Bipolar Support Groups.com blog

By Dennis Thompson Jr. | Medically reviewed by Lindsey Marcellin, MD, MPH

Researchers argue about why the differences exist, but they agree that men and women are distinct creatures when it comes to emotion. These gender differences can affect emotional health.

Stereotypes of the way men and women are expected to deal with their emotions pervade our culture and society, easily eliciting images of overly reserved men and excitable, emotional women. Boys are told to suck it up; girls are told to let it all out. But do gender differences actually exist between men and women, and if so, how do they affect our emotional health?

The research is mixed regarding the emotional differences between the sexes. Strong evidence has been found that there are differences in the way men and women detect, process, and express emotion. Other studies show that men and women share more emotional similarities than differences.
The stereotypes of reserved men and emotional women are widespread and do affect the way young boys and girls are raised. Some researchers argue that we may be ingraining gender differences that do not naturally exist by accepting and passing on these stereotypes to our children. Other researchers believe these differences have developed due to the evolutionary roles placed on men and women to survive and thrive.

While researchers debate these gender differences, they agree that the differences ultimately can have a negative effect on members of both sexes.

Emotional Women, Emotional Men

Recent research has shown important ways in which men and women react emotionally and perceive emotion in others:

A global study of 55 cultures found that women tend to be more emotional, agreeable, extroverted, and conscientious than men.
Women read other people’s emotional reactions better than men, regardless of whether they receive those emotional cues verbally or visually.
Women reported experiencing love and anger much more intensely than men did in another assessment of gender differences in emotional response. These women also smiled more when recalling memories of happiness or love.
Men and women respond to stress in different ways. Women display greater sadness or anxiety than men, while men show an increase in blood pressure and a tendency toward alcohol craving.
Women are more inclined than men to experience disgust when exposed to stimuli intended to elicit an emotional reaction.

And those are just studies over the past few years. Decades of research have found numerous differences in the ways men and women interpret emotions and react emotionally. Also, studies have found that gender differences matter more than sexual orientation — a heterosexual woman and a homosexual woman have more in common emotionally than a heterosexual woman and a homosexual man.

Why these differences occur is less easily explained:

Some research has found that the differences may be rooted in cultural stereotypes. For example, women are perceived as being more emotional and behave that way because it’s believed that’s what women do, while men express emotion only when the situation warrants it.
Parents may have a hand in promoting these gender differences, expressing disapproval with boys who cry or express other “weak” emotions while shrugging off similar behavior in girls.
Other studies posit an evolutionary cause for these gender differences in emotion. Men serving as hunter-gatherers needed to take more risks and be more dominating, while women who stayed home and cared for young needed to be more nurturing and cautious. These roles have resisted change as human society has progressed, and indeed, progress may cause these roles to become even more pronounced.
How Gender Differences Affect Health

Gender differences in emotional processing and response have direct consequences on the physical and emotional health of men and women. Overly emotional women tend to be at greater risk for depression, anxiety, and other mood disorders, while men who repress their feelings tend to be at greater risk for physical ailments such as high blood pressure, and also tend to indulge in more risky behavior and vices such as smoking or drinking.

Researchers and doctors have several different proposals for dealing with these differences. Some argue that we should accept these gender differences, based on the fact that feminine women and masculine men tend to be happier than those who are gender-atypical. According to this line of reasoning, boys and girls should be allowed to develop both stereotypical and non-stereotypical emotional responses without judging them or trying to shape them.

Others believe that parents can help dull or negate these stereotypes by refusing to reinforce them. For example, fathers who take a more involved role in child-rearing tend to raise children who don’t fall into the stereotypical sex roles of the stoic male or expressive female.

Whether you’re trying to bring up children without gender stereotypes or looking after your own emotional health, be aware of these gender differences and how they affect both men’s and women’s experiences of the world.

Whenever a tragic event like last week’s shooting at UCSB happens, I first pray for the families of the young people killed. I read their biographies and shake my head in disbelief and sadness. And then I let out a heavy sigh, because with each shooting my job, as a person who fights tirelessly against the stigma associated with mental illness, gets harder. How am I supposed to convince a mom with a very anxious daughter to get help for her, because now the mom is even more petrified of pinning any diagnosis on her daughter — let alone keeping an open mind about treatment options. I mean, if I didn’t know anything about psychotropic drugs, I sure as heck would run the other way upon reading the likes of this slanted, irresponsible article published onWorldtruth.tv.:

Nearly every mass shooting incident in the last twenty years, and multiple other instances of suicide and isolated shootings all share one thing in common, and it’s not the weapons used.

