Bipolar Disorder
Depression: n. [ME depressen to push down < O. Fr. depresser < Lat. depressus p.part of deprimere : de-, down + premere, to press] A neurotic or psychotic condition marked by an inability to concentrate, insomnia, and feelings of dejection and guilt.
Mania: n. [ME, madness < L.Lat. < Greek] A manifestation of manic-depressive psychosis, symptomized by profuse and quick changing ideas, exaggerated gaiety (sometimes) and physical overactivity.
On March 28, 1999, I was officially diagnosed as having Bipolar Disorder, which is a disease characterized by the malfunction of certain neuro-transmitters in one's brain. Upon being diagnosed, I joined the ranks of millions of celebrities and lay-people, including Abraham Lincoln, Lord Byron, Patty Duke, Johnathon Winters and Robin Williams. I soon realized I needed to stop living life day by day and concentrate harder on living life breath by breath.
There is speculation as to the exact cause(s) of Bipolar Disorder, but the general concensus is that it is passed down from generation to generation. In fact, in studying people with this disease, one will find that that is often the case. My personal battle with this disease isn't that much different from others', but here is my story.
As long as I can remember I have been depressed. I can vividly remember coming home from first grade when I was six years old and crying uncontrollably because I wanted to die, but at the same time, I was terrified of death. I lived the next 18 years in a fog, crying most of the time. I spent countless hours thinking of ways to kill myself. I continually isolated myself from the people I loved because I couldn't let myself experience happiness. I didn't deserve it. When I went into fits of rage, I would take knives, box-cutters or my fists and repeatedly beat or otherwise mutilate my arms, legs, hands, knees, face, feet, thighs, stomach or chest. I deserved this. I was a horrible person and I needed to be punished. Or at least that's what I thought.
In early 1998, I began to lose almost all of my fine motor skills. I couldn't walk, make a fist, work, write or type. I was told that I had brain cancer and would soon die. As I prepared for my impending death, I obviously became very depressed and even more suicidal. When the doctors told me that I didn't have brain cancer, I was relieved but still so angry that I had lost so much time to this inexplicable illness that still wasn't gone. I sunk deeper and deeper into despair. On March 27th, two days after having an EMG (a tortuous battery of muscle tests), I was sitting at my desk reading and holding one of my cats on my lap. The only thing I remember is seeing a box cutter sitting on my desk near me; the next thing I remember is being covered in blood (this is how these episodes of self-mutilation would often occur -- I would be completely oblivious to what I was doing to myself.) I stayed up all night long crying, and called a psychiatrist in the morning. I honestly believe that it is that call that saved my life.
It was on this day that my life began to change for the better. Not only were my physical symptoms determined to be an allergic reaction to a certain medication I was taking, but I was diagnosed as Bipolar II RC (explanation to follow) and was immediately put on a combination of several anti-depressants, anti-psychotics and anti-seizure medications, and was placed as an outpatient in a psychiatric hospital in Houston. I went to several therapy groups as well as one-on-one sessions that did more than simply "lift my spirits." I wasn't the only one suffereng from this disease. I wasn't the only one who constantly wanted to die. I began to accept myself and my disease and eventually became comfortable with the fact that I will have to be on medication for the rest of my life.
That is my story. As I said, it's not incredibly different from other sufferers' stories, but as always each one is unique.
What follows is some helpful information I have taken from a website in order to help people understand the inner workings of Bipolar Disorder.
National Institute Of Mental Health
BIPOLAR DISORDER
Bipolar disorder (also called manic-depressive illness) is a mental illness involving episodes of serious mania and depression. The person's mood usually swings from overly "high" and irritable to sad and hopeless and then back again, with periods of normal mood in between.
Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness, and people who have it may suffer needlessly for years or even decades.
Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating compmlications. These include marital break-ups, job loss, alcohol and drug abuse, and suicide.
Here are some facts about bipolar disorder.
AWARENESS
Bipolar disorder has a devastating impact on many people.
--Almost 2 million Americans suffer from bipolar disorder.
--For those afflicted with the illness, it's extremely distressing and disruptive.
--Like other serious illnesses, bipolar disorder is also hard on spouses, family members, friends and employers.
--Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors.
--Bipolar disorder tends to run in families, and is believed to be inherited in many cases. Progress has been made in identifying a specific genetic defect associated with the disease.
D/ART: A national educational program
The National Institute of Mental Health (NIMH) has launched the Depression/Awareness, Recognition and Treatment (D/ART) campaign to help people:
--recognize the symptoms of depressive disorders, including bipolar disorder.
--obtain an accurate diagnosis.
--obtain effective treatments.
D/ART also:
--encourages and trains health care professionals to recognize the signs of bipolar disorder and utilize the most up-to-date treatment approaches.
--organizes citizens' advocacy groups to extend the D/ART program.
--works with business and industry to improve recognition, treatment, and insurance coverage for depressive disorders.
RECOGNITION
Bipolar disorder involves cycles of mania and depression.
Signs and symptoms of mania include:
--excessive "high" or euphoric feelings.
--a sustained period of behavior that is different from usual.
--increased energy, activity, restlessness, racing thoughts, and rapid talking.
--decreased need for sleep.
--unrealistic beliefs in one's abilities and powers.
--extreme irritability and distractibility.
--uncharacteristically poor judgement.
