Complex posttraumatic stress disorder (C-PTSD) is a diagnosis not found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (which defines all recognized mental illnesses), but, rather, one that has been proposed and one that denotes a certain type of PTSD. C-PTSD has been proposed as a diagnosis for a form of PTSD that occurs when a trauma is repeated or ongoing such as in the case of a prisoner of war or someone trapped in a sexual exploitation ring (PTSD in Rape and Abuse Victims). This form of PTSD contains the symptoms of standard PTSD in the DSM-5 but additional ones as well.

Another name sometimes used to describe this is “disorders of extreme stress not otherwise specified” (DESNOS) or “developmental trauma disorder” when the chronic trauma is experienced by adolescents and children with PTSD.

Complex PTSD (C-PTSD) Symptoms

About 92% of people with C-PTSD also meet the criteria for a PTSD diagnosis. This means that those with C-PTSD experience the usual physical and emotional effects of PTSD like:

• re-experiencing of the traumatic event (flashbacks)
• nightmares
• increased response when startled
• avoidance of things that remind the person of the trauma
• irritability or angry outbursts

and other symptoms of standard PTSD. On top of this, people with C-PTSD also experience these C-PTSD symptoms, specific to this condition:

• Difficulty in emotional regulation – may include persistent sadness, suicidal thoughts, explosive or inhibited anger.
• Difficulty in cognitive awareness – may include forgetting the trauma, reliving the trauma or having episodes of dissociation (where person feels disconnected from the self or from the world around him or her).
• Difficulties in how one views oneself – this may include feelings of helplessness, shame, guilt, stigma and a sense of not being like other people.
• Having distorted views of the perpetrator of the trauma – examples of this include attributing total power to the perpetrator, becoming preoccupied with the relationship with the perpetrator or becoming preoccupied with revenge (PTSD From Domestic Violence, Emotional Abuse, Childhood Abuse).
• Difficulties in relationships – this may include isolation, distrust or a repeated search for a rescuer.
• Negative changes in one’s beliefs – such as a loss of faith or a sense of hopelessness and despair.

Complicating correct diagnosis is that complex PTSD symptoms may be misread by doctors leading to an incorrect diagnosis such as that of borderline personality disorder. Also, the jury is still out on whether long-term use of marijuana for PTSD helps or hurts the patient. However, marijuana use over time mimics some of the C-PTSD symptoms described above.

Complex PTSD Treatment

While C-PTSD can be a severe and debilitating disorder, C-PTSD treatments do exist and are effective. Primarily, the same treatments that are used with standard PTSD also help people with C-PTSD. These treatments and PTSD therapies include:

• Various PTSD medications to treat symptoms
• Exposure therapy
• Cognitive behavioral therapy
• Eye movement desensitization and reprocessing (EMDR) therapy

A combination of the above may be best for those with C-PTSD. Animals can be helpful too, so check into the possibility of having a PTSD service dog, too.

However, additional therapy such as traditional psychotherapy may also be needed to work through the specific C-PTSD symptoms noted above and to address interpersonal difficulties.

Dr. Judith Herman of Harvard University, a C-PTSD expert, states that:

. . . recovery from Complex PTSD requires restoration of control and power for the traumatized person. Survivors can become empowered by healing relationships which create safety, allow for remembrance and mourning, and promote reconnection with everyday life.

While C-PTSD treatment can be challenging, it is worthwhile as it is through these therapies that C-PTSD recovery is possible.

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Signs of bipolar in a man can are hugely variable, and they won't be the same for everyone. While it's true that men and women experience bipolar disorder in similar ways, the effects of the condition may be different depending on hormones, brain chemicals and environmental factors. Men often exhibit symptoms of bipolar differently than women, so it helps to know what to look out for. With this in mind, what are the signs the man you're dating has bipolar, and what should you do if you spot them?

Signs of Bipolar Disorder in Men

Bipolar signs in men, outlined by the DSM-5, are the same as they are for women. However, the symptoms of bipolar disorder may present differently according to gender.

The most common signs of bipolar disorder in men include:

Cycles of mania and depression: Defined by a state of euphoria, fast speech, lots of different ideas or intense anger or irritability, mania affects people with bipolar I disorder. People with bipolar II disorder typically experience cycles of hypomania (less severe symptoms that never reach the full criteria for mania) and major depression.

