Mixed State Bipolar Aspergers
From LoveToKnow Autism
An individual experiencing mixed state bipolar Aspergers is faced with some complexities that can be difficult to overcome. Identifying the comorbid condition is a crucial aspect of the problem.
Bipolar Disorder
Bipolar disorder, otherwise known as manic depression is a condition that involves extreme shifts in emotional states, ranging from elation to despair.
Mania and Hypomania
Hypomania involves feelings of omnipotence and wellbeing. The individual does not experience extreme symptoms, making episodes difficult to detect. He may feel productive, energetic and excited. Less sleep, bouts of creativity and great confidence are common during the phase. Hypomania is a comfortable state but it can lead to manic episodes.
Manic episodes are highly charged. It is important to note that mania does not equate to happiness; many feel easily aggravated and anxious rather than elated. Inspiration morphs into an attack of uncontrollable thoughts that are difficult to organize. The overwhelming nature of the manic state can lead to more complex psychotic conditions.
Symptoms of mania are outlined on WebMD.
Cycling
Duration of the respective states varies from one individual to the next, but the individual must experience both depression and mania (or hypomania) in order to be diagnosed with bipolar disorder.
Rapid Cycling
Some experience rapid cycling, occurring when an individual has at least four stages of depression or mania (including hypomania) in one year. Mixed state bipolar Aspergers is complex because it includes shifts in mood with the Asperger characteristics.
Asperger’s Syndrome
Asperger’s syndrome is a condition that affects an individual’s ability to process social interaction. Responses, behaviors and interests of an AS-diagnosed person often confuse neurotypical people. In turn, AS individuals may find many behaviors, phrases and emotional responses displayed by others confusing as well.
Mania and Aspergers
Among Asperger syndrome details are focused mental processes that are fixated on certain topics of interest. When an individual has such focus, she is more apt to excel in a certain area, making inspired thoughts and ideas during hypomania exceedingly exciting. However, after entering a manic stage, the individual becomes bombarded with ideas, making thoughts overwhelming and aggravating.
Diagnosing Mixed State Bipolar Aspergers
Diagnosis is especially problematic because there fundamental differences between neurotypical and AS mood states. Sovner suggests that four specific domains need to be considered in the process of diagnosis:
- Baseline exaggeration differences suggest that unusual base behaviors can interfere with proper diagnosis.
- Psychosocial masking make some unusual behaviors seem like disorders when they are not.
- Cognitive disintegration may interfere with proper diagnosis since an individual may exhibit odd behavior in response to seemingly insignificant occurrences.
- Intellectual distortion involves confusion in communication; a person may say he is afraid instead of angry.
The American Journal of Psychiatry features Treating a Child With Asperger’s Disorder and Cormorbid Bipolar Disorder, which states that bipolar disorder should be considered as a possible factor when:
- Patterns of highs and lows are present
- Cycles
- Increased and decreased interest
- Activity levels change
- Behavior fluctuates
- Apparent behaviors indicate that a mood disorder is present
The article explores examples that indicate that a cormorbid condition is possible:
- Depression
- Self-injurious behavior
- Crying
- Withdrawal from others
- No interest in favorite topics
- Sleep problems
- Mania
- Distracted
- Irritable
- Acting on impulse
- Noncompliance
- Agitated
- Silliness and excessive laughter
- Difficulty maintaining boundaries
- Pressured speech patterns
Treatment
Michele Raja and Antonella Azzoni offer insight into the complexities of combined AS and bipolar disorder in Cormorbidity of Asperger’s Syndrome and Bipolar Disorder. The exploration notes that treating the mixed state bipolar Aspergers condition involves addressing the mixed state rather than treating the respective diagnoses separately.
Treatment Strategies
An individual may respond well to common Asperger syndrome therapies but additional attention to the symptoms of bipolar disorder are necessary to help achieve realistic goals and objectives. A coordination of various services and interventions are necessary for the effective treatment of the complex condition.
- Social Pragmatics
- Vocational training
- Group therapy
- Social skills training
- Occupational therapy
- Psychotherapy
- Cognitive-behavioral therapy
The list is not comprehensive; individuals require unique strategies for their unique personalities, symptoms and strengths.
Medication
Asperger syndrome medication include SSRI prescriptions commonly used to treat depression and anxiety. Individuals who have cormorbid AS and bipolar may experience exaggerated symptoms of the mood disorder if they take antidepressants.
The fundamental challenge in properly diagnosing and treating cormorbid presence of mixed state bipolar Aspergers may be communication. As neurotypical individuals learn more about AS, they may gain a better understanding of how to identify and treat the combined conditions..
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Comments
April,
Thanks! Running and exercise is a great suggestion. It does help to recognize the signs of a meltdown before they occur, too.
-- Contributed by: Ella RainHave you guys tried running? My son can get too happy and his mood is very volatile then, it doesnt take much to go from too happy to all out meltdown...he as Aspbergers and i suspect he has manic states which are not confirmed by doc yet....these things move slowly...in the meantime when he is going too far up i get things quieted down and get him where he can run. To the park!! He will run until he is calmed down and the energy is dissipated....this stabilizes his moods and excersize is very good for avoiding both meltdowns and reversing states where he is so happy it becomes a volatile frenzy. We just go to the park and he runs on his own. You have to do this right a way, once meltdown looms too close your too late but i can usually see it coming.
-- Contributed by: aprilHi Lisa,
This is such a horrible ordeal for you and your daughter to face. When I was working in the field, I really didn't see any children benefit from medications. It's so hard to get the right dosage with growing kids. However, many find great relief from them.
Adolescence is a rough stage, too. The brain goes through changes and hormone levels are changing.
Testing is always a good idea. In fact, I think that there isn't enough medical/neuro testing for autism. (Hence the tendency for people to assume the conditions are over-diagnosed.) Tests can help determine how the brain is functioning. I am curious about the 3rd test she is getting.
I'm at a loss as to what advice to give. If it were my daughter going through this I think that I would try anything and everything until something worked. It's important to take one approach at a time. For example, if you want to try dietary changes, do this separately from medicine therapy. I hope that makes sense.
Please let us know about her progress. We're hoping for the best for you and your family.
-- Contributed by: Ella Rain
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