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Behavior question
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An_189140 posted:
Dr. Goldberg:


My boyfriend, who's bipolar, has been restless since he turned 50 and seems very manic right now. He's broken off our relationship for someone else and has found her online and is searching for something to revive his sex drive.
I am heartbroken. Could this be a manic phase? He's also started going to bars and all that.

Thank you.
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Joseph F Goldberg, MD responded:
Dear Anon,
Could be. Did you bring your concerns to his attention? Is he regularly seeing his doctor? Is he taking medicines that may be prescribed for him? If he is in fact manic, then it is certainly possible he may be making impulsive decisions and/or acting on sexual impulses. People can make all kinds of impulsive and reckless, sometimes disastrous decisions without much forethought when manic...and regret afterwards.
- Dr. G.
 
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Financegal replied to Joseph F Goldberg, MD's response:
As far as I know, he's on his meds, but he's also started taking hormones for his sex drive.
He's also drinking more. One of his new friends is a woman who has a severe drinking problem.
I could be wrong about all this. He was on Match.com and I asked him not to do that, that it hurts me.
It's obvious he did it anyway. I'm wondering if this is an impulse he can't control.
Really, he's made his decision. All I want to know is whether this part is of his manic phase hunting for the thrills and highs.
Thank you.
 
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Financegal replied to Joseph F Goldberg, MD's response:
How do you tell a manic stage from just normal decision-making?
 
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Joseph F Goldberg, MD replied to Financegal's response:
Could be. Drinking sure doesn't help matters either. He may be under-treated, in which case the hard part for you may then be not to take his behavior personally, strange as that may sound.
- Dr. G.
 
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Joseph F Goldberg, MD replied to Financegal's response:
Can be hard. Mania involves a combination of many different signs and symptoms: not sleeping, elevated mood, irritability, talking louder or faster and uninterruptibly, overconfidence, expansiveness, exaggerated self-confidence, lots of energy, new activities. Bad or spur-of-the-moment decision-making can be more likely to happen during a mania (or during periods of drinking) and for that reason it's usually wise not to make any big decisions while manic. Sometimes though faulty decision-making can happen even when mood symptoms are not so obvious. We look for rationales behind decisions that are made -- deliberate, planned, well-thought-through decisions are very different from "urgent" or impulsive ones where there is little reflection on the pros and cons, the implications, or the possible bad consequences. Again, drinking only muddies the waters more. For his sake, I would hope that your friend is as concerned about the status of his illness as you are.
- Dr. G.
 
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Financegal replied to Joseph F Goldberg, MD's response:
He's made a choice to choose someone over me, and I have to respect and live with that decision. I still care for him and I worry that he's going to make reckless moves. There have been many times when I've intervened before he was just about to make a bad decision.
He often rebelled against that. He said I lived by "too many rules." I suppose I became boring to him.
Thanks very much for your time.
 
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KimJimBoc replied to Joseph F Goldberg, MD's response:
Dear Dr. Joseph Goldberg MD.

Can having Bipolar disorder effect comprehension when talking to someone? Meaning, it registers differently than what was actually stated.
 
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Joseph F Goldberg, MD replied to KimJimBoc's response:
Dear KimJimBoc,

Possibly. Bipolar I disorder, in about 1/3 of people, can interfere with attention, verbal memory and what's called executive functioning, which means, the ability to manipulate information in your mind. These problems are not so evident in bipolar II disorder.

- Dr. G.
 
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fuzzer29 replied to Joseph F Goldberg, MD's response:
does it happen in bipolar II? That's what I have, and I do that all the time! I always thought it was some sort of comprehension issue. Thanks for the time you take to answer all these questions, it is greatly appreciated.
No matter how high the throne, there sits but an ass. -Voltaire
 
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Joseph F Goldberg, MD replied to fuzzer29's response:
Cognitive problems per se are not so pronounced in bipolar II disorder, though subjectively, other symptoms (like anxiety, or depression, or hypomania) could be misconstrued as cognitive phenomena. Much more common in BP I disorder.

People also of course can have other, additional problems such as nonverbal learning disabilities, ADD, or other causes of comprehension problems that may have nothing to do with also having bipolar disorder.

- Dr. G.
 
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fuzzer29 replied to Joseph F Goldberg, MD's response:
OK, what on earth is a nonverbal learning disability? I have never heard of this? I think ADD is considered one? What are others if you don't mind?
No matter how high the throne, there sits but an ass. -Voltaire
 
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Joseph F Goldberg, MD replied to fuzzer29's response:
A nonverbal learning disability is a type of developmental disorder that involves deficits in nonverbal areas -- such as motor coordination, ability to grasp social cues or maintain normal social interactions, and poor spatial organization. An example would be Asberger's Syndrome. ADD is not considered a developmental disorder, and it involves verbal skills (ie, attention) rather than nonverbal skills.

- Dr. G.
 
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fuzzer29 replied to Joseph F Goldberg, MD's response:
OK, I think I understand what that is now. So if I understand this, then one could have just one or two aspects of this? Such as comprehension difficulties, esp. with nonverbal social communication? Thank you once again for your valuable time!
No matter how high the throne, there sits but an ass. -Voltaire
 
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Joseph F Goldberg, MD replied to fuzzer29's response:
Potentially, yes. NVLD's are usually diagnosed by psychological testing after ruling out other problems, and also NVLD's usually also show a mismatch in IQ testing between verbal (good) and performance (poor) abilities.

- Dr. G.


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