High self-esteem: High self-esteem or extreme confidence often presents in mania. However, these symptoms can be conflated with expressing masculinity, so it can be difficult to differentiate this from "normal" behavior.

Denial anything is wrong: Some men struggle to admit that anything is wrong when they’re experiencing mental health issues, particularly if they exist in a society (as many still do) where they’re expected not to show emotion.

Poor decision-making and reckless behavior: Risk-taking behavior in men might include hyperactivity, sleeplessness, hypersexuality, abusing alcohol or drugs, excessive spending and other pleasure-seeking behaviors.

Suicidal thoughts/actions: Sadly, suicidal behavior is an attribute of bipolar depression, and it carries a higher risk for men than for women. For this reason, early identification of bipolar disorder in men is essential to intervene, treat, and prevent risk-taking behavior. If you're worried the man you're dating could be suicidal, you can seek support and advice from the National Suicide Prevention Lifeline (1-800-273-8255).

What to Do If Your Man Has Bipolar

If you suspect the man you’re dating has bipolar, it’s important to approach the subject sensitively. The last thing you want is for him to feel you're labeling him or criticizing him for something he can't control. What's more, although we're more accepting and understanding of mental illness as a society, a stigma around bipolar still exists for men, yet bipolar affects men slightly more than it affects women (2.9%, compared to 2.8%).

Try saying something like, "I've been finding out more about bipolar disorder, and it's more common than people think. I think you might have some of the symptoms. Do you want to know more?"

Ultimately, your partner's response to this information will impact how you respond. Although you can encourage him to see his doctor and ask for a referral to a psychiatrist, you can't force him to go. Explain that you don't think he's "crazy" – you just want him to be as happy and healthy as possible, and you feel like his symptoms are getting in the way of that.

Offer to support him by going to the doctor’s office with him or suggest couple's counseling if you suspect bipolar is ruining your relationship as bipolar in relationships can be quite difficult. However you react to signs the man you're dating has bipolar, do it without judgment, and always listen to his point of view.

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Bipolar depression and light therapy are a combination that both mental health professionals and people living with bipolar depression have wondered about for some time. The idea is attractive. Imagine practicing some quiet, relaxing self-care by sitting comfortably in front of a light and almost effortlessly reducing depression. Does it sound too good to be true? Perhaps surprisingly, light therapy for bipolar depression just might be effective, giving you another tool to overcome depressive episodes in bipolar disorder.

Light therapy, also called bright light therapy, involves exposure to a bright, full-spectrum light with a UV filter. Often, people sit in front of a light box, but some people prefer to wear a light visor for mobility. Either way, taking in full-spectrum light can be helpful in reducing bipolar depression.

Despite the need for more studies (existing studies, while promising, are small and thus limited), the American Psychiatric Association has stated that in bipolar depression, bright light therapy is an acceptable alternative or addition to medication and psychotherapy (Nasr, et al., 2018). In order to benefit from light therapy as well as avoid harm, it’s important to know how to properly use it.

Light Therapy and Bipolar Depression: How to Use It and Recommendations

Perhaps because it’s considered to be a medical treatment, lightbox instructions are given in dosages. A dose of light therapy involves a few important factors:

• The intensity of your light (measured in lux)
• Your distance from the lightbox
• Duration of your exposure

A common light therapy dose is between 5,000-7,000 lux for 15 to 60 minutes.  Other doses are used, too, because each person is different. Light intensity and duration of exposure vary greatly, as illustrated by these examples:

• 400 lux for 2 hours per day
• 2000 lux for 2 hours per day
• 7000 lux for 45 to 60 minutes per day
• 10,000 lux for 45 to 60 minutes per day

Higher doses of intensity or duration may bring greater risks. It’s recommended that people starting bright light therapy for bipolar depression consult with their doctor for guidance on a dose that’s both safe and effective.  Usually, people begin treatments with 15 minutes per day and work their way up to 60 minutes by 15-minute increments over the course of weeks.

Time of day is an important factor, too. The optimal time of day for bipolar depression and light therapy is around noon.

Effective distance and positioning is typically one foot away with your head at an approximately 45-degree angle to the light. It’s not necessary to stare directly into the light box. The light simply should enter your eyes at an angle between 30 and 60 degrees.

