What is...Bipolar Dissociation?

[@karenmatuska3812]

Thanks again for another helpful video. As a therapist I am getting so much out of this series and it matches with what I am seeing in my clinical practice (especially the DP/DR and PTSD with dissociation combined with bipolar). I am also getting so much out of reading the comments. This is a great community!

[@thectadclinic]

Thank you, Karen. It truly is a wonderful group here! It is really important knowing that therapists are finding the videos helpful.

[@ILoveFountainPensCdn]

Thank you for educating yourself as a therapist! I’m sure that your clients benefit from It greatly!

[@emmalyckajacobsson590]

Thank you! I have discussed this with my therapist about the difference; I am not bipolar, but have alters that have/had very different temperament and energy.

[@BaraNoUta17]

Thank you for sharing info on this important, and often overlooked, topic. We were misdiagnosed with bipolar disorder for a period of time in our late teens. We happened to be starting medication right around the time we left home for college, so it appeared to work... but "mysteriously" it would stop working whenever we visited home, at which point we would start having a lot of depressive symptoms again. We eventually were able to try going without the med, and when we noticed we didn't feel any different being off it than we had on, concluded the bipolar was a misdiagnosis... but that was confusing, because it had felt so accurate at the time. After our DID diagnosis, it suddenly ended up making a whole lot more sense. Without getting into all the details of our specific situation, it turns out two alters were co-hosting at the time, one who tends more toward "hypoarousal" (low energy, like a collapse response) and the other who tends more toward "hyperarousal" (high energy, with a lot of restlessness -- and in our case this was exacerbated by our ADHD -- and having a hard time relaxing; she has a strong flight response). The latter was able to help us get caught back up with things we'd get behind on, and to dissociate from a lot of the emotional pain so things felt more bearable again, but her energy level wasn't very sustainable... so after a couple of weeks she'd need a break from fronting. It's not hard to imagine then how bipolar could get misdiagnosed for us. (I'm sure that there are people who truly do have both though and need both to be treated. Just that -for us personally- it was a misdiagnosis.)

[@indigo.and.dissociation]

Thank you so much for this! It has been validating to hear that bipolar disorder can be comorbid with dissociation (I have at times felt like I was just making it up) - as a DID system who also experiences bipolar disorder! It is also interesting how (for us at least) the two seem to interact in that the mood shifts of the bipolar can seem to activate parts within the DID 🤯 but then also how manic episodes particularly can trigger, again for us, significant derealisation. Unfortunately, it is hard enough for services to get their head around the fact we are a system, nevermind one who has significant mood shifts as well!! Thanks again for the video 🫶🏻✨🌸

[@siobhanoconnell9444]

We are a System with bipolar 1 as well!

[@thectadclinic]

You are very welcome!

[@Sophie-ur2qb]

Thank you for this! I was diagnosed with bipolar over 10 years ago. But dissociation was never looked at. Although I remember telling the doctors times my mind would cut out and i would "go somewhere else". And times where I felt like I was coming out of my body. It was very scary. I didn't have the right words to name it at the time. Also I felt so embarrassed. I didn't know what was happening. I thought I was crazy.

[@thectadclinic]

Thank you, I suspect this is a very common experience of services.

[@becgarnett5861]

As a trauma therapist, I have always seen a link, thanks for the information

[@xariasys]

I recommended your channel to my therapist. With July 4th and summer vacations, we missed times we would normally have sessions. We met back up this week; it was obvious she's been watching your videos. We are so excited by this new direction! Thank you for your videos and the variety! I will be sharing this one with a friend with bipolar that shows a lot of dissociative signs. Again, thank you for your videos!

[@ayeayesailor]

Can you do a video on how age regression vs child parts/alters can show up in the therapy room- how can clinicians spot the difference?

[@lauraholladay]

great job with the editing flair. Your videos are very helpful, thanks!

[@Jennifer-oq4zj]

Thank you for another amazing video. I don’t have BP but it was one of the many things I was treated for before my diagnosis of DID Look forward to the next video 😊

[@siobhanoconnell9444]

We have Bipolar 1 with Psychotic features, C-ptsd and DID. Our bipolar is managed with an antipsychotic (Geodon ziprasidone) and Cogentin (benzotropine, Parkinson medication anti-cholinergic) for the nastY side effects such as twitching Extrapyramidal symptoms. We also finally found a local therapist who takes our insurance so hopefully we can start processing traumas and other stuff such as our anxiety. We have been on almost every antipsychotic and have had horrid side effects from them, risperdal causes weight gain, ability caused oculogyric crises and akinesthia (sp?)...we think the horrible twitching may be permanent or at least being on the Cogenin to manage it will be long term.

