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Despite a number of falls, a number of panicked, emergency calls for various medical and personal crises, and the stress of periodic hospitalizations, mom was convinced she could “live on her own.” The fact that she was wreaking havoc on the lives of nearby family members didn’t register in her mind at all. Despite touring a few assisted living places, she always insisted that she had no need for such a place and dug in her heels about staying put, citing the increased expense of assisted living. She steadfastly fought against moving out of the little apartment that she loved and losing the independence she cherished.Finally, she had a serious medical event that put her in to a care facility for an undetermined amount of time. Rather than pay for two places, the family made the executive decision to close down the apartment and put things into storage, and tell the care facility to get her a permanent room there.We did not consult with her on this decision, she was too sick and delirious at the time.After a few weeks she got somewhat better and inquired about returning home, and then we broke the news to her. Let’s just say that she was not amused. She bitterly complained that “her family put her in a home” without her consent. She made it a point to tell anyone who would listen that she would never forgive us for doing this. This went on for the remainder of her life.The fact is, that the downhill slide was evident, and she was utterly uncooperative in a voluntary move. While we may have handled it better, we had reached the end of our collective ropes and determined that she needed ongoing, on-site professional care.Lesson: When you are old, be proactive about your own care, and be mindful of the burden you place on your family when you do fail to do so.In the end, she thrived at the place, appearing often in the facility newsletters, volunteering to help people worse off than herself, and making the most of her last years. She remained studiously bitter about being moved there against her will.So, I don’t know the best way to approach them, other than to tell them unless they act on their own, action will ultimately be taken with or without their cooperation.

Meet Dr. Eugene Lazowski - a Polish hero who saved thousands of Jews from the Holocaust.Lazowski had the extreme misfortune of being scooped up by the Nazis immediately after the 1939 invasion, as they sought to eradicate Poland’s intelligentsia.Lazowski did, however, have the extreme fortune of not being executed like the majority of the captured, instead being shipped to a PoW camp.One night at the camp, after three years in captivity, he spotted a hole in the barbed wire fence, and took his chance. After scaling the perimeter wall, he landed outside, next to a horse and cart. Moments later, a Nazi soldier walked past, and Lazowski saluted him. The soldier smiled back.Lazowski rode back to his hometown, Rozwadów, and promptly joined the Red Cross - and the Polish Underground. He went on to wage a devastatingly successful, impressively daring one-man crusade against the Nazi occupation of Poland, without firing a gun once - and in plain sight.He began by giving medical help to Jews - a crime punishable by death. His home was located near the Rozwadów ghetto’s fence, and he devised a system whereby sick inhabitants would tie a white rag to the fence, and he would slip out to surreptitiously give treatment and supplies under cover of darkness. Using creative accounting, he massively inflated the amount of medicine and supplies he was using on non-Jewish patients to hide his plot. It was never even suspected in the three years it operated.His next ruse, an absolutely sublime intrigue, was concocted when a young local visited him towards the end of 1942. The lad had a unique complaint - he wanted Lazowski to diagnose him with a serious disease, so he wouldn’t be sent back to the labour camp he’d been toiling in for some time.The Nazis were terrified of epidemic outbreaks among their soldiers, and demanded Polish doctors alert them to any cases of infectious diseases they came across. Infected Poles were simply expelled from the camps and allowed to return home - infected Jews were killed on the spot.Lazowski was keen to help, but knew he’d have to offer the Nazis more than a paper diagnosis for the ‘patient’ to be set