Benefits and Risks of Bright Light Therapy for Bipolar Depression

Thus far, researchers have observed more benefits to light therapy for bipolar depression than risks. Some observations in studies and by physicians using light therapy with patients include:

• Bipolar depression remission; in one study (Watson, 2018), over two-thirds of participants experienced remission
• Fairly quick response time; typically 4-6 weeks
• Non-invasive
• Minimal side effects

Such a positive response in a short time is a positive sign that light therapy can be effective in treating bipolar depression. Still, every treatment carries risks, and knowing the risks can help you make an informed decision about whether bright light therapy is right for you.

Side-effects that have been identified thus far include:

• Headaches
• Agitation
• Eye strain
• Menstrual irregularities (rare)
• Insomnia (this is less of a problem when light therapy is done no later than noon)
• Mania

Among the drawbacks of light therapy:

• Lightboxes can be expensive and usually aren’t covered by insurance
• It’s time-consuming
• Relapse is likely after stopping

Of all side-effects and drawbacks, perhaps the biggest one is the risk of entering a manic episode. Because of this danger, it’s important to consult with your doctor before beginning. Make sure that light therapy is right for you and your unique experience with bipolar disorder. Continue to touch base with your doctor throughout the process so they can monitor how you’re doing and adjust your dose as needed.

Lightbox therapy for bipolar depression has the potential to help people resume living full lives. Indeed, “Evidence suggests that bright light therapy is an effective, well-tolerated, and affordable adjunct treatment for bipolar depression “(Nasr, 2018).

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Bipolar depression triggers vary from person to person, but there are some common factors to consider. Depending on their diagnoses, many people with bipolar type I or II find their depressive episodes to be the most detrimental to daily life, so they tend to avoid anything that could trigger a depressive episode. Sometimes, there is seemingly no cause for a depressive episode in bipolar disorder other than chemical or hormonal changes in the brain. However, certain factors may increase the likelihood of a "down" period, so here are some common bipolar depression triggers to consider.

Common Bipolar Depression Triggers

Bipolar depression triggers are external environmental and psychological factors that set off episodes of periods of bipolar depression or make existing symptoms worse. The most common bipolar depression triggers include:

• Poor quality sleep
  
  Changes to sleep patterns is a hallmark symptom of bipolar disorder, but it can also be a trigger. Studies show that poor sleep can trigger bipolar depression, while a lack of sleep can trigger mania. This trigger is most common in women with bipolar disorder, especially those who are caring for new-born babies. Cognitive behavioral therapy (CBT) and interpersonal and social rhythms therapy (IPSRT) can help you develop an orderly sleep schedule and manage your symptoms more effectively.
   
• Conflict with loved ones and relationship breakups
  
  Stress that occurs from conflict is a major trigger for bipolar depression. Sadly, marital problems are also common in people with bipolar disorder – especially those who experience extreme manic episodes. Seeing a marriage counselor could help you manage conflict more effectively, while treatment for manic and depressive episodes can keep symptoms in check. If you're going through a divorce, make sure you have an experienced legal representative who understands your condition.
   
• Substance abuse
  
  The aftereffects of alcohol and drug abuse can trigger depression-like symptoms in otherwise healthy individuals. In people with bipolar disorder, the symptoms may be more severe and depressive episodes are usually longer. Studies show that one in five people with bipolar disorder has a substance abuse problem. It's important to seek help if you think you have a problem with drinking alcohol or drugs, as there is plenty of support available.
   
• Medications
  
  Prescription medications can also act as bipolar depression triggers because they alter brain chemicals. Drugs that are known to trigger depression include anticonvulsants, benzodiazepines, statins, opioids and certain birth control medications. You should always check with your doctor before taking any new medicines. If you are dealing with a new doctor, make sure to tell them you have bipolar disorder so they can consider that when prescribing medications.
   
• Changes to weather
  
  Changes to weather trigger bipolar depression in 20% of people. Studies show that winter is more likely to trigger a depressive episode, while the transition to spring and summer can cause mania or hypomania.
   
• Financial stress
  
  The sudden loss of a job can be a trigger for bipolar depression, as can ongoing financial stress. Many people find careful money management to be vital in reducing stress and avoiding episode triggers. It may help to limit your access to specific accounts and credit cards during manic or hypomanic episodes, as many people overspend during these periods.
   
• Bereavement
  
  Some life circumstances, such as the death of a loved one, are out of our control. Although bereavement is a common depression trigger in people with bipolar disorder, it can also lead to mania. If you have recently lost a loved one and you have bipolar disorder, you should work closely with your doctor to make sure you have the support and treatment you need.

