So today my psychologist made a suggestion that seriously has me asking what if. The question was that in a small number of people, mania from bipolar can occasionally manifest as other disorders such as OCD, agoraphobia, paranoia and even transgender. He then asked if i think this may be the case with me. I will admit yes my dysphoria is worse when im manic but manageable when im not and now im seriously asking myself what if my dysphoria is.just that and the reason why it's manageable when im not manic is because.im really not.....god im so fu#king confused right now....i mean why would someone who's only job for me is control my bipolar and psychosis even ask that?

GGGRRRRRRRR!!!!!!

Sorry for the minor rant but any thoughts would be nice.

Well, it is a question that should be asked.  When there are a number of things going on, we need to sort them out.

My question would be, does your dysphoria predate your bipolar symptoms?  It is sort of a "chicken or the egg?" question.

In medicine, it's commonly referred to as comorbidity or comorbid conditions. http://en.wikipedia.org/wiki/Comorbidity

Basically, you can have an individual with a primary illness, disease, condition... and the same individual may have a secondary or tertiary issue as well. Medical professionals need to determine which is the primary issue in order to deal with it properly. Furthermore, they need to properly diagnose all other issues and figure out to what affect the primary issue is affecting or being affected by the other issues occurring concurrently.

Kinda like treating a cancer patient, that was in a car accident and ruptured their spleen, and caught Dengue Fever while in the hospital. What do you treat first? And what is primary issue and what interplay may exist between all of them.

Quote from: kariann330 on July 19, 2013, 07:36:42 PM
So today my psychologist made a suggestion that seriously has me asking what if. The question was that in a small number of people, mania from bipolar can occasionally manifest as other disorders such as OCD, agoraphobia, paranoia and even transgender. He then asked if i think this may be the case with me. I will admit yes my dysphoria is worse when im manic but manageable when im not and now im seriously asking myself what if my dysphoria is.just that and the reason why it's manageable when im not manic is because.im really not.....god im so fu#king confused right now....i mean
why would someone who's only job for me is control my bipolar and psychosis even ask that?
GGGRRRRRRRR!!!!!!

Sorry for the minor rant but any thoughts would be nice.

I'd encourage you to explore ur frustration/anger with ur helper, who will help to be able to trace where you're coming from and put a context to how you're feeling and help you figure out all the influences upon your sense of self.  Their job has lots of features, including establishing rapport and trust with you so that you can be who you really are, with all your feelings, with them, so that you can be supported to figure out what's going on for you, and from multiple perspectives.  So, for example, mania and bipolar are features of mind that co-occur with many other features that make you an individual.  They are experiences that do not occur without a context of your 'you-ness'.  Another facet of their support for you is to help you figure out the relationship of various mental states to your gender identity (seems from reading your post, that is).  That's important, I'd have thought, so that you can establish how closely your experience of dysphoria reflects you in your 'happy-content' state, versus when you don't feel quite right, within.

On another perspective on this, my position on 'mental illness' is not that it is the 'presence' of 'something', but rather the 'absence' of an ingredient, or a 'spice' on a 'spice rack'.  So, to heal a mental state that's troubling you, the question is 'what ingredient you need to add to what you are experiencing'.

To make this a little more concrete (on another condition, entirely, not what you're talking about here ) Nelsom Mandela is visionary.  However he is also a deeply empathic man, who sees the place, role and purpose of multiple kinds of empathy in multiply stratified social systems.  He's a deeply kind human being.  However, pathological narcissism, in my view, is "vision minus empathy", so that gives us the grandiosity of the narcissistic mode of thinking, and the tendency to use others as objects to fulfil our need, without empathy for them.  So, Mandella is "Narcissism+the ingredient of empathy=visionary"

For Mania, it is a highly adaptive experience, *when* the spice you need to add to it is 'discovered'.  Mania is a powerful tool for innovative thought, for burning in overdrive for short bursts, for fending off depression, and for a rocket ship blast into your next best form--*when*--the right 'spice' is added to that.

When I broke up with my partner, I *realised* I was entering a state of elevated mood, that had manic features.  My survival instinct was behind the 'leap' into the manic state.  I had a sick realisation that I didn't have 'escape velocity' to evade a crisis of faith after breaking up with peter, and my survival instinct kicked in.  I work hard, and just couldn't 'afford' a crisis of faith.  So, I got manic - *but* I realised I *was* manic.  I had *insight* in the elevated,  expansive mood.  So, I consciously adjusted my language, took steps not to overdo it, and I 'held' myself in an elevated state, *while* I worked darned darned hard to repair my underlying self-esteem wound, and self-soothe, and see good friends, got a counsellor, nourished my mind, my heart and my soul with kindness.  I read shamanic books.  I read about grief. I read about healing and self love.  And I 'lifted' the self-esteem up until I could, almost consciously, release the mania.

Mania is a defense.  It can be really really helpful on the healing  journey, but it's 'addictive' if you use it to compensate for the underlying 'hurt' or 'hole' in the self.  Fill the hole--be beautiful, think beautiful.  You *are* a beautiful human being.  If you read this and don't yet 'feel' that, that's where you start the work.

Because your worth as a human being and your beauty are *innate*.  There are no conditions on that, and if you don't yet feel that to be true, go on a fact-finding mission and root out the thoughts that make you feel down on yourself.

Be Kind to you.

Kind Regards
stav

Hi KariAnn,
I don't want to make any assumptions about what your psychologist actually said,  but it sounds as though they are implying that your dysphoria is 'caused' by your manic state.  What may be more likely, is that your underlying feelings of being transgender are constant and what is changing is your ability to cope with those feelings.   For myself, whether I'm extremely happy or depressed or running on an even keel... I always feel trans.  What changes when I become depressed is how much it bothers me and how much it affects my ability to function.  Coping or not coping does not make me more 'trans' or less 'trans'.  It's just a function or how well I'm dealing with it and other issues.