The overwhelming evidence suggests the single largest common factor in all of these incidents is that all of the perpetrators were either actively taking powerful psychotropic drugs or had been at some point in the immediate past before they committed their crimes.

That effectively sends the message to all of those parents out there with kids who are struggling(including my own) that once you try to get them the appropriate help, they could very well take a steak knife to school with them and express what’s been building up on their insides.

I do have my issues with our “drugs first” culture — the fact that most physicians are more comfortable writing out a prescription than inquiring about diet. However, I know from my own mental health battle and from witnessing kids struggle with everything from schizophrenia to anxiety, that there is a place for drugs. They can be agents of healing.

With each article like this, the slight improvements we’ve made in stigma busting since the day of the last mass shooting are sadly diminished. Because the association of violence with mental health is again sealed together, an association that is popular but inaccurate.

On Thursday, May 29, I participated in a #HealthTalk Twitter chat co-hosted by Everyday Healthand the National Alliance on Mental Illness (NAMI) – New York City chapter in which we discussed the UCSB shooting and how to dispel the misconceptions regarding mental health and violence. A number of experts weighed in on the topic. The services director of NAMI-NYC shared the statistic that 96 percent of violent acts are perpetrated by individuals without a mental illness. Psychologist Joe Taravella, PhD, said research supports the view that the mentally ill are more often victims than perpetrators of violence, and that substance abuse is a major determinant of violence and is the issue we should be delving into. That’s a point often articulated by Psych Central CEO John Grohol, PsyD, an expert on the topic. In his passionate post, “Myth Busting: Are Violence and Mental Illness Significantly Related?” Grohol lists seven predictive risk factors for serious violence found in recent research that are almost never covered by the media:

• Growing up in an unstable, antisocial household
• Parental history of physical abuse
• Parental history of neglect
• Parental history of both physical abuse and neglect
• Binge drinking
• Stressful life events
• Being male

He concludes:

The upshot from this most recent research confirms what I’ve been harping on now for the past decade — the relationship between mental illness and violence is not a direct one. It is a complex one that is primarily mediated by substance use and abuse. Take away the substance abuse and you have a weak relationship that is likely no more predictive than the person’s age.

I think John says it as well as anyone. Violence is complex. Tragedies like the one at UCSB are incredibly messy. We may want to blame it on the “crazies” taking handfuls of antipsychotics or antidepressants or stimulants, and be done with it. That feels better than displaying all the delicate pieces on the table to study and consider. However, pinning it on the pill poppers is not only inaccurate, but it’s also unfair and unkind. And it makes my job much more difficult.

People with bipolar disorder may become a danger to themselves and to others. Learn how legal guardianship works to protect them.

If you have a loved one with bipolar disorder, there may come a time when the disorder causes him to need your help, even though he may not want it.

“Although anyone over 18 is entitled to make their own health care decisions, if a person with bipolar disorder is a danger to themselves or others, any caregiver interested in the person’s welfare can ask a court to give them legal guardianship,” says Alice B. Taylor, a lawyer in Waltham, Mass., who deals with family law issues.

A legal guardian takes responsibility for the other person’s decisions. For someone with bipolar disorder, this can include decisions about legal matters, medical care, and living arrangements.

When Is Guardianship Necessary?

Bipolar disorder is a lifelong illness that causes extreme shifts in mood, with recurring episodes of mania and depression. Some symptoms of bipolar disorderthat may cause a person to be a danger to himself or others include:

• Extreme risk-taking behavior
• Making impulsive decisions regarding finances, sexual activity, and alcohol or drug use
• Inability to concentrate and make decisions
• Thoughts of suicide

Becoming a Legal Guardian

There are two ways to become a legal guardian. The person with bipolar disorder can ask the court to appoint a legal guardian. This is called a voluntary guardianship. If a caregiver becomes concerned that the loved one with bipolar disorder is in danger, but is not asking for help, the caregiver can also petition a court for involuntary guardianship. The caregiver who is asking the court to grant them guardianship is called the “petitioner,” and the person with bipolar disorder is called the “proposed ward.”

