder. Although we all share the same symptoms, the severity of the symptoms can vary greatly.
There are three main diagnoses of bipolar disorder. Cyclothymia, bipolar disorder two and bipolar disorder one. All share mania and depression. Cyclothymia means a person has milder episodes. Bipolar two means a person has full on depression symptoms and a lower level (thought still very disruptive) form of mania called hypomania. Bipolar one has full on depression with hypomania and full blown mania.
People with bipolar one who have full blown mania have a 70% chance of being psychotic during a manic episode. This is the most important piece of information you need in order to answer the question about black outs.
When a person is in a full blown manic and psychotic episode, memory is greatly affected. In fact, it is rare for someone who is is a deep episode to remember all that happened. This is why it’s called a black out.
The average person in this situation remembers maybe 50% in my experience. They can remember the big details- such as, “I had an affair.” But if you press them for the specifics, it’s often a fog. In some cases where the episode is super intense, all memories can be lost. This is especially true if substance abuse or other drugs that cause mania are involved.
I have bipolar disorder two. I lived with long lasting hypomanic episodes that completely wrecked my life when I was younger. Even though I had NO insight into what was happening when I was hypomanic, I do clearly remember my behaviors. In my experience, people with hypomania often remember everything.
What does this information mean for people who love someone or want to help someone with bipolar one? I teach a system in my books that we can all use in order to prevent mania, that has to be the first step. But what about those of you who have lived through a massive episode from the outside looking in?
You need answers and you need to be heard by the person who has the illness.
Here is a scrip you can use to talk to someone who doesn’t remember what happened during a massive episode. This is from the perspective of a partner.
Thank you for talking with me about your bipolar disorder. It means so much that you are willing to be open about what happened. I now understand that it’s normal for people in full on manic and especial manic and psychotic episodes to forget what happened. I am learning how bipolar disorder affects your brain. I now need your help. I wasn’t sick when you were in this episode, so I remember everything. I need to process what happened and I need you to hear my side of things. We had two very different experiences. It’s almost a luxury that you can’t remember because believe me, I’m having trouble forgetting what I went through and what our kids went through when you got sick. I would like to share with you what I experienced. I know this might be really hard for you. I know you are embarrassed and unhappy and maybe even scared to hear it, but I believe that talking about it will greatly improve our relationship. We are a team and I need to share what I go through when you get sick.
This is a start. When we focus on our own needs in a non judgmental way, it’s easier for people with bipolar disorder to hear us. As you may know, I had a partner for ten years who has bipolar one. I wrote my book Loving Someone with Bipolar Disorder:Understanding and Helping Your Partner about our experiences. We lived with two people in a relationship with bipolar disorder and communicated extremely well using this technique.
Seeing both sides of a situation- such as understanding that a person who says they don’t remember an episode usually isn’t lying can help you get through the stress of an episode. A person’s brain often goes off line during these mania and psychotic episodes and memory is affected. Teaching those of us with bipolar disorder that you as a person who doesn’t have the illness do remember what happened and do need to talk about it creates an open relationship around this illness.
I am always positive about relationships when a person has bipolar disorder. It is a very treatable illness.
Of course, you may care about someone who will not talk with you about what happened. If you focus on your needs, it gets easier to decide what you want to do for yourself.
To learn more about mania and how it affects the brain, I highly recommend the excellent Bipolar Light videos from my friend and colleague Dr. Jay Carter.
If you want to learn more about the bipolar disorder spectrum, I highly recommend the pioneering work of Dr. James Phelps at http://ift.tt/1pHbrrV.
PS: If you are a person with bipolar disorder who has trouble remembering what happens in an episode, the first step is to prevent these episodes by any means possible. Heck no, this isn’t easy, but it can be done. Next, ask the people in your life to tell their side of the experience. This really helps. I live on both sides as a person with bipolar and a person who had a partner and has family members with bipolar disorder. We need to work together to manage this illness. This is a serious topic, so here’s a picture to make you laugh.
via bpHope – bp Magazine Community
Julie A. Fast