The Person or The Illness
December 6, 2013 6:05 PM   Subscribe

A person that I know to be selfish, arrogant, materialistic, stuck-up and combative, has recently been diagnosed bi-polar. How much of 'them' is them and how much is illness? Can treatment reveal them to be a considerate & pleasant person?
posted by jacanj to Health & Fitness (12 answers total) 7 users marked this as a favorite
If a person communicates to someone, be it love or scorn, sorrow or doubt, try and assume that their general attributes are theirs, while any ups and downs that might surface are affecting their mood, and therefore, causing great stress and anxiety. The person may not know what these features are, and what to do about them. For genuine information about what the symptoms of bipolar are, I encourage you to visit the websites for NAMI or NIMH.

I would also ask the person this very question when they are receptive. If the person has real insight to their mental health issues, this person should be able to tell you the difference. Making assumptions to this can greatly affect one's relationship with this person. The proper treatment and/or medication should take the away the lows and the highs.
posted by captainsohler at 6:21 PM on December 6, 2013

The problem lies in the will. Generally unless the person embodies a threat of harm to themselves or others, we don't force treatment on anyone.

The person has to elect to be treated, somehow, and has to be willing to undergo treatment to its meaningful conclusion.

A number of folks I know with mental, emotional and/or physiological issues undergo treatment, get a prescription, fill it and start taking meds and as soon as they start feeling good, they stop taking meds. The will to commit to the treatment and stick with it is the difficult part to commit to and to stick with. It can sometimes take years for a person who is used to how they felt pre-treatment to get to a point where they take that pill or go to that therapy session or do the meditation or the exercise every time it's scheduled, not just when they don't feel good.

So even if there is a treatment that reveals that the brusque parts of your acquaintance are mostly caused by their diagnosis, it will likely not be day and night if they get effective treatment. It's likely to cycle in and out between wellness and not until your acquaintance summons up enough commitment to stick to whatever plan come up with with their mental/physical/emotional health caregivers.
posted by kalessin at 6:22 PM on December 6, 2013

Have you found them to also have another side prior to diagnosis? If not, you are unlikely to see one after treatment. Bipolar disorder implies that there are at least two "poles" to the personality (or behavior). It's possible that what you are describing is the result of ongoing mania that will be mitigated by treatment, but if you've never seen anything else that's fairly unlikely. You may just know someone who is narcissistic who has been misdiagnosed.
posted by OmieWise at 6:26 PM on December 6, 2013

Being bipolar doesn't make you a bad person it alters a persons mood. It doesn't make someone selfish, arrogant, materialistic, stuck-up or combative.

It's an awful thing to live with, its painful, confusing and scary and people in the depths of mania or depression can act in ways that would be unfathomable to them when they aren't in those depths but its a disease that amplifies what's there. So yes maybe someone can act badly because of the pain, trauma and moods wings inherent of the illness hurts them.

But having bipolar doesn't make you a monster and its not fair to those who have it and those who love them to act like it does.
posted by SpaceWarp13 at 6:45 PM on December 6, 2013 [3 favorites]

I answer from the perspective of one who has a close, beloved family member who is bipolar. When this person is well, she is wonderful. When this person is ill, she is monstrous. If you are a stranger and you came upon her when she is ill, she is someone you would probably cross the street to avoid. If you are close loved one, during periods of illness she will steal your possessions if she can, speak poisonously, take advantage of any kindness. So yes, monstrous. I know both sides of her, and thankfully don't see the sick side very often. But if you only knew that part of her, you'd be sure she's a terrible human being.
posted by BlahLaLa at 6:55 PM on December 6, 2013 [1 favorite]

My partner has bipolar disorder. He was very few of those things you describe when he was untreated, and he is very few of them treated. Setting aside for the moment the one time he was seriously manic, my partner untreated is a bit more of his character traits, both the good and bad ones. But he's still very recognizably himself either way, treatment does not fundamentally change his character, as far as I see it.

I will say that when he was manic, he was very much like a completely different person who happened to share the house with me. But that was also very different than who he'd been before or since. So if you're seeing a sudden drastic change in behavior, sure, that's possibly the mental illness talking.

If this is who your person has always been, then treatment may moderate personality traits, but I would hazard a guess that an inconsiderate person is not going to suddenly become extremely considerate, or a combative person easygoing.

That's just advice coming from my experience of my partner, though. I've also spent enough time in bipolar support groups to realize that it's an extremely variable illness - some people described very different experiences, and probably would say that they are totally different people treated vs. not. Unfortunately there's just no way for you to know what's going to happen with the specific person in your life until/unless your person gets and sticks with long-term treatment.