The process for filing a court petition for legal guardianship varies from state to state, but here are some basic steps involved:

• The petitioner must officially notify the proposed ward.
• The petition must be made public.
• The petitioner must present the court with a doctor’s certificate that supports the need for guardianship.
• The petitioner will usually have a lawyer helping him or her.
• The proposed ward has the right to be present and to have a lawyer.
• Witnesses can be called and examined by the judge or by the lawyers.
• After a hearing, the judge may grant temporary, limited, or total guardianship.

Protecting the Rights of the Bipolar Patient

“Courts are reluctant to grant a petition for legal guardianship,” says Taylor. “In recent years changes to legal guardianship laws have swung the pendulum back to protecting the rights of the proposed ward. In the past there was a ‘set it and forget it’ tendency that sometimes led to abuse.”

Some ways that the courts may protect the rights of the person with bipolar disorder include:

• Limiting the powers of the legal guardian
• Requiring frequent oversight of all the decisions made by the legal guardian
• Requiring the judge’s permission before selling property, changing living conditions, or making certain medical decisions
• Allowing the person with bipolar disease to ask the court to end the guardianship
• Protecting civil rights such as the right to vote, to privacy, to marry, and to have children

In an emergency situation the judge may appoint a temporary guardian immediately, but the legal guardianship process usually takes a month or more. Legal guardianship can be the best option in some cases, and most caregivers and courts do have the best interest of the person with bipolar disease as their main concern.

“Becoming a legal guardian is a big responsibility and can be a complicated legal process. One way to avoid the expense and the time is for people to plan ahead and have a valid health proxy and a durable power of attorney already in place. Assigning someone you trust to act as guardian in advance can help you bypass many of these the legal burdens,” advises Taylor.

What you say to your loved one with bipolar disorder can make a difference — either in a positive way or in a harmful one.

If your loved one has been diagnosed with bipolar disorder, you may be in shock and may not know what to say. It’s important to choose your words carefully, because what you communicate can either support your loved one and encourage him to seek treatment or make him feel even worse about himself and his diagnosis, discouraging him from getting the help he needs.

Bipolar Disorder: The Nine Worst Things to Say

You may have been surprised by your loved one’s diagnosis and his behavior may be very frustrating, but no matter what he does (or doesn’t do) and how upset you get, do your best to avoid saying the following:

1. You’re crazy.
2. This is your fault.
3. You’re not trying.
4. Everyone has bad times.
5. You’ll be okay — there’s no need to worry.
6. You’ll never be in a serious romantic relationship.
7. What’s the matter with you?
8. I can’t help you.
9. You don’t have to take your moods out on me — I’m getting so tired of this.

The truth is that bipolar disorder is a genetic medical illness — and it is treatable. Your loved one may cycle between being depressed with very little energy to being hyperactive or “manic.” This is all part of the illness and he can’t help it. It’s important that you be supportive, without nagging him. It will also help you if you know what to expect and how to spot when your loved one is not doing well or has stopped taking his medication.

Not finding someone to love romantically is something your loved one may be concerned about, so be careful not to reinforce that idea, even in frustration, especially since it’s not true. “There are plenty of people with these illnesses that get married. It just means that they have to do their best to get the condition under control,” says Jeffrey Rakofsky, MD, a psychiatrist at the Emory University Bipolar Disorders Clinic in Atlanta.

Bipolar Disorder: The Eight Best Things to Say

What should you say to be supportive and help your loved one to do his best to manage the condition without being too pushy? Some of the best words of encouragement include:

1. This is a medical illness and it is not your fault.
2. I am here. We’ll make it through this together.
3. You and your life are important to me.
4. You’re not alone.
5. Tell me how I can help.
6. I might not know how you feel, but I’m here to support you.
7. Whenever you feel like giving up, tell yourself to hold on for another minute, hour, day — whatever you feel you can do.
8. Your illness doesn’t define who you are. You are still you, with hopes and dreams you can attain.

