Comorbidity with bipolar illness?

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I am still having a hard time understanding how ASD (Asperger's and Aspergian symptoms), bipolar illness, and PTSD can share a comorbidity.

I don't mean to offend anyone, but it sounds like a bunch of label collecting to warrant more meds.

I am more concerned with how Asperger's and bipolar disorder occur in the same individual simultaneously. What if accomplishing a lot associated with a special interest is simply because you are passionate about what you were working on? But what if that energy you put into the project can be called mania? See, it's really confusing.

Thoughts on this?

I don't know much about all this, but my guess is that it depends on the extremes of the mania/depression.

I get hyper-focused at times, but not to the point where I am staying up all night or going without eating or other things like that that. I get down, too, but not to the point where I am not taking care of myself for weeks on end. I might have a day at a time when I don't *feel* like getting out of bed (but I do anyways.) I think what I have are normal ups-and-downs. They are not debilitating.

I suppose that depression and mania could be a sort of spectrum, too. Probably most people deal with the them at some point, but most do not have a problem that is extreme or debilitating.

Mania is not about how much energy you put into a project. It's a state of high excitability or euphoria, that usually involves having a sense of grandiosity, flights of fancy or an inflated ego. The person feels like they can do anything. They might make impulsive decisions or take risks that are highly likely to have negative consequences. They may not sleep, or sleep very little, for days or weeks at a time.

Take the example of a writer who begins working with intense focus on a new project. They might skip a few meals, or sleep less than usual, but they still take care of themselves. They may put off some of their usual activities until the project is done. But they are able to break away from writing to do other things. They are still basically grounded in reality. They still remember to pay bills, buy groceries, feed the dog, etc. They understand that the project may or may not be successful.

But a writer who is severely manic may focus so intensely on the project that they lose touch with reality. They may suddenly quit their job or neglect personal responsibilities so they can focus on writing. They may feel certain that the project is going to make them famous, or earn a lot of money. They may begin counting on that success and talk as if it has already happened. They may work on the project continuously for several days without sleeping. They may feel such an internal pressure to write that they are unable to break away from it.

The difference is not so much the level of energy a person is putting into something, it's the level of energy they are feeling and how that informs their perspective. In mania a person is feeling so high and excited that they lose perspective.

Thank you so much for outlining it the way you did. I am better able to understand.

This is my issue. Since my being a teen, it seems anytime I mention something to a psychologist or psychiatrist about my goals, it is cause for alarm. They would also take into account my family background, socioeconomic status, etc. to assess whether I had any realistic claim to having such goals, whether that had been to go straight to a 4 year college, apply to law school out of state, and have other projects besides what my job assigns me to work on. Now that I am an adult separated from my family, I don't really think that the background factors should be considered when assessing whether or not I'm manic, psychotic, delusional, whatever.

I have never told anyone that something is "done" as if it has already happened. I am actually quite terrified of letting people know what I'm up to because of judgements they may have. I have problems with sleeping and it calms me when I am doing something in those hours that I cannot sleep. However, I have kept the same job for a little over a year, pay my bills, take care of myself, etc.

The thing is, I think my mother had some odd form of Munchausen's Syndrome by Proxy that involved mental illnesses. As a teen I was moody and hormonal and my mother started reading things about bipolar disorder and schizophrenia from WebMD. She would exaggerate my symptoms to psychiatrists, I was not allowed to see a counselor or psychiatrist alone until I was 18, and when I was younger, my mother would do all the talking for me, claiming that I was too ill to speak for myself. She would always pull the race and culture card if doctors wanted to speak to me alone, so I never did get to tell them about what I think were my true problems.

The person I am seeing now has noted that my diagnoses of bipolar disorder by 3 different psychiatrists prior before I turned 18 are questionable. In college I got re-evaluated with the consensus being that I more likely had PTSD. The current person is very astute to my body language and listens to the things I tell her I struggle with daily. She thinks I likely am "on the spectrum" but does not want to totally discard PTSD and bipolar disorder as well.

I have relatively low self-esteem, I'm not exactly ever euphoric. I can be giddy and childish, but that's the closest it gets to euphoria. I do things in the hours that I cannot sleep. Laying in bed staring at the ceiling is terrifying to me. There are times when I do have obsessive thoughts and speak rapidly, but it is usually related to periods of high stress (pending deadlines). I am more receptive to criticism than praise. Praise actually makes me suspicious as to whether it's true acknowledgement or patronizing.

Manias...

A true Bipolar I mania is the best high in the world, and a perfect thing of beauty. That is before the dysphoric mania sets in, or the suicidal crash. Lol.. You are bullet proof. Nothing is beyond you. Every idea is terrific. You are top dog! King/Queen! The world is just something you manipulate.

The world plods along at a aggravately slow pace. You want people to make decisions NOW! You "know" where you are going (ha!), and they are harshing your mellow.

Your happy is beyond technicolor. You can't sleep because there is just too much to see and experience. And your anger is full tilt nuclear core melt down (not an Aspie meltdown).

I have never done coke, but I met a person who has Bipolar I. He said the manias he experienced were exactly like his coke highs. When his manias crashed, he did blow to get that feeling back.

If someone could bottle manias up, and sell it, he'd be a multi zillionaire.

They are that good.

But the crash back down, and the scorched Earth left by manias are that horrific. I miss them, but don't want them back.

I'm not bipolar, but I have Borderline Personality Disorder, but I think autism and emotional disorders together are very common.

You're welcome. Reading your reply though I'm not sure if I explained it very well. I was giving some examples of what the extremes of mania might look like regarding a passionate interest.

In actuality, mania is not always that severe or obvious. And unless/until the person begins to face really life-altering consequences to their behavior, they may not be able to recognize what is going on. Bipolar people are notoriously good at self-delusion.

Many people with bipolar disorder have hypomania, which can be very mild. But a person who typically experiences hypomania can still cross the line into full blown mania.



Being evaluated primarily on the basis of a mother's testimony is not a reliable means of diagnosis. But that doesn't mean the diagnosis was incorrect.

You did explain it well in the scope of special interests. However, this is specifically what concerned me in the past:

1. I graduated college in four years. I don't exactly get how that's an achievement but if that's what I am to be told based on what I revealed about my personal issues, then sure, it's an achievement. I did not once ask for an extension on an assignment except my senior year after an incident with a former boyfriend.

2. I refused disability accommodations because if I were to have bipolar disorder, it would not be a learning disability, but a problem with mood.

3. Anyone who has a decent sense of cultural sensitivity would gather my ethnic group doesn't usually go for advanced degrees. Federally I am not given accommodations for such, but because I want something more than a Bachelor's degree and my parents don't support that, and I had long been told this was something I'm not capable of doing, that gives a psychiatrist pause as to whether I have a serious mental illness?

4. If I have fluctuations in mood, they are situational. It is not a shift in mood for what seems to be no reason.

5. Perhaps I should be more honest in sessions. Maybe I should expound upon what I listed, and tell them that hatred of my mother, ethnic self-loathing, and shame because tax dollars went to relatively low interest loans to pay for an education that never was motivates me to not sit on my ass all day and perpetuate stereotypes of people with problems. I didn't feel I was worthy of moving on with my life until I paid off the $19,000 of loans I carelessly accrued for what I am repeatedly told was a shoddy degree. I will be done in December. But how is that rationale hard for a psychiatrist or psychologist to understand? I feel like a thief and I am very ashamed to have wasted hard working taxpayers' money on something so ridiculous.

I am sorry for ranting. It is just that this process is very frustrating and upsetting to me.