free. He decided to give the man an injection, and then sent a sample of his blood to a German lab. He soon received a telegram confirming his patient had typhus, and was exempt from having to serve in a labour camp ever again - as were the patient’s entire family.You see, Lazowski and his medical school friend, Dr. Stanislaw Matulewicz, had discovered if patients were injected with dead typhus cells, they would test positive for the disease.The pair didn’t stop there. Inspired and emboldened by their success, they set about ‘infecting’ the entire town with dead typhus. As they noted in a paper authored after the war:“When many cases were reported in an area, it was declared by the German Public Health Authority to be an ‘epidemic area’ - the Germans were inclined to avoid such territories and the population was free from atrocities.”The plan was carried out in total secret, with even patients unaware of the true nature of the injections they received. So as not to arouse suspicion, the pair emulated the fluctuations exhibited in real epidemics - the rate of detection would slow in warmer climes, and more cases would be ‘discovered’ when the temperature dropped.Lazowski and Matulewicz would also ‘infect’ patients and send them to other doctors (locally and elsewhere) for diagnosis. These doctors would duly report the infections to the Nazi authorities.In time, Rozwadów was deemed an epidemic area, and the Nazis stopped visiting them. The Jews were now free to leave the cramped, inhuman conditions of the ghetto, and live as normal people - completely free from the threat of execution, or transportation to Auschwitz.Despite their meticulous attention to detail, the cunning scheme was almost derailed when the inhabitants of Rozwadów didn’t start dying. The Nazis smelled a rat, and dispatched a team of doctors to investigate.Lazowski greeted them with a range of fine food, and plenty of strong vodka. While the higher ups sat around chatting, snacking and getting thoroughly sozzled, their gophers toured the town with him.The junior doctors were absolutely horrified by what they saw. After quickly conducting a few token blood tests, the existence of the epidemic was determined to be very real, and they scarpered in short order.You see, Lazowski had gathered the unhealthiest looking inhabitants he could find (and ‘mocked up’ a few to look like they were at death’s door for good measure), and injected them with dead typhus cells.The visitors were so scared of getting infected they checked no records, and barely inspected the hospital.In a gorgeous irony, as WW2 neared its end in Europe, the Nazi occupiers began to flee the advancing Russians. A military policeman, whom Lazowski had befriended (and secretly treated for venereal disease), approached and urged him to escape. He had been put on the Gestapo cleanup hit list.The policeman went on to reveal Lazowski’s membership of the Polish Underground had been known about for some time by the occupying authorities.He hadn’t been executed though, as they needed him kept alive to fight the typhus epidemic that had befallen Rozwadów.Lazowski emigrated to the US in 1958 on a scholarship from the Rockefeller Foundation. In 1976 he became professor of paediatrics at Illinois SU. He kept quiet publicly about his intrigue until 1977, when he and Matulewicz published an article about the conspiracy in the American Society for Microbiology’s newsletter.In private, he told his wife Murka. It turned out she’d long-suspected the plot, and knew he was in the Polish Underground too.You see, Lazowski had frequently traded secret messages with another Polish Underground member, ‘Pliszka’.‘Pliszka’ was none other than Murka herself…He went on to write over a hundred scientific dissertations, and also published a memoir, Prywatna Wojna (My Private War). Strongly recommended reading.In 2000, Lazowski returned to Rozwadów for the first time since 1958, to take part in a wartime reunion.He received a hero's welcome, with people flocking from Israel, Poland and all over Europe to salute him.Ever humble, Lazowski explained his actions thus:“I was just trying to do something for my people. My profession is to save lives and prevent death. I was fighting for life.”He died in 2006, aged 93.In all, Dr. Eugene Lazowski rescued as many as 10,000 Jews from the Holocaust, and a great many Poles from potential death too.