Kristin Finn, author of Bipolar and Pregnant, a mental health advocate and member of the speaker’s bureau of the Depression and Bipolar Support Alliance, was diagnosed with bipolar disorder 30 years ago and is the mother of a 17-year-old daughter with bipolar disorder. Finn stresses that as important as it is to know what to say, it is also important to know when not to say anything. Finn says when her daughter’s mood changes suddenly, the best thing she can do is give her daughter space and not ask “What’s wrong?” or “Is it something I did?” She adds, “Remember it’s not about you. You’ve got to let the person experience what they are experiencing.”

Finn also recommends suggesting a support group to your loved one or finding books about the condition that may help him realize that he is not alone and that lots of people live with bipolar disorder every day.

Dr. Rakofsky adds another important point to remind your loved one of: “People with bipolar disorder are often very creative [and] talented. We have people like Vincent Van Gogh and other artists and actors out there that speak to that.”

Living with a husband or wife who has bipolar disorder can be difficult. Try these tips for coping with the inevitable mood swings.

If you’re married to someone living with bipolar disorder, you already know it’s a rough ride sometimes. The mood swings can make your days together sometimes exhilarating and other times frustrating. Yet you and your bipolar spouse can beat the dire statistics that predict the end of many of these marital unions.

New Orleans resident “Mary” has been married to her husband for 25 years. Almost halfway through their marriage, he was hospitalized at age 42 and received a diagnosis of bipolar disorder. The diagnosis was not surprising due to a strong family history — but it helped to clarify the situation, says Mary, age 51.

“The diagnosis made it easier, because you know the reason, but it doesn’t change anything. It is a roller coaster. You can have months that are perfectly fine and then all of a sudden it will come from nowhere,” she says.

Mary says she knows the statistics showing higher rates of divorce and abuse in marriages that include one spouse with bipolar disorder. She describes her husband as a “rapid cycler” (“On a day to day basis you never know what it’s going to be,” she explains) and says there are many days and weeks when she is tired, frustrated, and wondering why she is still married. After so many years of marriage and successfully raising a daughter together, she has developed a philosophical and compassionate view of her husband and her relationship.

Coping with Bipolar Spouse Mood Swings

Here are some tips for surviving and thriving in your relationship:

• Breathe. When things are tough, take a deep breath and step back. “It’s a disease — it’s not the person. So you try to remember that,” advises Mary.
• Build support. Caring for someone with a disease can keep you focused on his needs, but you also need your own sources of support. Joining a support group for family members of bipolar patients can help. Working with your own therapist may also be a good idea. Support from understanding family and friends is also invaluable. Mary has never joined a support group — and says she probably could have benefited from one — but she does find support in her friends.
• Get away. Mary says part of what keeps her sane is her job, for which she occasionally travels. Despite the fact that her business trips often coincide with times when her husband stops taking his medications, she values her time away. At home, when her husband’s moods are out of control, Mary acknowledges, “I try to avoid him.”
• Laugh. Whether you can insert humor into the situation and get a good response is highly individual, but Mary says this tactic works for her. “I try to make him laugh, to get him out of it,” she says.
• Enforce meds. Mary has made it clear to her husband that taking his medication is non-negotiable. “If you can keep them on the meds, you’re okay. It’s a fight. It’s like having another child,” she says. If he refuses to take his meds (as he often does when he is manic), she leaves, even if only to spend the night at a friend’s house to make her point. That usually gets him back on track.
• Recall your love. There are hard times in marriage to a bipolar spouse, acknowledges Mary. But she prefers to see the man she fell in love with, even when his moods are unpredictable.
• Know (or grow) your philosophy of marriage. Mary believes in the commitment she made when she married her husband. “You know, I married a man for better or for worse. I did not marry a disease.” While she acknowledges bipolar disorder is difficult, she also notes, “The person I fell in love with is still there. Would I want someone to leave me? I don’t think so,” she explains.
• Look for triggers. “When your spouse is in a stable or more favorable mood, pay close attention to what environmental triggers precipitated and are maintaining the stability. Often there are specific environmental stressors or soothers — including relationship issues — that influence mood swings. Use the soothers to help maintain the mood that both of you are desiring,” advises marriage and family therapist Tracy Todd, PhD, based in Alexandria, Va.
• Ask. Despite the mood swings, your spouse can tell you what he needs. “Have an honest discussion about what is helpful to your spouse when he is in an undesirable mood. Incorporate ideas, plans, and strategies so that there can be a minimization of harmful effects,” advises Todd.
• Keep talking. There may be days and weeks when it is not easy, but communication is essential. “Communication during and between mood swings is critical to managing the accompanying stressors,” says Todd.

