Bipolar Support Groups.com blog

Participating in a faith community could give you a boost when you need it and buffer you against difficulties, even life-threatening ones.

A strong commitment to spirituality may help people withbipolar disorder cope and build a foundation of greater self-worth.

“Religion can be supportive [by providing] social support and resources and the internal means of being able to cope with the impact of the illness on their lives,” says psychiatrist Mario Cruz, MD, associate professor of psychiatry at the University of New Mexico School of Medicine in Albuquerque.

While excessive religious behavior was once seen as a symptom of psychosis, Dr. Cruz says, there’s little evidence to support this. Rather, his research, which involves interviewing people who have bipolar disorder, suggests that people who are bipolar often use religious activities, especially prayer and meditation, as ways to cope with distress.

A study of 168 people with bipolar disorder published in 2013 in Bipolar Disorders found that those who report the ability to cope through spirituality, such as feeling a spiritual connection with others and believing in a fundamentally benevolent world, have a higher quality of life and less depression.

Benefits of Faith and Spirituality

Cruz says his research also shows that when depressive symptoms become severe, religious participation drops off.

The benefits of religious participation for people with bipolar disorder, Cruz says, can include:

• A supportive network of friends and acquaintances
• Financial and other types of practical support
• Uplifting messages and activities that may help regulate emotions and provide a source of hope
• Scriptural messages that interpret the challenges of bipolar disorder as a way to grow closer to God or to grow spiritually
• Reinforcement of the messages of many substance-abuse programs, especially 12-step programs

In a study published in 2014 in The Gerontologist, researchers looked at mood and faith participation in more than 7,000 adults and found that those who were active in their faith communities or prayed often had less risk for depression over a two-year period. Another study, published in 2013 in the Journal of Religion & Health,reviewed existing research and found that faith participation is particularly beneficial for people with depression (but found no benefit or harm for people with bipolar disorder).

Further, belonging to a religion that has a moral objection to suicide may be protective against acting on suicidal feelings. Psychiatrist Maria Oquendo, MD, a professor of clinical psychiatry at Columbia University Medical Center in New York City and co-author of several papers exploring the relationship between religiosity and suicide risk, published the results of a literature review in the July 2015 issue of the Archives of Suicide Research that found a possible protective effect of religion against suicide attempts, though religious participation did not protect against thinking about suicide.

RELATED: 6 Ways Spirituality Can Make You Healthier

The relationship between religiosity and mood is mixed, however. If you are conflicted about your faith or have conflict in your faith community, that can negatively affect your mood, Dr. Oquendo says.

“If you’re really struggling to understand how your core beliefs can be reconciled with broader faith-based beliefs, that can contribute to anxiety,” says psychiatristHolly Swartz, MD, a professor of psychiatry at the University of Pittsburgh in Pennsylvania. She recommends making an effort to address those conflicts to find some resolution.

Finding Hope and Meaning in the World: Julie’s Story 

Julie Fast, author of Loving Someone With Bipolar Disorder, says she had her first psychotic episode when she was 19. She had a vision of herself walking into traffic, being hit by a car and thrown, dead, at her own feet. Despite her hallucinations, periods of paranoia, and the severe effect of bipolar disorder on her daily life, Fast learned she had bipolar disorder only at age 31.

Now 51, Fast describes herself as someone who was raised Christian, although she is not a practicing Christian today, and as someone who has a profound, connected feeling of the metaphysical depth of life. At her lowest point with depression, she says, she lost contact with that deeper positive spiritual meaning that had always been a support to her.

RELATED: How Prayer Strengthens Your Emotional Health

Fast says one strategy that helps her, and which she recommends, is to understand that bipolar disorder is like an added layer on top of a person’s identity. She says that if you know what your baseline beliefs and temperament are, it’s easier to know when bipolar disorder is affecting you. For her, knowing that she was losing her belief in the world as a positive place, which was her baseline belief, became a rally for change. She began to do the hard work of pulling out of severe depression and can now say that her strong foundation has returned.