If I may project a little - are you asking this because you are trying to figure out what you should do or how you should feel about interactions? If so, I would offer you this: It kind of doesn't matter what the reason behind the interactions is. You deserve to have your feelings, and to take care of yourself, no matter whether this is your person's illness or personality. The illness is not a blank hall pass to treat you badly, and if that's happening you do not have to wait for treatment to kick in. You can talk to your person about it now, work on self-care now, find a trusted friend or therapist of your own now, perhaps start attending a support group or do some self-help reading now. Put on your own oxygen mask first.
posted by Stacey at 7:11 PM on December 6, 2013 [12 favorites]

A couple of things:

Everyone with bipolar disorder is different, in the same way that everyone in [group which sort of correlates with some aspects of behavior] is different - two different gay people, two different members of the same political party, two different fans of the same football team, etc. There are people in my support group who share nearly all of my diagnoses who I cannot stand, and people with the same diagnoses I really love talking with, etc.

In general the things I find that correlate with "better behavior" and/or "Fee likes this person" include being in treatment for a longer period of time, having found a medication regimen that they think really works for them, having found a therapist and therapy modality that they think really works for them, having spent at least a few weeks/months in CBT, having spent at least some time in an inpatient or intensive treatment setting while not actively psychotic, and in general "having good insight." Oh, and almost everyone with mental illness who has a job or a volunteer activity that they feel is meaningful, I get along with really well.

On the other hand, while I am quite certain that there are people legitimately diagnosed with the following, who I would enjoy spending time with, I haven't met any yet: cluster A personality disorders, cluster B personality disorders, and dependent personality disorder. This is the long way of saying "the personality disorders I've never been diagnosed with," as well as "the personality disorders that regularly show up to support groups (there's a reason very few avoidant folks are in groups.)"

There are, though, a heck of a lot of people inappropriately diagnosed with borderline personality disorder who I get along with - this is because lots of professionals give that diagnosis to any female patient who they dislike, who talks back, who has ever done anything even remotely self-harmy, or who actually has bipolar disorder.

Anyway, treatment can totally help you be less up-and-down, stop having as many seriously angry spells, and find it easier to do the work of therapy. But it doesn't really change who you are - it helps you get stable and get to know who you really are and make better choices and stuff.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 8:21 PM on December 6, 2013

Another way to think about it: treatment has made me less scary but, generally speaking, no less annoying.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 8:26 PM on December 6, 2013 [2 favorites]

Different people respond to mental illness differently, the same way as any illness. I lost a family member to AIDS back in the early 90s. He was, in the last year or so of his life, nearly impossible to be around, because he was miserable and sick and he wasn't coping very well with those things and it made him self-centered and irritable and prone to spending a lot of money on indulgences to try to feel make life suck less. But nobody blames you for that when you're dying, you know? Other health problems, mental and otherwise, can be taxing in a way that can result in negative personality changes, though. Some people handle illness with nobility and grace, but a lot fewer than you'd think from TV movies.

On the other hand, some people are just jerks.

It's really hard to know. If treatment involves therapy and not just medication, even the just-being-a-jerk types aren't, like, incapable of becoming better human beings.
posted by Sequence at 3:38 AM on December 7, 2013 [1 favorite]

It's worth considering that bipolar disorder and borderline personality disorder are sometimes diagnosed when the other diagnosis would be more appropriate.
posted by slkinsey at 6:39 AM on December 7, 2013 [1 favorite]

I have bipolar disorder. Prior to getting therapy/medication seven-ish years ago, I was in many ways a fairly awful person. Not in a moral judgement kind of way, but it was pretty awful being me and I'm pretty sure I wasn't all that great to be around through most of it.

The thing about bipolar disorder (indeed, any long-term mental illness, really), is that it's in many ways a full time job. For me, it often took all my emotional resources to remain even vaguely functional. Sometimes my illness required more resources than I actually had, and then it was mostly a matter of trying not to die. I was selfish and self-absorbed because being any other way would have killed me. Of course, this also prevented me from building the kinds of support networks that I really needed at the time, but mental illness is filled with those kinds of catch-22's.

Before I began to recover, I was unable to distinguish between the illness and its consequences and the person who was ill and had to deal with all those consequences. These days I think of myself as the person that I always had the potential to be. Bipolar disorder stops you dealing with emotions normally. The negative stuff that mentally healthy people deal with and file away just hangs around forever because it's either too awful to deal with or doesn't actually seem to matter at all. For me there was quite a long road between no longer being actively ill and being mentally healthy. I had about twenty years of emotional development to catch up on. It sometimes feels like my life only really began at the point of my recovery. Everything before that almost feels like it happened to someone else; I was there, but I wasn't able to be me.

I'm not speaking for everyone with bipolar disorder, but this was (and is) my experience of it. There wasn't really a 'person' underneath the illness, rather, there was something a bit raw and unformed that (finally!) got the opportunity to become a person. No longer being ill was only the first step on a long journey.
posted by xchmp at 11:51 AM on December 7, 2013 [5 favorites]

Imagine this person spends alot of money on fancy clothes and wristwatches. Is he selfish and materialistic? Or is he spending compulsively due to mania? You don't know. Materialistic is a perception, a label you give someone, like you're trying to describe his essence. His behaviour might change with treatment. Your perception might change as you come to understand the illness.
Either way it is probably more helpful to focus on setting limits on the behaviour that impacts you.
posted by SyraCarol at 4:06 PM on December 7, 2013

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