Chemical or Behavioral or Environmental?

I think the answer to the question above is all three. The chemical part is the trigger for everything, it's the spark that creates the momentum for the swings and also accelerates them. But, that's only part of the story. The environment matters...circumstances matter. m2m has many fears when she is low, none when she is high. Going to your in-laws house is a frightening situation for her when low. She feels inadequate when low. Judged. Worthless. Exposed. So the fear she creates in the face of something uncertain exacerbates her lows.

But, the behavioral is the most frustrating thing, because we see the glimpes of normalcy that make us feel manipulated. When m2m is high she manipulates aggressively, but its more of a malicious kind...she lies, she says hurtful things, she's unappreciative, and she's somewhat explosive and will show anger. When she's low the manipulation is more attention-seeking...more the sacrificial lamb of despondency. Her face is visible different...her face sags when she is low, her eyes are hollow, her mouth bent in a constant frown. Almost like she's trying to look sad..."look at me I'm sad...can you see it on my face?" Her famous quote from our childhood (as she moves her glasses down her nose a bit so that we can get a good look at her sad eyes), "Do I look tired to you?". Yes, m2m, you look DEPRESSED, you manipulator!

Can we help her? Not really. We can only do the best we can to protect our families from it...like the blog says...Deal With It. The WebMD website had a recent article on helping relatives deal with Bipolar during the holidays. The site is here:

http://www.webmd.com/content/article/129/117518.htm

Kind of takes a pandoring approach if you ask me, but it's an interesting point of view nonetheless. I actually think this one is a bit more practical:

http://www.webmd.com/content/article/102/106806.htm?z=4249_00000_5022_pe_01

Is it hereditary, many studies say, yes. Is it mandatory? No. The sense that I get is that there isn't too much we can do other than make the best of it and contain the pain that it spreads to loved ones as much as possible. The hurt she causes isn't intentional I don't think, it's part of the illness. She looks for the negative side in other people and other relationships because she has very few of her own and almost none of them positive...it makes her sphere of relationships seem more normal to point out the faults in others.

Like your postings with her quotes, I've had similar ones from m2m in recent months: "Don't you get frustrated by your son's tantrums?"; "Do you do all the cooking?"; "Why does your wife do so much laundry?"; "Do you have to go to work today [on a random tuesday]?"

The answer to all of these, is "Yes, I/we are living our life/lives." And, very happily, I might add, in spite of ...