“Maybe religion is not put on this Earth to stop suffering; maybe it’s to help you get through suffering,” Fast says. Dr. Swartz agrees that being part of a faith community and having a strong religious belief can buffer people with bipolar disorder against difficulty.

New mothers with bipolar disorder are more likely to have PPD, and bipolar disorder may be more likely to be misdiagnosed as PPD after giving birth.

About one in 10 new mothers experiences a serious mood disorder known aspostpartum depression, with such strong feelings of despair, anxiety, and sadness that they can’t cope with daily life.

These feelings are very similar to those experienced by women with bipolar disorder, so much so that much research has gone into possible links between the two conditions.

Bipolar disorder, also known as manic depression, involves extreme swings in mood, energy levels, and activity. People riding a manic high might be highly energetic and outgoing and productive, and then might slip into a depressive funk in which they are lethargic and withdrawn.

Some studies have found that women with bipolar disorder may be more likely to have postpartum depression, or PPD. Other studies have found that bipolar disorder may be misdiagnosed as PPD, which can lead to inappropriate treatment of mood symptoms.

How Childbirth Can Affect Bipolar Disorder

New mothers are expected to have shifts in mood. There’s the joy of finally holding their baby in their arms and the happiness of having family around them as they begin their new lives. But many experience the opposite: As many as 70 percent of new mothers experience the “baby blues” after childbirth. Within the first few days after the baby arrives, they may become angry for little reason, cry without warning, feel self-doubt, and have difficulty eating or sleeping. But these feelings usually resolve on their own, in a matter of days.

However, new mothers who have previously dealt with bipolar disorder are more likely to suffer a mood swing far more deep and devastating than simple “baby blues.” Studies have found that women with bipolar disorder are more likely to have postpartum depression than either healthy women or women with majordepression. The research indicates that anywhere from half to two-thirds of women with bipolar I or II disorder may face severe depression in the months after delivery.

Pregnancy itself has been historically considered to be a positive experience for women with bipolar disorder. Studies have found that pregnant bipolar patients have a reduced risk of psychiatric admission and suicide. But after delivery, bipolar women in the postpartum period become even more vulnerable to a recurrence of their mood disorder.

Mistaking Bipolar Disorder for PPD

Many women with bipolar disorder have not been diagnosed with the mood disorder, and researchers have found that when they show bipolar symptoms following delivery they are often misdiagnosed with postpartum depression. For example, a study of 56 women who had been diagnosed with postpartum depression found that 54 percent actually had bipolar disorder their whole lives.

Researchers have speculated this may be due to doctors missing the “manic” part of bipolar disorder. Some of the normal symptoms of mania or hypomania — diminished sleep, feelings of elation, and increased activity — tend to be experienced by many new mothers following childbirth. Women may fail to report these manic moods, and doctors may not pick up on them. When doctors miss the manic symptoms, but spot patients’ depressive lows, they are likely to diagnose the condition as postpartum depression and prescribe treatment accordingly.

Misdiagnosis of bipolar disorder as postpartum depression can have terrible consequences. Inappropriate prescribing of antidepressants could serve to fuel the new mother’s bipolar disorder, increasing her risk of requiring psychiatric hospitalization. As a result, some researchers have recommended that women be screened for bipolar disorder early in their pregnancy. That will set an emotional baseline against which their postpartum mood swings can be measured.

Whether they’re trained to help with specific issues or are just lovable family members, pets and service animals can ease bipolar symptoms and help patients feel better.

People struggling with bipolar disorder might be able to find four-legged solace from their depressed lows and manic highs through service animals and even regular pets.

Pet therapy, also known as animal-assisted therapy, is often recommended for people with bipolar disorder or other mood disorders. Service animals, such as psychiatric service dogs, provide companionship and are trained to work with a specific patient to help that person deal with his disabilities, including specific bipolar symptoms.