--increased sexual drive.
--abuse of drugs, particularly cocaine, alcohol and sleeping medications.
--obnoxious, provocative, or intrusive behavior.
--denial that anything is wrong.
Signs and symptoms of depression include:
--persistent sad, anxious, or empty mood.
--feelings of hopelessness or pessimism.
--feelings of guilt, worthlessness, or helplessness.
--loss of interest or pleasure in ordinary activities, including sex.
--decreased energy, a feeling of fatigue or of being "slowed down."
--difficulty concentrating, remembering, making decisions.
--restlessness or irritability.
--sleep disturbances.
--loss of appetite and weight, OR weight gain.
--chronic pain or other persistent bodily symptoms that are not caused by physical disease.
--thoughts of death or suicide; suicide attempts.
Some people with untreated bipolar disorder have repeated depressions and only an occasional episode of mania (Bipolar Type II.) In others, mania or hypomania (a mild form of mania) may be the main symptoms and depression may occur only infrequently (Bipolar Type I.)
Hence, when someone is diagnosed as bipolar II, (s)he spends more time in the depressive phase than in the manic phase. RC simply signifies someone who cycles rapidly between the two poles; instead of the usual months or years in between cycles, the RC person spends weeks, days and sometimes only hours in each cycle. --JV
Symptoms of mania and depression may be mixed together in a single episode of bipolar disorder.
Recognition of the disorder is essential so that the person who has it can obtain effective treatment and avoid the harmful consequences of the disease, which include destruction of personal relationships, loss of employment, and suicide.
Bipolar disorder is often not recognized by the patient, relatives, friends, or even physicians.
--an early sign of bipolar disorder may be hypomania -- a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior.
--Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.
--Also in its early stages, bipolar disorder may masquerade as some problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance.
--If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged mania and clinical depression.
TREATMENT
Most people with bipolar disorder can be helped with treatment.
--Almost all people with bipolar disorder -- even those with the most severe forms -- obtain substantial relief from their symptoms.
--One medication, Lithium (Li), is usually very effective in controlling mania and preventing the recurrence of both manic and depressive episodes. Other medications are also available and may be of significant value.
--For the treatment of depression, several effective medications are available.
--Electrolconvulsive therapy (ECT or electro-shock treatment) is often helpful in the treatment of severe depression that does not respond to medications.
--Psychotherapy may be very helpful in providing support, education, and guidance to the patient and his or her family.
GETTING HELP
Anyone with bipolar disorder should be under the care of a knowledgeable physician, typically a psychiatrist. The physician should be skilled in the diagnosis and treatment of this disease.
Other mental health professionals, such as psychologists and psychiatric social workers, can assist in providing the patient and his/her family with additional approaches to treatment.
Help can be found at:
--university- or medical school-affiliated programs.
--hospital departments of psychiatry.
--private psychiatric offices and clinics.
--health maintenance organizations.
--offices of family physicians, internists, and pediatricians.
People with bipolar disorder often need to get help.
--Often people with bipolar disorder do not recognize how impaired they are or blame their problems on some cause other than mental illness.
--People with bipolar disorder need encouragement from family and friends to seek treatment.
--Family and friends and the family physician can "propel" the person toward treatment by insisting that something is wrong and that the attention of the mental health professional must be sought.
--Some people need even more belp, and must be taken for treatment. If the person is in the midst of a severe episode, he or she may have to be committed to a hospital for his or her own protection and for much-needed treatment.
--Ongoing encouragement and support are needed after the person obtains treatment, because it may take awhile to discover which therapeutic regimen is best for that particular patient.
--It is important for patients to understand that bipolar disorder will not go away, and continued compliance with treatment is needed to keep the disease under control.
--Many people receiving treatment also benefit from joining mutual support groups such as those sponsored by the National Alliance for the Mentally Ill (NAMI), the National Depressive and Manic-Depressive Association (NDMDA), and the National Mental Health Association.
--Families and friends of people with bipolar disorder can also benefit from mutual support groups such as those sponsored by NAMI and NDMDA.
For Further Information Contact:
National Institute of Mental Health
Parklawn Building, 15C-05
5600 Fishers Ln.
Rockville, MD 20857
301.443.4513
National Alliance for the Mentally Ill
1901 N. Ft. Myer Dr. Ste 500
Arlington, VA 22209
703.524.7600
National Depressive and Manic Depressive Ass'n
Merchandise Mart, Bx 3395
Chicago, IL 60654
312.939.2442
National Faoundation for Depressive Illness
245 Seventh Ave., 5th floor
New York, NY 10001
212.620.7637 or 1.800.248.4344
National Mental Health Ass'n
1201 Prince St.
Alexandria, VA 22314-2971
703.684.7722
MESSAGE
This information was produced by the National Institute of Mental Health (NIMH), the U.S. Government agency that supports and conducts research to improve the diagnosis, treatment and prevention of mental illness. NIMH-supported studies alleviate suffering and bring hope to people who have a mental disorder, to those who are at risk of developing one, and to their families, friends and co-workers. Thus, mental health research benefits millions of Americans and reduces the burden that mental disorders impose on society as a whole. NIMH is part of the Alcohol, Drug Abuse, and Mental Health Administration, a component of the U.S. Department of Health and Human Services.
Lewis L. Judd, M.D. Director, NIMH
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