Can Bipolar Depression Be Triggered in People Who Are Not Bipolar?

If you have a relative with bipolar disorder, you may wonder whether bipolar depression can be triggered in people who don't have this diagnosis. The short answer is yes – any one of the triggers above could spark a manic or depressive episode that may later lead to a diagnosis of bipolar type I or II, but only if the person is genetically predisposed to this condition.

Many people do not know they have bipolar disorder until something triggers an episode, or else they are misdiagnosed with regular depression until a manic or hypomanic episode occurs. According to statistics, the majority of people with bipolar disorder are diagnosed during their teenage years or in early adulthood. It is believed that the stress experienced during these years is what triggers depression in individuals with bipolar disorder.

If you think you might have bipolar disorder, you should monitor your symptoms and seek help from your physician. Bipolar depression triggers (as well as triggers for mania and hypomania) can be avoided with a healthy lifestyle and routine, and your symptoms are treatable with a combination of medication and talking therapies.

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A big part of bipolar disorder is depression so it’s critical to know how to deal with bipolar depression. This can feel impossible as dark feelings like pessimism, indecisiveness, and sadness, plus painful physical symptoms like when appetite and sleep changes take hold, but coping with bipolar depression is possible. Here are three major types of coping skills that can help with bipolar depression.

#1 Dealing with Bipolar Depression – Being Involved in Treatment

While medical treatment may not be a self-help bipolar depression coping skill, being actively involved in your treatment is. The first step is ensuring you have quality treatment. Just any treatment isn’t enough. You need to ensure that you get the best treatment you can which usually involves seeing someone who specializes in bipolar disorder, if at all possible. If the medical care you are receiving today isn’t helping, make sure you look at alternatives.

You can also help deal with your bipolar depression symptoms by tracking them and giving the results to your doctor. Looking for triggers that may cause or worsen bipolar depression can also help. Additionally, noting side effects can help you decide if a bipolar medication isn’t right for you.

In short, just because your doctor is prescribing the medication, it doesn’t mean you can’t have an active voice in the process.

#2. Dealing with Bipolar Depression – Crisis Planning

While no one wants a bipolar depression to escalate to a crisis point, part of learning to cope with bipolar depression is to make a plan in case it does.
Making a crisis plan for a psychiatric emergency means:

1. Knowing what a crisis looks like, including what specific symptoms are likely to be present
2. Knowing what to do if that crisis arises
3. Knowing who to alert to a crisis

For example, a crisis plan might be:

1. Suicidal rumination, self-destructive behavior, an inability to sleep and a refusal of food
2. Taking the person to a hospital or even calling 9-1-1
3. Contacting the person’s treatment team and loved ones as listed by the individual

Part of a crisis plan is also writing this plan down along with all diagnoses, medications and any other pertinent medical information (e.g., allergies).

#3. Dealing with Bipolar Depression – A Wellness Lifestyle

Dealing with bipolar disorder also means adopting a healthy lifestyle. This type of lifestyle can not only help if a bipolar episode hits but also help avoid its presence in the first place.

Healthy lifestyle examples include:

• Practicing your therapy tools
• Learning about your illness
• Getting treatment for any comorbid (co-occurring) disorders such as a substance use disorder
• Establishing practices in your life that you enjoy such as walking your dog or a hobby
• Keeping your life calm and peaceful and using relaxation exercises to help
• Spending time with people who support you and your efforts

There are many other components to a healthy lifestyle as well (Bipolar Natural Treatment Diet: Does Diet Affect Bipolar?).

You Can Deal with Bipolar Disorder and Bipolar Is Treatable

It’s important to remember that mood disorders like bipolar are treatable. And you can learn to deal with bipolar disorder not just through medical treatment and psychotherapy but also through skills you develop yourself as well.

Bipolar depression causes many people to struggle with day-to-day living. For others, it can be episodic, accompanied by periods of mania or hypomania. No two experiences of bipolar disorder are the same, and the causes of bipolar depression are complex and varied. However, genetic, biological and environmental factors can make it more likely that you will develop this condition. Bipolar disorder is characterized by periods of depression and mania or hypomania, but the exact bipolar depression causes aren't always clear.

Bipolar Depression: Causes and Risk Factors

Bipolar depression causes symptoms similar to regular depression, but there is a difference. The essential feature of depression is low mood over a sustained period nearly all day, every day. It is often accompanied by feelings of hopelessness, loss of enjoyment in almost all activities, insomnia, fatigue and suicidal thoughts or actions. To meet the diagnostic criteria of bipolar disorder there should also be a history of manic episodes or hypomanic episodes.