However, you don’t need a specially trained animal to get psychological benefits from having an animal nearby. Recent studies have shown that simply owning a petcan help someone who is recovering from a serious mental illness.

Bucky: A Special Service Dog

Donna Dykstra, 54, of Seattle, owns a service animal, a 10-year-old Shetland sheepdog named Bucky. Bucky has been trained to help Dykstra deal with problems related to her health and her bipolar disorder.

During severe manic mood swings, Dykstra sometimes hallucinates. Bucky helps her sort out what’s real and what is not. “Seeing and hearing unusual things was really scary sometimes,” Dykstra recalls. “I used to see dead people — people around me would [appear to be] dead. Then I would start seeing dead bodies lying around. [Bucky] is trained to alert to anything that is unusual around him. If there really was a dead person lying on the sidewalk, he would be responding to it.” Once Dykstra is reassured by Bucky that what she is seeing isn’t really there, she is able to perform stress-reduction techniques to calm herself down.

Bucky also is trained to help Dykstra deal with the social withdrawal that can result from a depressive episode. “When I am feeling particularly depressed, I want to withdraw and interact with absolutely nobody,” she says. “Part of my self-care and wellness plan is taking Bucky for walks in a very busy park. I have no choice then because he will interact with other people and draw me out. Little kids come up and say, ‘Can I pet the baby Lassie?'”

Bucky also helps Dykstra deal with another problem she has, a partial seizure disorder. Earthquakes sometimes happen in Seattle, but Dykstra can’t always trust her senses. “I experience earthquakes that aren’t really happening,” she says. “Bucky alerts to earthquakes. So if I feel an earthquake, I look at him. If he’s alerting, then it’s really an earthquake. If he’s relaxed, then it’s a seizure.”

Other Benefits of Pet Ownership

Having a service animal specially trained to deal with your symptoms can be a huge help. However, Fido the mutt or Zsa Zsa the rescued cat also can help soothebipolar symptoms. Doctors have found that pets are of tremendous benefit for people recovering from serious mental illness:

• Pets provide a sense of being known and understood, with a sense of unconditional love that can restore a person’s empathy.
• Pets enable bipolar patients to feel more connected with the world — they may feel a connection with the pet or, like Dykstra, find that the pet forces them to connect with other people.
• Pets create a comforting sense of family for the person with bipolar disorder.

And they can help build your sense of self-worth and confidence. You might feel more in control of your life because you are taking good care of your dog or cat. Pets also can provide a sense of purpose to a patient in particularly bad shape. “I couldn’t commit suicide, back when that was an issue, because I had to take care of my dog,” Dykstra says.

Paranoia — a belief that people are following you or talking about you — is a symptom of psychosis in bipolar disorder that can be managed medically and with other strategies.

One of the symptoms of psychosis in bipolar disorder is paranoia, a belief that the world is full of people who are “out to get you.” Though many of us tend to use the term loosely in everyday conversation, paranoia is a serious condition for people with bipolar disorder.

The beliefs that come from paranoia are referred to as “persecutory delusions” — that is, beliefs that other people are talking about you, plotting against you, following you, or in some other way literally persecuting you.

Paranoia is not inevitable for people with bipolar disorder. Many people with bipolar disorder experience a wide range of mood swings and other disruptions in their life, but never experience the severe highs or lows that can lead to psychosis and paranoia.

Paranoia is unlikely to be the only symptom affecting a person with psychosis and bipolar disorder. Other symptoms of bipolar psychosis may include:

• Disrupted, disorganized, or hard-to-understand speech or thought patterns
• Hallucinations
• Unrealistic beliefs
• Difficulty managing daily activities
• Difficulty knowing what is real and what is not

As with many bipolar symptoms, the mechanism behind paranoia is not easily understood. There is some evidence that interrupted sleep — especially insomniaor a prolonged period of getting less sleep than normal — can trigger paranoia. Interrupted sleep is a hallmark of bipolar disorder, particularly when people enter the manic phase and sleep less than usual or not at all.