What would be worrisome is if your feelings about being trans change with your mood.  If that seems to be the case, then your psychologist has very good reasons to ask about it.  They might have expressed their suggestion in better terms, but it's a valid question if you suffer from any form of psychosis.

You say that the dysphoria is more manageable when you aren't manic, so I take that to mean that the dysphoria is still there whether you are feeling manic or not.  If that's true, then just let your psychologist know that.  If the feeling of being trans is a constant in your life then it isn't an occasional manifestation. It's your base state.  Just be honest about how you feel at the moment and take it from there.

Quote from: SunKat on July 19, 2013, 11:38:20 PM
Hi KariAnn,
I don't want to make any assumptions about what your psychologist actually said,  but it sounds as though they are implying that your dysphoria is 'caused' by your manic state.   What may be more likely, is that your underlying feelings of being transgender are constant and what is changing is your ability to cope with those feelings.   For myself, whether I'm extremely happy or depressed or running on an even keel... I always feel trans.  What changes when I become depressed is how much it bothers me and how much it affects my ability to function.  Coping or not coping does not make me more 'trans' or less 'trans'.  It's just a function or how well I'm dealing with it and other issues.

What would be worrisome is if your feelings about being trans change with your mood.  If that seems to be the case, then your psychologist has very good reasons to ask about it.  They might have expressed their suggestion in better terms, but it's a valid question if you suffer from any form of psychosis.

You say that the dysphoria is more manageable when you aren't manic, so I take that to mean that the dysphoria is still there whether you are feeling manic or not.  If that's true, then just let your psychologist know that.  If the feeling of being trans is a constant in your life then it isn't an occasional manifestation. It's your base state.  Just be honest about how you feel at the moment and take it from there.

that's how I read it as well--I was wondering if the psychologist had wanted KariAnn to ponder that riddle, not to judge, but to explore this.

I have been wondering what this means when dysphoria is less manageable in the manic state.  Do you mean "you're less likely to act on feelings of gender dysphoria" when not manic or "you're less distressed about gender identity when not manic".

They are two very different things with different implications. 

KerriAnn, can you say something about the kinds of insights you have about yourself when your mood is elevated and when it is not?

Kind Regards
stav

Quote from: SunKat on July 19, 2013, 11:38:20 PM
Hi KariAnn,
I don't want to make any assumptions about what your psychologist actually said,  but it sounds as though they are implying that your dysphoria is 'caused' by your manic state.  What may be more likely, is that your underlying feelings of being transgender are constant and what is changing is your ability to cope with those feelings.   For myself, whether I'm extremely happy or depressed or running on an even keel... I always feel trans.  What changes when I become depressed is how much it bothers me and how much it affects my ability to function.  Coping or not coping does not make me more 'trans' or less 'trans'.  It's just a function or how well I'm dealing with it and other issues.

What would be worrisome is if your feelings about being trans change with your mood.  If that seems to be the case, then your psychologist has very good reasons to ask about it.  They might have expressed their suggestion in better terms, but it's a valid question if you suffer from any form of psychosis.

You say that the dysphoria is more manageable when you aren't manic, so I take that to mean that the dysphoria is still there whether you are feeling manic or not.  If that's true, then just let your psychologist know that.  If the feeling of being trans is a constant in your life then it isn't an occasional manifestation. It's your base state.  Just be honest about how you feel at the moment and take it from there.

I really think you hit the nail on the head and now that im not mad about it can better understand his asking that.

To clear things up some, i constantly feel like im trans. When im manic tho my dysphoria can be triggered by anything, weather it be i can't get my makeup right one day and i look like a drag queen, wanting to go out en fem one day but cant because of where im going or who im going with, or even my legs being kinda stubbly can set it off....along with my ocd too. When im not manic tho those things do bother me, and do act as a trigger, but the reaction isn't as bad as when im manic. When im depressed, my penis is just another reason to kill myself.

While i do also suffer from psychosis, hallucinations, extreme OCD, extreme agoraphobia ect, that's really just the icing on my slice of transgender and bipolar cake....which is yummy btw.

A classic "Chicken or Egg" question.

I tend to analyze things to death. An occupational hazard in my case. When I was basically forced into taking a good hard look at my life and all it's major F' ups, I basically came to the conclusion that a good part of them had a root cause of me being TG. Up until then my way of handling it has been through diversions, distractions and some denial.

Four years later I now sometimes ask myself, Was I just running away from my problems? Is blaming things on being trans just a convenient excuse?; as I continue to over analyze things.

The simple fact is I am a far better and happier person now then I was before. Does the exact causality really matter? One can even argue that if me taking on the TG beast and making changes in my life brought about positive results, then I likely am just what I always felt I was. On the flip side I was simply motivated to grow as a person. Only the end result matters, not the how's or why's

I can easily drive myself into a WTF! funk by trying to sort this all out. But why? Life is better, I am healthier happier person now. It is working for me. Stop trying to predict, no... control, the future. It hasn't yet worked for me. So now I am trying to live in the present applying lessons learned from my past

Huh, I have read about comorbidity and TG and many sources do suggest that untreated GD can lead to other disorders - so in Your case it may just as well be the other way around. You have always been TG, but repressed feelings and possible denial? have developed into other anxieties... For myself, the main reason I believe I was totally hyperactive during my whole childhood was because my TG issues were totally disregarded - at least these are my thoughts, since there is absolutely no way of going back to find this out .