Depression in bipolar disorder is a defining symptom. No one knows exactly what causes bipolar depression – or indeed bipolar disorder itself. However, research has unearthed some risk factors and causes of bipolar depression that are worth noting.

• Genetics: Some studies suggest that there may be a genetic component to bipolar depression. This means that symptoms of bipolar disorder are more likely to emerge if you have a relative with this condition.
• Brain-chemical and hormone imbalances: Neurotransmitter imbalances, along with hormonal problems, appear to play a crucial role in mood disorders such as bipolar.
• Environmental factors: There is some evidence to suggest that people with a history of abuse or trauma may be more at risk of developing bipolar disorder. However, it is unlikely that you or anyone else can “cause” bipolar depression if you are otherwise healthy and there is no genetic history of the disorder.  

Triggers and Causes of Bipolar Depression

Some people do not know they have the condition until something triggers their symptoms. The most common triggers of bipolar depression include:

• Periods of high stress: These can include grief, loss or an otherwise traumatic event. Stress can trigger the first episode of bipolar depression or mania in some people.
• Drugs and alcohol: Even a small amount of alcohol can make bipolar depression worse, while recreational drugs can trigger mania.
• Lack of routine: Sticking to a daily routine is a good way to keep bipolar symptoms at bay.  
• Conflict: Fighting with a spouse or loved one can trigger a depressive phase in people with bipolar disorder.
• Sleeping too much or too little: Sleeping too little has been known to trigger mania in people with bipolar disorder, while too much sleep can cause bipolar depression.
• Sensory overload: Lights, crowds, loud music and working too much can be triggers for people with bipolar disorder.
• Quitting your medication: If you are being treated for bipolar disorder or depression, you should never stop taking your medication without talking to your doctor. Suddenly stopping an antidepressant or mood stabilizer can trigger symptoms and could have dangerous side-effects.

Do the Causes of Bipolar Depression Even Matter?

The causes of bipolar depression are not always clear-cut. If you think you have bipolar disorder, your doctor will be less interested in what caused your condition and more interested in treating it. That said, your family history will be taken into account.

It can help some people with bipolar disorder to pinpoint the causes of bipolar depression so that they can avoid anything that triggers an episode. Keeping a mood journal or mood diary may come in handy in helping you determine what leads up to a bipolar depressive episode, so you can avoid it in the future.

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Getting help for bipolar depression can make a positive difference in the quality of life of anyone living with this often-debilitating disorder. Several different types of bipolar depression help and support are available, and what you choose will depend on such factors as current level of mood stability, the nature and intensity of your depression symptoms, the area of your life that’s being impacted the most (relationships, work or school performance, motivation, etc.), and any other concerns you have about what you’re experiencing. When you know you need bipolar treatment help, it can be daunting to know where to begin. Use this resource to learn what sources of help for bipolar depression are available and how to find them.

Types of Help for Bipolar Depression

Because the support you need varies over time, different types of facilities and organizations exist. In general, you might receive treatment or support in these settings:

• Inpatient hospitals
• Outpatient programs based in hospitals
• Outpatient clinics
• Private psychiatrists
• Private mental health therapists
• Mental health organizations in your community

Inpatient treatment involves overnight stays, usually so medication can be monitored closely and adjusted until an effective combination and dosage is determined. While hospital programs vary greatly, many offer individual and group therapy, exercise programs, and other positive treatment experiences in addition to stabilization with medication.

Outpatient programs, no matter where they’re located, provide a focused therapy experience. Many outpatient treatment programs run for several hours each day for a set number of days or weeks. Focus is on helping people develop ways to ensure they follow through with their treatment plan and take medication correctly as well as developing coping skills for dealing with bipolar depression.

Private care providers, like psychiatrists and therapists, have an office that you visit at intervals determined by you and your doctor or therapist.

Community-based organizations are mental health groups that provide information, referrals, classes, and support groups. These can be an excellent source for learning how to create a quality life with bipolar depression.

Numerous sources of help are available, but sometimes they’re hard to find when you’re in the throes of a depressive episode. This collection of resources can help you find what you need to move forward past bipolar depression.