NEWSLETTERWhat's the difference between borderline personality disorder and bipolar?Last reviewed Wed 6 February 2019 By Jennifer Huizen and Dillon Browne, PhD‘People sometimes confuse borderline personality disorder and bipolar disorder because they can have similar symptoms, such as intense emotional responses, depression, and impulsive behavior.’‘However, borderline personality disorder (BPD) and bipolar disorder are two separate types of condition with different symptoms and treatment options.’‘In this article, we discuss the primary differences between BPD and bipolar disorder, including the symptoms of each condition and the most common treatment options.’Borderline personality disorder vs. Bipolar DisorderBipolar disorder and BPD have a number of similar symptoms.BPD is a type of personality disorder that causes people to feel, think, relate, and behave differently than people without the condition.Bipolar Disorder is a type of mood disorder, which is a category of illnesses that can cause severe mood changes.People with BPD experience an ongoing cycle of varying self-image, moods, and behaviors.These patterns typically cause issues that affect a person's life and relationships and the way in which they understand and relate to others.According to the National Institute of Mental Health, about 1.4 percent of adults in the United States have BPD.Bipolar Disorder affects a person's mood, energy, thoughts, activity levels, and functionality in cycles that can last for days to months. It is more common than BPD and affects an estimated 2.6 percent of the population in the U.S.Symptoms of BPDPeople with BPD experience instability in their self-image, moods, and behavior. These symptoms can lead to impulsive actions and problems with interpersonal relationships.Symptoms of BPD include:uncertainty about one's role in the worldfrequently changing interests and valuesa tendency to view things as either all good or all badchanging opinions about others quickly, e.g., perceiving someone as a friend one day and an enemy the nexta pattern of unstable, intense relationships with family and friends, for whom feelings alternate between closeness and love to hate and angerunstable, distorted self-image or sense of selfattempts to avoid imagined or real sources of abandonment, e.g., stopping communications with someone in anticipation of them cutting off tiesself-harming behaviors, such as cutting, burning, or overdosingdifficulty trusting people, sometimes because of an irrational fear of their intentionsfeelings of dissociation, such as feeling unreal, having a sense of being cut off from one's body, and seeing oneself from outside the bodyrecurring thoughts of suicideimpulsive or reckless behavior, such as unsafe sex, drug misuse, reckless driving, and spending spreesintense episodes of depression, anger, and anxietychronic feelings of emptinessfear of being aloneNot everyone with BPD experiences all of these symptoms. Some people may have only a few minor symptoms, while others experience severe and frequent symptoms.Stressful or emotional events can trigger some of the symptoms of BPD. To other people, these events may appear minor or disproportionate to the response that they generate.Symptoms of Bipolar DisorderPeople with Bipolar Disorder can experience extreme mood swings. In many cases, people will alternate between highs (manias) and lows (depressions) with intervals of stable mood.Some of the most common symptoms of mania include:extremely elevated moodreduced need for sleepan exaggerated sense of confidence and optimismracing speech, thoughts, or bothreckless or impulsive behaviorgrandiose ideasinflated sense of self-importanceirritability or aggressionpoor judgmenthallucinations and delusions, in severe casesSymptoms of Bipolar Depression include:constant fatiguefeelings of worthlessness and guiltinability to concentrate or make simple decisionsunexplained aches and painsprolonged periods of sadnessunexplained crying spellssignificant changes in sleep patterns and appetiteirritability, anger, and agitationindifference and pessimismexcessive anxiety or worryinability to find pleasure in former interestssocial withdrawalthoughts of suicide and deathNot everyone with Bipolar Disorder will experience depression. In fact, experiencing a manic episode is the only requirement for a Bipolar I Disorder diagnosis.People with bipolar II can experience the symptoms of depressive episodes, but they have hypomania, which is a less severe form of mania.Manic episodes usually last for at least 7 days, and they can sometimes be so severe that hospitalization is necessary. Depressive episodes often persist for at least 2 weeks.Some people have rapid-cycling bipolar disorder and experience four or more mood episodes within a year.DiagnosisPeople with BPD may have intense relationships with others.To diagnose either bipolar or BPD, a mental health professional will ask a person questions about their symptoms, including their severity and duration.They will also ask about the person's family medical history, specifically whether any of their relatives have or had a mental illness.They may use questionnaires to acquire information about symptoms and symptom history.A bipolar I diagnosis requires that someone has had at least one classic episode of mania that lasted for at least 7 days or required hospitalization.People who experience a major depressive episode and an episode of hypomania may receive a diagnosis of bipolar II.In cases where it is challenging to distinguish BPD from bipolar disorder, a doctor may focus on specific symptoms to help differentiate between them. These