[@thectadclinic]

The meds can be truly difficult to live with, and many drop out, becoming worse. I hope you are ok.

[@siobhanoconnell9444]

@thectadclinic we don't have any side effects right now from the Geodon but there's a good chance the EPS are permanent from when we were on Abilify. We are just grateful that the oculogyric crises are gone. Being blind without being blind was terrifying. The Cogentin (benzotropine) has made a world of difference. No more dystonia, Tourettes-ish muscle twitching and no more oculogyric crises amongst other ones. Being a "middle" is really tough. I'm the host and stopped physically growing by age 10 but stopped mentally aging at age 13. Most of the alters in our system are around 15 - 17 years old. We are supposed to be 32 yrs old. We are technically a midget, we are 4 foot 7 inches tall, not a Little Person because it's not dwarfism. It's from an endocrine disorder called Albright's Hereditary Osteodystrophy. Employers tend to think I am really weird. We do have college degrees...it's very upsetting to think we may always be on Social Security because we are not employable despite being really smart and knowing alot about history and psychology. Our state (New Jersey) is a Therapy Desert especially with very few therapists who are willing to work with DID and C-PTSD.

[@thetrashcansystem]

This makes more sense, as with us, we have such a hard time with distinguishing sense of self. always a lot of emotions being felt, a lot of thoughts being thought.. sometimes we don't realize why we're feeling some type of overwhelmed. either in thoughts or emotions. other videos on this channel have helped this but taking into account that sometime in junior high, they said we had manic depression. if this is bipolar disorder now, then it makes sense that the last few years i'd been looking into bipolar disorder for myself. I suppose I was afraid that if anything else were a fit that it would mean all of us weren't real. but since then I'd learned that the comorbidity is actually relatively high for this. It's a comfort to know that both can exist.

[@thectadclinic]

It’s a sad thing to have going on, but glad that some comfort can be found!

[@zioah4560]

What excuse do services still have in this day and age to not be educated on or aware of dissociation? It’s these services that can result in great harm and further trauma due to missing really important things. Good on you for offering some suggestions for health services and clinicians near the end of vid.

[@Cathy-xi8cb]

Physical medicine has the same problems with rare disorders as psychiatry. I know someone with a rare genetic disorder (vEDS) who was sent home from the ED bleeding internally. They missed the cause of her back pain. She had a vertebral artery bleed.

[@thectadclinic]

No excuse, realistically. Training is available, and some teams will get this in. When I have provided NHS training, rooms are often packed and double booked, so the interest and willingness to learn is there in clinician. We have also seen entire management levels be dismissive of dissociation, which is really sad, or they say they know about it then muck it up.

[@Karangela]

I am really glad to hear about this! I experienced DDNOS with people that did things for me while I watched from a chair behind my eyes. Later I was diagnosed with bipolar disorder. My bipolar was long episodes of depression with the desire to be dead all the time along with periods of weak hypomania. Recently, I have discovered I am Autistic as well. I found your comments very interesting. I will be following your videos.

[@becgarnett5861]

As a trauma therapist I find neurodiverse people are more susceptible to structural Dissociation. We are more easily traumatised and have more difficulty fluidly moving between self states

[@_Myriad_]

Really thoroughly explained, thankyou! And i appreciate the candor that theres only so much research available now, im glad your recommendations might lead to more studies in the future from people who know what theyre talking about! The better we learn the better we can provide care and this is a great step to start with

[@ichi_san]

thanks for this, bipolar disorder is so stigmatised so it's nice watching a more neutral review of it

[@claudiaburger4671]

Thank you!! I have a question regarding DID and OSDD. It is known that these conditions can include 'hearing voices'. can you explain the difference between dissociative voices and psychotic ones? I was misdiagnosed for years, now OSDD.

[@shellsnott]

First I would like to say thank you - your vid's help people across the world who would otherwise have no access to help. Could you possibly link bipolar, dissociation and CPTSD, it is difficult to figure out between the three what is what. I have always maintained that most mental health disorders are caused by childhood trauma, and it seems as the decades pass by new information keeps pointing towards this. To the other people watching, I wish you healing and peace.

[@mikaMKP]

We’ve heard a few times that there could be a similar link between childhood trauma and borderline personality “disorder” presenting with dissociative symptoms. Oh my…

[@alittlespacetime]

Thank you for sharing this! ❤

[@thectadclinic]

You are so welcome!