Where to Find Help for Bipolar Depression

You can find information locally, in your community. Common places include:

• Doctor’s offices and clinics
• Hospitals
• Community centers
• Libraries
• University or high school health centers

Online sources of help can be useful, too. These organizations have extensive resource pages that include links to more references, informative articles, and bipolar disorder treatment- and support group locators which allow you to search for bipolar depression help by zip code. Among the most reputable and helpful are:

• American Psychiatric Association: Help with Bipolar Disorder
• Mental Health [dot] Gov: How To Get Mental Health Help
• National Alliance on Mental Illness (NAMI): Find Support
• National Institute of Mental Health: Help for Mental Illnesses
• Mental Health America (MHA) Resource Center: Find an Affiliate
• Substance Abuse and Mental Health Support Alliance (SAMHSA): Behavioral Health Treatment Services Locator
• International Bipolar Foundation: Get Help

A great source of bipolar depression help for children, teens, college students, and families are

• Active Minds: Chapter Network

Crisis lines are important to have on hand. If your bipolar depression ever makes you feel so hopeless that you consider harming yourself or taking your own life, these sources of bipolar depression help connect you with people who are there to listen, talk, and provide additional help.

• National Suicide Prevention Lifeline (1-800-273-TALK [8255])
• Suicide.org for international crises lines

Getting help for bipolar depression can help you not just survive the difficulties it creates but move past those difficulties and thrive. Use the above information to find people, programs, and support groups that fit you, then utilize the processes to start improving your life.

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What are the common reasons bipolar relationships fail? The answer is rarely clear-cut, of course, and there are many complex factors to consider. Many people with this condition have happy, fulfilling partnerships just like everybody else. Bipolar is also treatable, so most adults with the disorder are good at recognizing their triggers and knowing how to respond. Navigating a romantic relationship can be challenging at the best of times, but everyday issues become more complicated with a mental illness in the mix, especially one as unpredictable as bipolar disorder. So why do bipolar relationships fail, and how can you stop it from happening?

Do All Bipolar Relationships Fail?

Not all bipolar relationships fail. It's important to recognize this, as it's easy to blame yourself or your illness if things aren't working out for you and your partner. Relationships end for all kinds of reasons, and your diagnosis (or your partner's bipolar diagnosis) is probably only part of that equation.

Mental illness does bring its own issues to a relationship, however. The statistics for divorces involving a person with bipolar disorder are substantially higher than the national average. An estimated 90 percent of these marriages end in divorce, according to a 2003 study, compared with just 40% where neither partner has bipolar disorder. So how can you beat the bipolar relationship odds?

Reasons Why Bipolar Relationships Fail

Here are some of the common reasons why bipolar relationships fail:

Unpredictable moods and behavior: Bipolar disorder exists on a spectrum, but most people with either bipolar type I or II experience episodes of mania/hypomania and depression. Both of these mood states can make people behave unpredictably in relationships. Mania, for example, may induce pleasure-seeking behavior such as heavy drinking, partying or excessive spending, while depression can cause people to withdraw and detach from their partners, which can seem as if they don't care. These mood changes are very challenging for people with bipolar disorder, but they can also feel difficult for their partners.

Infidelity: Infidelity in bipolar disorder is a common, and often tragic, consequence of mania. However, this typically occurs in people who have not yet been diagnosed or are off medication for some reason. According to Bipolar Lives, the reasons infidelity occurs in bipolar disorder are as follows:

• Hypersexuality
• Impaired judgment
• Poor impulse control
• High self-esteem
• Grandiosity, feeling invincible

The stress of dealing with a partner who has a mental illness: According to David A. Karp, professor of sociology at Boston College and author of The Burden of Sympathy: How Families Cope with Mental Illness, supporting a partner with a mental illness like bipolar disorder can be more difficult than having a partner with cancer.

Bipolar Relationship Breakups: How to Cope

While not all bipolar relationships fail, we all have to deal with breakups at some point. The end of a relationship can be challenging to cope with for all of us. However, relationship breakups can be especially difficult for people with bipolar disorder, not just because of the emotional instability that ensues, but also because of the change in routine, stress, and loss that can trigger either mania or depression.

Let yourself feel the emotions

Everybody reacts badly when they are hurt or rejected, but when you have bipolar disorder, your reactions can be extreme. These emotions can feel uncomfortable for someone with bipolar disorder, but they are a normal part of a relationship breakup. Give yourself time to work through your feelings one by one, and remember they are a normal part of the grieving process when a relationship ends.

