Some of the greatest minds of all time have suffered from bipolar disorder. For example, D. Jablow Hershman and Julian Lieb discussed Isaac Newton's manic depression in their book, The Key to Genius: Manic Depression and the Creative Life. This illness, one that many people fear, is all around us on a daily basis. According to The National Institute of Mental Health, about 2 million Americans, or 1 percent of the population, suffer from bipolar disorder in any given year.
Often times, the public's fear of this disorder comes from a lack of knowledge on the subject. Bipolar disorder is a very difficult disorder for patients to live with. Eliza (whose name has been changed for privacy) was diagnosed a year and a half ago and immediately placed on Depakote, a mood stabilizer. She said learning to live with her disorder is one of the hardest things to deal with in her life.
Les Fehmi, director of the Princeton Biofeedback Centre, believes that people have a model of bipolar patients in their head. According to Fehmi, the public sees them as having "a broken nervous system in the sense that the hormones are very much out of balance and treatment is thought of as replacing chemicals that are not in the proper ratio with other chemicals."
Fehmi, as well as others in his practice, believes that people misuse their systems, and this is why chemicals become unbalanced. He believes that most people merely treat the endocrine system, the system that regulates hormones, but that it is more important to treat that person's life and get them back to a position where they are functioning properly with a "normal physiology."
"At first I felt obliged to tell everyone as if they all knew and I had to justify everything," one patient wrote in her personal account of being bipolar, which she gave to the Mental Health Foundation in hopes helping others. "Manic depression is so difficult to describe and I don't know anyone with it. But hell, it's my illness. Only I have to understand it."
It is very important for a bipolar patient not only to accept the illness, but also to acknowledge the potential dangers it presents to their life. If bipolar disorder goes untreated, it can lead to increased suicide risk. Patients must realize this risk and put their consideration for a healthy life above their fear of facing the disorder and treatment.
Eliza explains that she only had one hypomanic episode before she was diagnosed.
"It was scary being so happy," she said. "I couldn't control how I drove or thought. I almost drove into a divider on the highway. I was lucky that I didn't kill my friends or myself. That was one of the scariest moments in my life, but when I look back on it, it's mostly just a blur."
The Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV, characterizes
depression as having to last at least two weeks. You must present at least five
of these symptoms during that time period to classify as depressed :
When Eliza described her depression, she said she was "constantly crying."
depressed mood most of the day, nearly every day
- markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day
- insomnia or hypersomnia nearly every day
- psychomotor agitation or retardation nearly every day observable by others, not merely subjective feelings of restlessness of being slowed down
- feelings of worthlessness or excessive or inappropriate guilt
- diminished ability to think or concentrate, or indecisiveness, nearly every day
- recurrent thoughts of death."
"I could hardly wake up to go to school and when I went I felt dead," she said. "I felt as if I might as well have never woken up at all. All I wanted to do was die."
In this short description of her feelings, Eliza covers four of the symptoms that the DSM-IV describes for depression.
A study was published in the Journal of Clinical Psychiatry that found bipolar patients believe their depression to be more disabling than their manic phases. This study goes against previous assumptions under which psychiatrists focused treatment on the manic phase rather than the depressive phase. With one side of the illness being kept under more control than the other, it becomes even more essential for patients to monitor their own mood and learn to cope with their disorder.
Because bipolar disorder is characterized by both extremely high and extremely low moods, those who suffer from it have more difficulty managing their lives. Going to see a therapist and a psychiatrist are both very important ways to keep on track.
According to the Mental Health Foundation, manic and depressive phases are caused by "biochemical changes in hormones and neurotransmitters." This is why taking medication, is an essential factor in staying healthy and balanced. The National Institute of Mental Health says "it is important to understand that bipolar disorder is a long-term illness that currently has no cure," though the "episodes of mania and depression naturally come and go." They also stress that the episodes may worsen once treatment is discontinued.
Although doctors are important in getting and staying better, they are not the only way to stay healthy. It is very important for patients to take responsibility for their own lives and learn ways to recognize symptoms and treat them prior to having a full-blown episode.
Manic and depressive symptoms require different forms of care, but they both need to be treated. The Mental Health Foundation suggests taking control for both up and down moods. They feel it is important to monitor and pay careful attention to the decisions made during these times. When a person is bipolar, it is very important for them to avoid alcohol and other recreational drugs. Sleep is another important factor in the fight to stay healthy. Not getting enough sleep can mean the emergence of a manic episode, while sleeping too much can imply the presence a depressive episode.
Staying in touch with friends and family also plays a major role in staying out of a depressive phase. When beginning to feel depressed, according to the Mental Health Foundation, one loses the ability to stay social, which can lead to even deeper depression. If a person does not stay social and cuts people out of his or her life, that individual ends up feeling more and more alone.
Because forms of psychosis may also accompany bipolar disorder, according to the National Institute of Mental Health, it is very important for a patient to learn to tell the difference between the delusions they believe to be true, such as the idea that "no one cares about me," from the reality, that those people do care. Without staying in touch with friends and family, it will only be harder to be able to tell the difference between delusion and reality.
Fehmi believes that stress-management is one of the most important aspects of treating bipolar disorder.
"Bipolar disorder is at least, in part, a stress related phenomenon," Fehmi said. "When techniques are used to treat physiology, symptoms diminish."
His method of treatment, which has had high success rates with patients, includes teaching people how to relate to the world in a way that makes them less stressed. When one section of a person's physiology relaxes, Fehmi believes their whole physiology relaxes, which leads to a healthy balances life.
Eliza explained that she sees a therapist and a psychiatrist regularly, which is a major help in stabilizing her life.
"It's hard with all the stress here at college, but I deal with it," she said.
Eliza also said that she tries to stay away from alcohol and drugs for the most part and when she starts to lose sleep she takes a sleeping pill.
"Sometimes I worry that I won't be able to deal with this forever," said Eliza. "It's hard with the medicine and then trying to relax when you are under so much pressure, but it's just something you learn to deal with when you have to."
For bipolar patients, it is very important that they regulate their life. Without recognizing they have a problem and learning to live with it, they could end up with worsening symptoms throughout their life, and, in the worst circumstance, committing suicide.
Proper treatment and care from a professional is essential, but home treatment is very important as well. When bipolar disorder is treated, it is not a scary thing. With two million people being treated for it yearly, it is being taken under control and those living with it are able to live healthy, normal lives.