Bipolar Disorder and Self Injury - What are the Risks?
written by: Rene Wolf
• edited by: Emma Lloyd
• updated: 9/15/2010
A symptom of bipolar disorder is extreme periods of depression during which time the person with bipolar disorder will do self injury in an attempt to release the overwhelming negative emotions they feel. Treatment is possiable for those who have bipolar disorder self injury behaviors.
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People with bipolar disorder experience a continuous series of up and down episodes. They will generally have periods of manic episodes followed by periods of depressive episodes. During the times of depression they have extreme feelings of hopelessness, confusion, anxiousness and sadness which led to thoughts of worthlessness. When the negative emotions become extremely overwhelming for someone with bipolar disorder, self injury may occur, as an attempt to cope with the overwhelming negative emotions brought on by the depression.
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Self injury, also called self mutilation or cutting, is done in the attempt to deal with the overwhelming negative thoughts and feelings. There is a variety of ways an individual may choose to inflict self injury to their body such as cutting their skin with a knife, razor or any sharp object. There are also individuals that may scratch, bite, burn or hit themselves. Regardless of rather the self injury behavior is an impulsive one or a ritualistic one, it is an unhealthy and dangerous attempt to release their built up stress, anger or frustration. For the individual with bipolar disorder self injury may ease their pain and/or relieve their negative emotions, it is their way of forming a coping technique.
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Self Injury and Suicide
People with bipolar disorder do have a high risk of suicide, however, those who inflict self injury are not necessarily attempting suicide, but are attempting to rid themselves of their negative feelings and emotions. Suicide and self injury are different, however, self injury should not be pushed aside as a simple problem. The damage done to their bodies leaves extensive scars, both physically and emotionally. Those who have self injury behaviors, may make the decision to take the self harm to a higher lever and discuss, plan or attempt suicide. It is important for the individual doing self injury seek professional help to learn healthier alternatives for coping with their negative emotions.
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Individuals diagnosed with bipolar disorder and self injury is occurring, treatment plans are available. When the individual receives proper treatment for the bipolar disorder as well as the self harm, they can learn valuable information for keeping their moods in check. Treatment will teach techniques for avoiding the overwhelming feelings of sadness and helplessness that often lead to self injury behaviors. Treatment plans typically consists of both medications and therapy. There also include the need for hospitalization, in order to stabilize the individual before beginning a maintenance treatment plan.
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Someone with bipolar disorder self injury, may be required admission into a psychiatric hospital. Hospitalization will allow staff specialized in treating those with bipolar, to monitor the individual closely. Monitoring provides insight to the individuals possible need for change in medications, for prevention of self injury and to provide frequent/intense therapy sessions.
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Medications are used as part of the treatment plan for stabilizing the mania and depression mood swings. Medications are also used when the individual has symptoms such as psychosis. The medications will vary according to the individuals symptoms as well as any other prescription medications they be taking. There are several categories of bipolar medications including mood stabilizers, antidepressants, antipsychotic, anti-anxiety and sedatives.
Mood stabilizers are used to treat the mania and hypomania. Lithium is the primary medication most often prescribed due to its ability to be used in conjunction with antidepressants. Lithium was also the first medication created specifically for bipolar disorder.
Antidepressants are also used for treating bipolar disorder, however, they are typically prescribed to be taken along with a mood stabilizer to prevent the mania from appearing. The most common antidepressants are selective serotonin reuptake inhibitors (SSRI’s) and serotonin nor epinephrine reuptake inhibitors (SNRI’s).
Antipsychotic are prescribed to lessen or eliminate the symptoms of hallucinations and/or delusions. There are two classifications of antipsychotic, typical and atypical.
Anti-anxiety and sedatives are prescribed to relieve symptoms such as anxiety and sleeping difficulties. Anti-anxiety medications include prescriptions such as Xanax and valium.
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Self injury can become an addiction for some, therefore it is sometimes necessary for the individual to receive addiction therapy, dual diagnosis therapy or hospitalization to determine the best therapy for the individual. When therapy is sought it should include treatment plans for both the self harm and the bipolar disorder. Cognitive behavioral and psychotherapy are the two types of therapy treatment recommended for bipolar disorder and self injury.
Psychotherapy also referred to as talk therapy can be quite effective for individuals with bipolar disorder and self injury. During psychotherapy sessions the bipolar individual is encouraged to talk about how their illness is effecting them as well as their families. The individual also may benefit from the objective monitoring of the therapist concerning the individuals moods and potential to self harm. The therapist will work with the person to teach coping and social skills that are typically impacted by the bipolar disorder.
Cognitive behavioral therapy involves the therapist teaching the individual various methods to help them become aware of their distorted thinking. The bipolar individual learns how to reduce the negative thoughts by knowing when and how to identify them, therefore preventing negative outcomes, such as self injury. Cognitive behavioral therapists work with the individual to teach them skills for decreasing the mood swings, motivate them to remain on their medications and coping skills to function through awareness of the bipolar symptoms.
Psychotherapy and cognitive behavioral therapy are effective in treating those with bipolar disorder and self injury, however, it is important the individual seek medical advice as both therapies have a more beneficial result, when used in conjunction with medication treatment.