Managing Paranoia in Bipolar Disorder

“Antipsychotic medications can be useful in reducing paranoia,” says psychiatrist Michael Peterson, MD, PhD, an assistant professor in the department of psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison. Antipsychotic medications can be used temporarily or may be used over a long period to stabilize thoughts and emotions.

With true psychosis, patients may not be able to question whether their paranoid beliefs are real. Often, their paranoid beliefs are unshakable. In these cases, medical management may be the only way to reduce the strength of these beliefs.

However, according to Dr. Peterson, there are many people whose paranoia is not as fixed. “When people have some insight into these fears and thoughts, cognitive approaches can be useful, too,” he says.

In these situations, options for management include:

• Therapy. Going to therapy and learning how to work with paranoid thoughts may help lessen the paranoia. “An example of this might be rationalizing why the fears may not be real or ways of testing how real these might be,” Peterson explains. Look for a professional trained in cognitive-behavioral therapy or who specializes in working with people with bipolar disorder.
• Social support. “Reviewing these fears with a loved one or trusted friend, in addition to health care providers, can also be useful,” says Peterson. Trust is the key, of course. Paranoia has the unfortunate side effect of eroding even the closest relationships if it is not controlled.
• Support groups. Look for a suitable support group through a local community mental health center, National Alliance on Mental Illnesschapter, or another dedicated bipolar or schizophrenia support group. Remember that it is okay to try out a few support groups until you find one that you are comfortable with.

Paranoia is a distinctly unpleasant experience for people with bipolar disorder. However, it can be controlled, managed, and reduced so that it has less impact on your daily life.

Even trained professionals may find it difficult to distinguish between these two conditions, since the differences are subtle.

Delusions of grandeur, a heightened sense of your own abilities or accomplishments, unrealistic fantasies of power or success: If you are plagued by these beliefs or if you recognize them in a loved one, you may wonder whether you are facing the manic phase of bipolar disorder, narcissistic personality disorder, or something else. Even trained professionals have a hard time distinguishing between some mental illnesses and personality disorders, based on these symptoms alone.

Determining which condition or conditions you are facing is key to getting the right treatment. With bipolar disorder in particular, pay attention not just to the symptoms but their pattern.

“One distinguishing feature is the timing,” says psychiatrist Michael Peterson, MD, PhD, an assistant professor in the department of psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison. “Personality disorders are pervasive patterns of relating to others and situations that are long-standing. In bipolar, manic or depressed periods typically last weeks to months, but are not always present.”

Meanwhile, several of the symptoms of bipolar disorder can overlap with other conditions and lifestyle choices — leading to confusion. “Many of the core symptoms of bipolar can be confused with normal variability in mood, changes associated with personality disorders — including narcissistic or borderline personality disorder — or changes associated with alcohol or drug use,” says Dr. Peterson.

A little bit of detective work may be required before a final diagnosis can be made.

Bipolar Disorder Symptoms

Bipolar disorder is characterized by dramatic, intense shifts in mood. When in a down cycle, withdrawal, sadness, and despair are hallmarks of the depression many bipolar people face. On an upswing, extroversion, high energy, and intense joy may accompany what is called the manic period. Different people cycle at different rates — some moods can last weeks or months, others just a few days. At times, symptoms and mood shifts may be so severe that the individual cannot carry out normal daily activities or relationships. Most people with bipolar disorder experience more depression than mania, says Peterson, but all eventually experience both. Symptoms of a depressive period include:

• Loss of interest in activities that were once enjoyed
• Long periods of worry, sadness, or emptiness
• Tiredness or fatigue
• Difficulty concentrating or focusing
• Changes in appetite or sleep
• Restlessness
• Irritability
• Suicidal thoughts, plans, or attempts

Symptoms of a manic period include:

• Feeling jumpy or wired
• Extreme irritability
• Long period of feeling very energetic, outgoing, and upbeat
• Racing thoughts
• Talking very fast
• Not needing much (or a normal amount) of sleep
• Excessive/irrational confidence in one’s own abilities
• Poor impulse control (which may lead to overindulgence in sex, shopping, investments, and other high risk decisions.)