If feelings of depression become overwhelming or you feel suicidal, inform your doctor or seek urgent help by calling 911 or your local emergency number.

Protect yourself

Relationship breakups are hard, so you owe yourself some compassion. It doesn’t matter why the relationship ended or who was at fault – you must not blame yourself for the breakup. Somewhere down the line, you'll learn from any mistakes you made, but right now, the most important thing is to look after yourself and try to avoid engaging in behavior that triggers bipolar episodes.

Ask your doctor for help

When bipolar relationships fail, we often feel like we can’t cope. If your emotions get too much, be sure to ask your doctor for additional support. If you’re going through a particularly difficult patch, your doctor may suggest adjusting your medication or upping your therapy sessions.

Reach out to your support network

Your support network is vital during a bipolar relationship breakup, so be sure to ask for help if you need it.  If you don't have a support network nearby, resist the urge to reach out to your ex-partner unless it's an emergency. You need to heal, and you can't do that if you're always in touch with the person you broke up with. Try attending a bipolar support group instead to help you manage your moods and avoid triggers.

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How do you make new friends and where do you find them? Find out how to make new friends.

Approaching Someone as a Possible Friend

Many people find it difficult to approach a stranger or someone they know very little about and begin getting acquainted process. It's easier to do this in some situations than others. Being in a class, working with someone, being in a club, being at a party or living in a dormitory or an apartment complex can put people in face-to-face contact on a regular basis. Many of these situations will provide the participants with an indirect way of getting acquainted. For instance, in a club, the participants get to know each other through mutual participation in a club activity.

Whatever the situation, one must still make that opening line, the "hello" and following sentence. Often the opener is most helpful and effective when it is directed at something common in the situation the two of you are in. For instance, your opener might focus on a book that the other person you want to meet is carrying or something about them like an insignia on their clothes or the fact that you are both interested in the same club. Or you might focus on the fact that you have the same hobby or that you both know a mutual friend. Focusing on these elements common to both of you can be more effective than asking for the time or commenting about the weather. It is important, however, to get beyond them to a common topic of interest.

Ask Open-Ended Questions

Attempt to avoid getting mired and trading vital statistics about one another, such as: "Are you married?","Do you have any children", "How long have you lived in this town?" One good way of getting beyond this type of questioning is to ask open questions as opposed to closed or narrow questions. Open questions, in general, demand more than a one or two word answer. Notice how much more information is required to answer a more open question than a closed one. "What do you intend to do with your political science degree?" cannot be answered easily with a single word or two. "Tell me something about what you do," requires a longer answer than, "Do you like your job?" The open question demands a longer response that gives you more information you can react to and develop conversations about.

Ask Questions Specific to the Person

Also attempt to ask questions specific to the person rather than general questions. It's better to say, "I noticed that when we talked about the situation with the President in class today, that you seemed to have a lot to say. How did you develop such a strong opinion?" that to say, "People sure have strong ideas about politicians, don't they?" Give people opportunities to share personal information and feeling by the nature of you questions. Similarly, share free and unsolicited information about yourself by expanding on an answer to what might have been a yes or no question. Give the person that's trying to get to know you more than they are asking for, more than their questions demand, without ending up spending the whole time talking just about yourself. What you hope to accomplish by these tactics is that you might find some mutual areas of interest and things you might have in common with the other person.

If the person you want to get to know gives signs that they want to continue the conversation, then, by all means, continue it, but be attentive to cues of disinterest or hesitation. Don't rush a relationship. If it does not seem to be developing smoothly at the moment, let it slide and return to it at a later time to reopen it.

People get to know one another through a mutual process of self-disclosure that takes place over time. In this process, they share information about themselves, and, at different points of this sharing process, each decides whether they want to continue sharing to deepen their relationship. You or they might decide that you want to maintain a relationship at an acquaintance level or deepen it further into a friendship or even an intimate one.

The process is a gradual one. It is important not to rush it and yet not neglect it either. It is best to convey to the person that you feel positive about the relationship if that is the way you feel about it. If you feel ambiguous about how the other person is responding to the relationship, it is best to give the person the benefit of the doubt about their interest and not to just assume they don't want a relationship of any kind with you. Obviously, this sometimes feels risky.