[@desiraangelle9844]

Great stuff

[@Sophie-ur2qb]

A traumatic memory came back to me recently. I don't feel like me anymore. I don't want to relive it. I don't want to remember any more. I'm so confused. I feel like im going crazy.

[@gwenstacy3033]

I'm so sorry you have to go through that. Don't be afraid to take time for yourself to scream into a pillow, cry, chuck ice at a brick wall, etc. Look into pendulation for trauma - there are some good videos about it here on KZbin. As someone who has been there, you'll make it through, even though it feels like hell right now. Sending love and support ❤

[@Sophie-ur2qb]

@@gwenstacy3033 Thank you so much 🩷 I screenshot your comment so I don't forget it. Thank you for all the tips 🙏 I need all the help I can get right now. I appreciate you so much! Sending love your way ❤️

[@davidrada241]

Will you please discuss BPD and dissociation next?

[@thectadclinic]

@@davidrada241 it’s on the list!

[@davidrada241]

@thectadclinic I know it's on the list, however, I was asking about Borderline Personality Disorder and are the conundrums in treatment similar.

[@thectadclinic]

@@davidrada241 yes, I took BPD to be Borderline PD!

[@Cathy-xi8cb]

@@davidrada241 Janina Fisher writes extensively about BPD and dissociation. The differences in treatment are often better reality testing in DID versus BPD, fewer episodes of testing the therapist, and less drama overall in treatment and in daily life. Relationships in and out of therapy are more stable in DID, and so are daily routines of work and self-care.

[@arayasununkingpet8496]

In my opinion, all mental health conditions can be in a higher risk of experiencing childhood trauma and childhood adversity to a person and that might lead to DID symptoms where, statistical link shows the vice versa.

[@ZadenZane]

You missed out schizoaffective disorder at the beginning. A lot of the experts think of that as a severe mood disorder, even though it's not officially categorised as such.

[@thectadclinic]

@@ZadenZane schizoaffective is a completely different disorder that I may add into the series on its own.

[@lambchoppyboy]

Thank you. I have DID and my daughter has bipolar 2. Is it possible that my trauma was inadvertently the cause of her bipolar? Sort of inherent? She was raised under my undiagnosed DID and dysfunctional coping. I never was abusive to her and in fact cherished and protected her from my abuser, my mother.

[@2biicoachingformndkarlotto317]

Thanks for another great video :D When I compassionately investigate my inner part (IFS) I have a bit of both, and isn't a disorder the same as a coping mechanism? When I read Peter Walker's book From Surviving to Thriving these two are found in the FLIGHT (bipolar) and FREEZE (dissociation) area of the four F´s. Fight, Flight, Freeze, and Fawn. What do you think??

[@thectadclinic]

I will vary, I have seen many bipolar patients who were simply ill, no coping strategy involved, for whom only medication would help.

[@2biicoachingformndkarlotto317]

​@@thectadclinic then it's not "real" bipolar, but a coopingmekanism. Thanks for reply, have a nice day.

[@jcwebb264]

I'm commenting here bc I have a question & don't want to leave it on a video from 6 years ago 😅 - I don't really understand the concept of dormancy. Like alters or dissociation or symptoms themselves are dormant. But if that's the case, isn't that kind of not having the disorder, if it isn't interfering with daily life?

[@nin9249]

Can you develop this disorder as a result of trauma ? If its been repressed for someones whole life? This sounds like trauma symptoms

[@michellebogenschutz9544]

A bit off topic, but can you at some point discuss when/why a therapist would drop a DID patient?

[@thectadclinic]

It would have to be narrowed down, there could be a million reasons!

[@EssleyGomezBHT]

❤❤❤

[@kevinbissinger]

Just FYI if you're autistic you're probably not bipolar. We feel everything 100% and that looks like bipolar but it's not a personality disorder, it's just how we perceive the world.

[@itisdevonly]

You can be both, and in fact the two are genetically correlated, so it's not uncommon to be both. Yes, sometimes autism gets misdiagnosed as bipolar, but that doesn't mean the two have no connection. I'm fairly certain I'm both autistic and bipolar. I do have innate emotional intensity, but that is different from (hypo)manic and depressive episodes, both of which I have definitely had. The bipolar mood swings have a distinct feel to them that is quite different from ordinary emotional shifts,. There's a sort of fervor and dis-inhibition that comes with mania that you don't really experience otherwise, even if you're excited and energized. There's a sort of disconnect from reality that goes with it. If you've heard the term "maniacal laughter," well that pretty much hits the nail on the head in terms of how mania presents differently from enthusiasm.