Ultimately, Mary’s experience has given her a unique depth of compassion, both forfamily members whose loved ones have bipolar disorder and for people who live with bipolar disorder. “[I’ve said before] that I would hate to be in his head — I can’t even imagine how he feels,” she says.

Suicide is not inevitable for bipolar children, but must be taken seriously. Learning about the risk factors and signs of suicide among bipolar kids can help parents plan a prevention strategy.

No parent wants to think about a child committing suicide, yet suicide is the third-leading cause of death for teens between the ages of 15 and 19. The harsh reality is that bipolar children and teens have a greater risk of suicide and attempted suicide than their peers. Up to 50 percent of these children and teens may attempt suicide. Knowing what signs to look for and how to respond is essential to safely shepherding bipolar kids into adulthood.

The average age of bipolar disorder onset is 18, but symptoms of the disorder can appear much earlier (before the age of 10). These early symptoms, even without an official bipolar disorder diagnosis, are correlated with an increase in substance abuse, risky behaviors, and suicidal thinking.

Knowing the Risk

Understanding your child’s risk for both the disease and extreme symptoms will help you plan to decrease the risk of suicide. Risk for developing bipolar disorder increases if there is a family history of bipolar disorder and depressive disorders, because the disease has a strong genetic component. If you are not sure whether bipolar disorder is in your family, know that a family history of suicide or attempted suicide also puts your child at risk for suicide.

If you or the child’s other birth parent has bipolar disorder, your child has a 50 to 60 percent risk of developing a mood disorder. Unfortunately, a diagnosis of bipolar disorder is linked to a significantly increased risk of suicide or attempted suicide, which is why parents should be concerned about their child’s symptoms.

Factors that increase the risk of suicidal thinking in bipolar kids include:

• Early sexual abuse
• Early parental neglect
• Early onset of bipolar symptoms
• Recent stressful events, such as divorce, loss of a loved one, or the end of a relationship
• Recent release from hospitalization
• Suicide of someone close to them, people in their community, or a celebrity

Signs of Suicidal Thinking or Risk

It would be helpful for parents if bipolar children could turn on a neon sign the moment they start to consider suicide. However, the signs are rarely that obvious. Instead, knowing whether your bipolar child is at risk for suicide may come down to a combination of gut instinct and close observation. Here are some of the signs to watch for (many of which are also signs of depression):

• Withdrawal from friends and family
• Sudden changes in appetite or sleep habits
• Doing worse at school
• Aggression
• Irritability
• Talking about or writing about suicide or death
• Calling himself a bad person or implying you or others will be better off without him
• Hopelessness
• Desperation
• Feeling overwhelmed
• Substance abuse (drugs or alcohol)
• Starting to give away toys or possessions, cleaning up, and organizing as if putting affairs in order
• Mood suddenly improves after a depression

What You Can Do To Prevent Suicide

There are a number of ways you can help your bipolar children prevent suicide and cope better with their disease. Here are some ideas:

• Get a diagnosis. Young people are often diagnosed many years after their symptoms first appear. If you have a family history of bipolar disorder or suicide and your child shows any symptoms — such as cycling moods, periods of irritability or high energy, or depression — the first step to prevent suicide is to get a diagnosis quickly and begin treatment.
• Stay open. Be alert for signs and symptoms and talk to your child about what you see. Some parents are afraid to bring up suicide, but it is actually better to ask directly whether your child is considering suicide.
• Family-focused therapy. Family therapy has been shown to be very helpful for bipolar kids and adults. It has been shown to keep moods stable for longer and also provides education for both the patient and his family about bipolar disorder, mood triggers, and other relevant factors. This type of therapy may also improve conflict within your family and benefit everyone.
• Therapy to address early abuse. If early sexual abuse, parental neglect, or other types of abuse are a part of your child’s history, therapy that emphasizes his current safety from these threats may help keep his moods stable.
• Support medication. Effective treatments exist for depression and unstable moods. Work with your bipolar child and her doctors to find ways that effectively keep her on her medications and maintaining stable moods.

