Q: Can having a gender identity problem or personality disorder be
causing my bipolar symptons. I have been diagnost as axis I, bipolar II. Please
consider answering me.
Dear Charles --
The way bipolar disorder is currently understood, the answer to your question is
clearly no. Now for a few qualifications on that answer. First, having a
gender identity disorder, or shall we say, the symptoms that get a label from
psychiatrists which clearly gives away the value judgments that used to (but no
longer should) accompany such diagnoses...ahem, where was I? Ah yes, having a
gender identity struggle, searching for a less laden term, most likely is a
pretty stressful thing to go through. And stress has been associated
with bringing on episodes of mood problems, from depression to and including
bipolar disorders. So in that sense, the answer to your question is yes.
Please note the distinction: if you somehow managed to have the gender issues
without experiencing them as stressful, then in the current way of thinking
about bipolar disorder, again the answer is no. That's how I see it, anyway.
Now, how about "personality disorders?" Again, we see
that old value judgment sticking out there. This really bothers me. In my
experience this term is used by most psychiatrists I know to distance
themselves from the patient and, I believe, excuse themselves from having to try
to really help this person the way they would a patient who didn't have a
"personality disorder" -- after all, the patient has an axis II condition, blah
blah, ... and one can just hear in their voice the underlying assumption that
this means the patient is not helpable in the same way other patients are
helpable. Sorry, there goes a soapbox, eh?
Anyway, it's relevant to your situation in that the
same logic applies here as with the gender issues. Whatever it is that's
getting labeled (in some people, perhaps not you) "personality disorder", those
very symptoms can can severe stress (disrupted relationships or lack
thereof; intense, extreme emotional reactions to minor events; and so forth).
That's not to mention the stress that might go along with being treated by a
psychiatrist who is like the ones I'm describing above, who say "personality
disorder" and then don't show much empathy, for example. (Just to finish that
soapbox, now that I've got myself started: I'm not saying the symptoms that
"personality disorder" aren't there in some people; it's just the value
judgment about what "kind of person" that label means has the symptoms, that's
what bugs me. And it's also true that these kinds of symptoms are hard to treat,
and sometimes we can't really help much, but very often there are
symptoms there that can be treated. And what bothers me is that the label, and
the labeling process, can sort of give permission to the mental health person to
not try not treat the symptoms could respond, or try less hard. There,
all done. For now. Oh well, no, better add one more thought to this
All that ranting needs to be accompanied by an
acknowledgement that psychiatrists and other mental health types are human, and
sometimes have their own damaged places, and I suppose we should cut them some
slack too. It's really hard to sit there while someone acts out their symptoms
on you. I just try to remember that I'm supposed to be there to treat
those symptoms, not throw people out (even to a small degree emotionally) for
having them. But sometimes, especially when you've seen a whole bunch of
patients in a short while, or a bunch of folks with this kind of symptom-set,
even a good psychiatrist can end up doing his/her own acting out. I certainly
have. So if you've encountered it, it's smart to try to look for some empathy
for the psychiatrist first -- and use that to keep my rant in perspective.
Sorry, got off your track a bit; but I hope that helps
address your concern to some degree.
Published April, 2004