Bipolar Disorder: 5 Things Everyone Should Know

June 30, 2009

Not too long ago I wrote a guest post for Urban Monk, in which I mentioned some of the symptoms of Bipolar Disorder. Several people wrote to me asking for more information about the disease since they, or others they knew, were struggling with it. I am no expert on this subject, nor am I a medical professional of any sort… but I lost my dad and my dear friend to BD, and I’ve learned a few things about it that I can share with you.

Here are five things I think everyone should know about Bipolar Disorder:

1.  Bipolar Disorder can be extremely isolating. Most people will never understand what you are going through as a patient, or as a caregiver to someone who suffers from BD. Until the symptoms get tremendously out of hand, it is easy to mistake the beginning of a manic episode for the patient just being in a really good mood.

I will never forget how frustrating it was when my siblings and I recognized the early warning signs of a manic upswing in my dad. We would try to get him to take the appropriate meds, and get help. But he, of course, refused… he was finally feeling great and didn’t want that feeling to end. Then he would tell anyone who would listen that we were conspiring against him, trying to get him “locked up” for our own selfish reasons. His friends would say, “Can’t you see he’s finally happy? Why do you want to take that away from him?” Then, inevitably, it would get out of hand and they would come running to us to do something, anything, to help him.

2.  Managing Bipolar Disorder is incredibly frustrating. One the one hand, you feel isolated since most people don’t understand the disease. On the other hand, the medical professionals you turn to for help don’t understand it much better. The current system of treatment and medication for the management of this and other mental illnesses is woefully inadequate. We’ve come a long way since “One Flew Over The Cuckoo’s Nest,” but we are nowhere near a good solution.

Psychiatric hospitals are not fun to be in. The care you receive there is minimal and sometimes misguided. Billing and insurance issues are a nightmare. About the only thing these places are good for is to keep the patients from hurting themselves or others. It’s basically adult daycare, since most of us can’t spend 24 hours a day making sure our bipolar loved one isn’t getting into some kind of trouble. The system is awful, and frustrating; but it’s the best we’ve got.

3.  There IS always hope. One of the best success stories I have found is the book An Unquiet Mind: A Memoir of Moods and Madness, by Dr. Kay Redfield Jamison. She is a psychiatrist who also suffers from bipolar disorder. What is encouraging about her story is that she has found a way to deal with the disease and still keep her career and life relatively normal.

What works for her may not necessarily work for someone else… but at least it means that some semblance of recovery is possible. I believe anyone can effectively manage this disease if they first admit they have it, and are willing to do whatever it takes to get well. Usually this means trusting someone else more than you trust your own brain, thoughts, or feelings. It isn’t easy, but it can be done.

4.  Recognizing the fulcrum is vital. The key to managing bipolar disorder is learning to recognize the fulcrum, or tipping point, from one extreme to the other. When my dad was so depressed he needed to be institutionalized and given electroshock therapy, he was released from the hospital with a prescription for anti-depressants. As he started to feel better, we were all happy that his medications were having the desired effect. But at some point, not-depressed became a little too happy.

Eventually my siblings and I got quite skilled at recognizing that transition point, at which he needed to  stop taking the anti-depressants. If he continued on them, he soon became manic and got himself in a world of trouble. The problem with my dad was, he never trusted anyone or anything but his own thoughts. So when we tried to adjust his medications, he thought we were purposely trying to keep him depressed, and he fought us all the way. You simply cannot help someone who refuses to be helped.

5.  Recovery requires a tradeoff. One of the things that makes it difficult to manage this disease is that the patient must be willing to give up the highs to avoid the lows. The manic highs and delusions of grandeur can be so incredibly addictive that sometimes the patient doesn’t want to give them up. It’s a little like a toxic relationship — an emotional roller coaster between horrible abuse, and incredibly amazing “good times”. Many people are unwilling to walk away from abusive relationships because the good times are so very wonderful. It’s kinda like this with Bipolar Disorder and other mental illnesses… at least in the early stages.

You may recall the movie A Beautiful Mind, in which John Nash KNEW he had a problem (in his case, Paranoid Schizophrenia) but hated to take the medications because they dulled his thoughts. He was incapable of his amazing mathematical insights when he was medicated with anti-psychotic drugs. It isn’t an easy decision to make, giving up the thrills of the high; but it’s one I fear is necessary in order to avoid the very real dangers of the lows.

If you, or someone you know, suffers from Bipolar Disorder, I strongly encourage you to pick up a copy of An Unquiet Mind: A Memoir of Moods and Madness. It is a great starting point on the journey to recovery. It’s a long road, but the chances are good that things can get better along the way.

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Posted in Overcoming Challenges, balance, depression, mental health