If you are concerned that your bipolar child is about to commit suicide, take these steps:

• Put all potential weapons or tools of suicide (such as pills) out of this reach.
• Do not leave him alone.
• Call his doctor.
• Call 911 in an emergency.
• Call the National Suicide Prevention Hotline (1-800-273-TALK) to talk to a trained counselor.

The reality of suicide is terrifying for any parent, but there are concrete steps you can take to try to prevent this tragedy. Talk to a trained mental health professional for more ideas about how to help your bipolar child.

Bipolar children face certain issues and challenges at school. Find out what accommodations are mandated by law for young bipolar children and bipolar teens in the classroom.

School can be stressful for all children, but for children and teens with bipolar disorder, the stresses of the educational process can be overwhelming. The challenges that bipolar children face on a daily basis contribute to their risk for school failure. Bipolar children may be sleepy from medications, have difficulty concentrating or making transitions, or have other learning disabilities.

Young bipolar children and bipolar teens are protected by two federal laws. First, the Individuals with Disabilities Education Act (IDEA) requires schools to identify students with special needs and provide needed educational service from K–12 until age 22. Next, under Section 504 of the Rehabilitation Act of 1973, schools must make necessary academic adjustments for students with learning impairments. Additionally, individual states have various laws regarding what school systems need to do to fulfill bipolar children’s requirements for educational assistance.

When applying the intent of these laws, schools and parents need to realize that every child is unique. “There are some more common approaches that can be used in an education setting,” says Nanci Schiman, MSW, program director of the Child and Adolescent Bipolar Foundation in Evanston, Ill. “But flexibility and open communication are key in managing the bipolar child.”

Just as each student responds somewhat differently to teaching methods and styles, the same is true for a child with bipolar disorder. Some of the more common accommodations that a school can make include:

• Extending time to take tests
• Reducing homework and allowing flexible due dates
• Providing the student with a place to go to regain composure or take a break
• Allowing unlimited access to water (important for children taking certainmedications) and unrestricted bathroom breaks
• Alerting the child and parents if there will be unexpected changes in a school day’s routine (for example, a substitute teacher, fire drill, field trip, or upcoming test)

Schools need to be proactive in anticipating issues that may arise as a result of unresolved problems that the bipolar child is experiencing. If the child is socially isolated or shy, teachers should take steps to prevent any bullying or teasing from the other students. The school staff can also foster a more positive environment by being patient and ignoring minor negative behaviors while encouraging positive ones. Teachers should also stay calm during difficult situations and be a model of desired behavior.

Disciplining the Bipolar Child

Schools are also governed by laws such as IDEA and Section 504 when it comes to disciplining students with bipolar disorder. “It’s important to look not just at the behavior but at the circumstances behind the behavior, the environment in which the problem occurred, and the events leading up to the undesirable behavior,” says Schiman. “Often, problematic behavior occurs when a child does not have the appropriate tools to cope with a situation.”

For example, a bipolar child may be emotionally immature or have problems with impulsivity, anger, mania, or depression. Other times a child may be trying to save face in front of peers so as not to cry, scream, or act in some socially unacceptable way. The more that the school staff can work to address behavioral problems by looking at the root cause, the better the chance the child will replace these behaviors with more appropriate responses.

How Parents Can Help the Education Process

“Parents need to be advocates for their children,” says Schiman. It is helpful for parents to learn about their child’s disorder, know their child’s educational rights, and communicate regularly with school staff in a non-adversarial way to foster collaboration for what is best for the child. Parents can also help the staff to understand the disorder, what works best for their child, changes in medications, or behavioral strategies that work at home. Schiman adds that open communication is the key.

“Human beings are manipulative by nature, and we manipulate our environment to adapt to ever-changing situations,” says Schiman. “A child with bipolar disorder will manipulate the environment based on what skills they have.” A bipolar child’s intent is not to cause trouble, but rather to cope with a situation that causes him stress or anxiety. By understanding the challenges presented by bipolar disorder, and accommodating the child’s needs as necessary, both parents and teachers can give the child a road map to success at school.