symptoms include:Sleep: People with Bipolar Disorder tend to have extremely disturbed sleep cycles during periods of mania and depression. People with BPD can have a regular sleep cycle.Cycling mood time: Aside from those with rapid-cycling Bipolar, people with Bipolar Disorder tend to have mood cycles that last for weeks to months. People with BPD usually have sudden, short-lived mood swings that last for a few hours or days.Self-harm: According to some estimates, 75 percent of people with BPD have self-harmed. They may see self-harm as a means of emotional regulation or a way to control unstable or intense emotions. Although self-harm is less common in people with bipolar disorder than those with BPD, the suicide attempt rate is higher.Unstable relationships: Many people with BPD have very intense, conflict-riddled relationships. People with bipolar disorder may have difficulty maintaining relationships because of the severity of their symptoms.Mania: People with Bipolar Disorder act impulsively when they are experiencing a period of mania. People with BPD also tend to act impulsively, but this behavior is unrelated to mania.Some additional information can help distinguish BDP from Bipolar Disorder including:Family history: Mood disorders, such as bipolar and depression, tend to run in families, although researchers have not yet identified a specific gene that is responsible. People with a close relative who has BPD also seem to have a higher risk of developing this condition.History of trauma: The cause of BPD remains unclear, but many people with this condition experienced trauma in their childhood or adolescence. Examples of trauma include abuse, abandonment, extreme adversity, unstable relationships in family life, and exposure to conflict.TreatmentIt can take some time and patience to find the right treatment plan for both BPD and bipolar disorder.Medication is not a standard treatment for BPD as its benefit is unclear, and there are no drugs that the U.S. Food and Drug Administration (FDA) have approved.However, some medications may help manage certain symptoms, such as depression and anxiety, if they are present.Psychotherapy, which may involve individual talk therapy or group therapy, is the most common treatment for BPD. Therapy can help teach people with BPD how to communicate and interact with others and how to express themselves.Some examples of the type of psychotherapies that can help treat BPD include:Dialectical behavior therapy (DBT): Experts developed this method specifically for people with BPD. It revolves around ideas of acceptance and mindfulness, as well as being aware of and attentive to one's current environment and emotional state. DBT may also help people reduce self-harm, improve relationships, and control intense emotions.Cognitive behavioral therapy (CBT): This type of therapy may help people recognize and change some of the core beliefs and behaviors that form their perception of the world. CBT may also help people with BPD learn how to interact better with others while reducing mood-related symptoms, anxiety, and self-harm.Doctors usually recommend a combination of medications, psychotherapy, and lifestyle changes to manage Bipolar Disorder. Some of the treatment options for Bipolar Disorder include:Medications: Medications called mood-stabilizers can help balance mood highs and lows. Other possible medications include anticonvulsants, antipsychotics, and other medications.Psychotherapy: Many types of therapy, including CBT, can teach people with bipolar to manage the challenges that their condition poses. Therapy can also help treat other mental health issues that can occur alongside the condition, such as anxiety, post-traumatic stress disorder(PTSD), and substance abuse.Self-management: People with bipolar may be able to control their highs and lows by learning to recognize the early signs and patterns of mania or depression. On noticing symptoms, a person can call their doctor and possibly make changes to their therapy or medication regimens before the symptoms become so severe that hospitalization may be necessary.Complementary health approaches: Exercise, meditation, mindfulness, yoga, and other stress-relief techniques may improve the mental well-being of people with bipolar and help them cope with their symptoms.OutlookTherapy can be beneficial in treating both BPD and bipolar disorder.BPD and bipolar disorder have some similar symptoms, but they are very different conditions. BPD is a personality disorder, and bipolar is a mood disorder.BPD can be challenging to treat. Research is ongoing to help develop new strategies to care for people with BPD and improve their quality of life.It can take time to find the best medication and the right therapist, so it is vital to keep trying.In general, a combination of medication and psychotherapy can be extremely effective for people with Bipolar disorder. Additional tools, such as self-management and complementary health techniques, may also help reduce symptoms and improve overall mental health.With effective treatment, people with Bipolar can often have extended periods without any symptoms.People with BPD and bipolar disorder have a higher risk of thoughts of suicide than the general population.Suicide preventionIf you know someone at immediate risk of self-harm, suicide, or hurting another person:Call 911 or the local emergency number.Stay with the person until professional help arrives.Remove any weapons, medications, or other potentially harmful objects.Listen to the person without judgment.If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.MEDICALNEWSTODAY PARTNER SOLUTION