Risks and Rewards of Getting to Know Someone

Getting to know someone does mean risk, because rejection is always possible. Rejection, however, is much less harmful if you are prepared to understand rejection as not meaning that you are disliked or unlikable. The reasons we usually reject opening a new relationship is not because someone is not likable. It is usually because we already   have a social network or established body of friends who meet our needs or that we can't see any mutuality of interest between ourselves and the new person. Making friends and developing a social network is a process of shaking out and identifying a group of people who are somewhat similar to yourself.

This means that some of the new people you meet are not going to be like you and are not going to want to continue the relationship with you --nor you with them.   Some are not going to "fit" with you, as you are not going to "fit" with them. If you would look at your actual experiences, you would probably see that you are actually disliked by very few people. You might have been indifferent about a lot of people while really liking a relatively few. Rejection is a two way street; we all reject and we all accept. Even if a given relationship you attempt does not work out, you can learn a lot about people and yourself in the process of trying to make it work that might help you as you pursue new relationships.

Maintenance of Friendships

Getting to know another person is often difficult and doesn't happen as quickly or as smoothly as we'd like. (However, once you have connected and developed a friendship, having someone with whom you can share interests and feelings can make all the effort worthwhile.) Just remember, however, that having a friendship is like growing a garden. Each needs attention and nurturing in order to produce the best results. You can't expect much from a garden that you let go to weeds through lack of attention.  

Different relationships may also need different levels of attention. Some may need an occasional "checking in," while others need some daily attention. Know how much you are willing to invest in a friendship. Don't promise more than you are willing to do and set limits when you are being asked for more than you are willing to give. Relationships built on a sense of guilt are difficult to maintain and generally aren't a lot of fun. Try to build your relationships on things that you mutually enjoy.

A Final Note

The last thing to be reminded of, perhaps, is that everyone has trouble establishing relationships from time to time and that not even the most successful people are successful every time. However, nobody is successful unless they try.

Note: This document is based on an audio tape script developed by the University of Texas, Austin. With their permission, it was revised and edited into its current form by the staff of the University of Florida Counseling Center.

You will find 10 distinct types of personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, (DSM-V). The different personality disorders are put into one of three clusters based on similar characteristics assigned to each cluster:

Cluster A personality disorders – odd, eccentric
Cluster B personality disorders – dramatic, emotional, and erratic
Cluster C personality disorders – anxious, fearful

It's common for people to receive a diagnosis of more than one of the personality disorder types, most commonly within the same cluster. As we explore further, you'll begin to see how the four common features come together to manifest in the different personality disorders.

Personality Disorder Types

The 10 personality disorder types (list of personality disorders) have descriptive similarities that allow them to fit into one of the three cluster categories. The American Psychiatric Association (APA) has suggested further investigation of an alternative model of categorization for the different personality disorders in hopes of adding clarity to this current approach. Until the development of a new model, the DSM-V (APA, 2013) adheres to the cluster grouping convention:

Cluster A Personality Disorders

Deemed the odd and eccentric cluster, Cluster A Personality Disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. If you know someone with an inflexible, long-term pattern of social awkwardness and social withdrawal punctuated by distorted thinking, he or she may have one of the Cluster A conditions.

Cluster B Personality Disorders

Considered the dramatic, emotional, and erratic group, Cluster B Personality Disorders include borderline personality disorder, narcissistic personality disorder, histrionic personality disorder, and antisocial personality disorder. If you know someone with marked and persistent impulse control and emotional regulation issues, he or she may suffer from one of the Cluster B disorders.

Cluster C Personality Disorders

Thought of as the anxious, fearful group, Cluster C Personality Disorders include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. The common factor of these three disorders is that those suffering from them have high levels of anxiety. People who have a persistent pattern of obsessive and compulsive thoughts and behaviors, feelings of inadequacy, or have an inordinate need to be taken care of by others may have one of the disorders in Cluster C.

To receive a diagnosis of a personality disorder, the person must exhibit a long-term and pervasive pattern of the behaviors and symptoms. Because of this, people sometimes don't receive a diagnosis until adulthood, at which time the onset of the disorder is traced back to childhood or adolescence. Most personality disorders decrease in intensity with age. People frequently experience the most troubling symptoms during their 40s or 50s.

When learning about personality disorders, it's important to remember that everyone may exhibit some of these disturbing personality traits at one time or another. But personality disorder diagnostic criteria require a long-term, pervasive pattern of these traits. In other words, the person must exhibit these behaviors for observation repeatedly regardless of time, place, or situation.

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