[@thectadclinic]

@@itisdevonlyI agree with this, the way emotions are experienced in bipolar have much longer duration, so can well be had alongside autism. Think a mood shift that seems unreactive and lasts for weeks, with a change in character ‘tone’ being highly recognisable.

[@kevinbissinger]

There is a reason I used the word probably. The likelihood of being originally misdiagnosed prior to coming to autism, especially for women, is significantly higher than the likelihood of having both. You also both probably know full well how many bipolar drugs make non-bipolar autistic people worse, often to suicide. Thus the FYI.

[@itisdevonly]

@@kevinbissinger I suppose it's an issue of semantics and subtext. I'm not saying you implied it was impossible to have both, but the apparent implication around probability that you made seems off. Due to the prior probability of bipolar disorder being low, then technically, yes, whether you are autistic or not, you are probably not bipolar. So on a strictly logical level, "if you're autistic, you're probably not bipolar" is technically true, since fewer than half of autistic people are bipolar. If you just take a random autistic person, they are probably not bipolar. However, they probably also have not been diagnosed as bipolar. The subtext of the phrasing suggests that either autism *lowers* your probability of being bipolar compared to if you are non-autistic, or that if you are autistic and diagnosed bipolar, then that is likely to be a misdiagnosis. Since the two are correlated, and autistic people are (slightly) more likely than non-autistic people to be bipolar, the implication that being autistic reduces the likelihood being bipolar is the opposite of what's true. If you are autistic *and* have a diagnosis of bipolar (irrespective of whether you have an autism diagnosis), you probably *are* bipolar. Although there are false positives, the rate of false positive identification of bipolar in autistic people likely less than 50%. I agree that it's worth pointing out that this is a common misdiagnosis in autistic people, but it being so commonly misdiagnosed as to have more false positives than true positives among autistic individuals is unlikely. Unless you can point to some scientific paper indicating this problem is so rampant as to invalidate the majority of bipolar diagnoses in autistic people? I have not seen any such evidence. I've only encountered some anecdotes on social media of autistic people being misdiagnosed as bipolar and inappropriately medicated. This belief that false positives are rampant among autistics is due to an availability heuristic bias. People who have been wrongly diagnosed are quite vocal about it, so you see that a lot on social media, and that makes it seem more common than it actually is. However, autistic people who have been *correctly* diagnosed as bipolar (as well as those who were not bipolar and never suspected to be nor diagnosed as bipolar) are unlikely to have a reason to speak up about it on social media. Especially as bipolar disorder has a stigma attached to it. Same deal with BPD. Lots of autistic people are misdiagnosed with BPD. But lots of them also have BPD in addition to being autistic, since that stems from a combination attachment trauma and genetic predisposition, and autistic people are especially prone to attachment trauma for a variety of reasons. Sometimes comorbid diagnoses aren't misdiagnoses, it's just that autism is a missed diagnosis. In my case, my autism wasn't caught until my 30's. But actually, most of my diagnoses were not caught until then (likely because of my autism). I have had to identify them all myself before anyone else could identify them in me, because I find it difficult to explain my experiences to mental health professionals, and I struggle to understand the questions in screening questionnaires and to accurately remember and report my symptoms (due to dissociation). The only thing the professionals caught (until I put them on the trail) was "unspecified anxiety disorder" with a note about it being rooted in adverse childhood experiences (which really should have pointed them towards trauma, but they did not screen for trauma until I came back years later with a suggestion that I had CPTSD, then they screened for it and subsequently diagnosed me with it).

[@traumaVerse]

I have never seen anyone in CMHT that knows what dissociation is let alone how to screen for it. They tend to put it down as delusional thought processes because they don't know how to differentiate the two.

[@Cathy-xi8cb]

No doubt that dissociative disorders are a specialty. I think most providers in CMHF would agree with that, and try to find clients a specialist. My best therapists have all been in private practice and did not accept insurance of any kind. I don't either. I won't work for the amount insurance will pay me. I would earn more as a barista.

[@traumaVerse]

@@Cathy-xi8cb in the UK they don't find us specialists because the NHS don't want to fund it unless we push for it. They are trained that DID is fictious so they have no training to sport dissociation and therefore don't know when they need to refer on. It's the same here that most decent therapists are private although Rape Crisis have some great counsellors.

[@traumaVerse]

@@Cathy-xi8cb We don't work on an insurrance model in the UK. Health care is funded by Tax and National Insurrance. CMHT are taught that dissociative disorders are false memory syndrome or delusions so they aren't given the skills to do the job. Even if they are just taught enough to correctly suspect dissociation and refer on to a specialist that would significantly reduce patient harm. I have seen hundreds of traumatised people damaged my improper mental health care.