Narcissistic Personality Disorder Symptoms

The hallmark of narcissistic personality disorder is an apparent absorption with yourself (narcissism). Because this is a personality disorder, the symptoms are always present to some degree.

Symptoms include:

• Love of self/great self-interest
• Preoccupation with success and power
• Attention seeking
• Boasting or bragging about one’s own achievements often
• Exaggeration of abilities and achievements
• Having unrealistic goals
• Fantasies of success beyond what is likely or possible
• Hypersensitivity to possible slights and insults from others (coupled with what could be an aggressive or angry response)
• Arrogant behavior
• Belief in one’s own uniqueness/entitlement to special treatment
• Difficulty understanding another’s emotions or perspective

“These symptoms could easily be confused with similar patterns that can emerge during manic phases of bipolar disorder,” explains Peterson.

Paying close attention to symptoms and the patterns that emerge over time may help distinguish between narcissistic personality disorder and bipolar disorder.

Memory loss caused by bipolar disorder is a common complaint among bipolar patients. Here’s some advice for coping with this frustrating bipolar symptom.

People with bipolar disorder often report problems with memory and cognition. They have trouble with short- and long-term memory, think things through at subdued speeds, and have difficulty thinking outside that so-called box.

These memory problems can pose considerable challenges for bipolar patients. One recent study presented the case of a 48-year-old computer programmer who had severe memory problems as one of his bipolar symptoms. His job was at stake because he had difficulty mentally accessing information memorized prior to the onset of his bipolar disorder. He told doctors that he was sure he knew the information, but couldn’t figure out how to get to it. He would eventually remember the information, but it could take hours before it would come to him.

Memory Loss and Bipolar Disorder

Memory problems in bipolar disorder typically have been considered a side effect of the manic highs and depressive lows of the condition:

• Mania. Some studies have shown that memory and cognition problems are at their worst during manic episodes. Patients operating at high speeds due to mania have a hard time encoding new information into their memories and also show difficulty accessing memories.
• Depression. Other research has revealed that depressive phases also can create problems with memory. “When your mind is preoccupied with negative thoughts about yourself, your world, your future, you aren’t as able to concentrate and [be] in the moment,” says Michael Thase, MD, professor of psychiatry at the University of Pennsylvania Medical Center in Philadelphia. “If your mind is occupied at one level, there’s less capacity to pay attention and encode and store information.”

More recent research has found that bipolar patients who are between mood swings also have memory problems and other cognitive deficits. That has lead some doctors to question whether mood swings are the real reason patients endure memory loss issues. Other possible explanations include:

• Differences in brain chemistry and function related to bipolar disorder. “It may be that depression causes memory troubles both in a mental way — by occupying your mind — and also in a neurobiological way by inhibiting the connectivity between nerve cells,” Dr. Thase says.
• Side effects of medications prescribed for bipolar symptoms. “You also can have memory problems with several of the more commonly prescribed medications, lithium being the most notorious,” Thase says.

Coping With Memory Loss

On a practical level, bipolar patients with memory problems can help themselves remember using some simple methods:

• Carry a pocket notebook with you and jot down things you want to remember.
• If you have a smartphone, use it to make to-do lists and take notes.
• Repeat things you need to remember several times in your mind; this gives your brain a better chance to properly encode the information.

Bipolar patients dealing with memory loss should discuss the medications they are taking with their doctor, Thase says, to see if lithium or another bipolar medication is the culprit. “If it’s a side effect [of] one of your medications, you might want to try lowering the dose or substituting that medication,” he says.

However, people on bipolar medication should take such steps with a degree of caution and always under their doctor’s supervision. “You don’t want to trade better memory for worse illness,” Thase says.