The Disorder Everyone Disowns

The movie “Touched With Fire,” the passing of actress Patty Duke, and World Bipolar Day on March 30 all have us talking about a mental health disorder that, for the most part, is rarely discussed. While a heightened awareness of bipolar disorder is a step in the right direction, health care advocates hope the chatter doesn’t stop.

Countless lives depend on it.

Bipolar disorder (or manic depressive illness) affects nearly 6 million Americans over the age of 18 in the U.S. alone, yet it is still a relatively unknown, obscure and unrecognized mental illness. That fact is tragic — because the disorder is highly treatable.

Patty Duke was one of the first celebrities to come out about her diagnosis decades ago. Since then, other celebrities have opened up about their ongoing mental health challenges to raise awareness of bipolar disorder and help destigmatize the condition.

Bipolar disorder most often presents in adulthood and causes dramatic shifts in a person’s mood, energy and ability to think clearly. You might have heard the term used casually or in jest about someone’s bizarre behavior. Manic and depressive episodes, however, can be debilitating, severely affecting a person’s ability to work or maintain good relationships with others. Sufferers can feel hopeless or worthless, and many consider suicide.

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“The individual’s mood shifts from extreme or moderate depression to extreme or moderate mania,” Dr. A.J. Marsden, assistant professor of human services and psychology at Beacon College in Leesburg, Florida, told LifeZette.

Recognizing the Signs
Depressive episodes of bipolar disorder include symptoms of what most people commonly associate with depression: feelings of sadness, emptiness, dejection.

Manic episodes, on the other hand, can run the gamut. “Elevated moods may result in goal-directed activities and increased confidence,” Jonathan Harland, M.D., site medical officer for the Harvard-Vanguard Burlington practice in Massachusetts told LifeZette. “However, they are more often associated with irritability, recklessness, impulsiveness, engaging in risky behavior like adultery or hard partying, and sometimes violence, although that is less characteristic.”

Changes can occur several times in a single day, even hour to hour, and the heightened, manic states are generally shorter than the depressive states.

[lz_bulleted_list title=”Signs of Bipolar Disorder” source=”http://www.nimh.nih.gov”]Extreme irritability|Restlessness|Impulsivity|Long periods of sadness|Loss of interests|Feelings of tiredness|Concentration problems|Social isolation|Thoughts of suicide[/lz_bulleted_list]

Yet, because we all have highs and lows, diagnostic criteria includes exhibiting at least three behavioral symptoms that last at least one week for a manic condition, and at least five over at least two weeks for a depressive condition. These symptoms must also impede a person’s ability to lead a productive life, and not be accompanied by other symptoms that are characteristic of other conditions.

It can be complicated to diagnose. In fact, up to 35 percent of patients can be misdiagnosed for up to 10 years, Dr. Gerald Maguire told LifeZette. Maguire is a clinical professor of psychiatry and chair of the psychiatry program in the School of Medicine at the University of California, Riverside.

Norman Sussman, M.D., a psychiatry professor and director of the Treatment Resistant Depression Program at NYU Langone Medical Center, said, “Bipolar symptoms present in many different forms and patterns. Individuals bring their own unique symptoms to the clinical picture. Unless there is a family member or physician who understands the patient’s history, they are usually diagnosed solely with unipolar depression. In these cases, prescribing an anti-depressant could induce either mania or more frequent mood swings.”

A misdiagnosis can make things far worse. “If misdiagnosed as unipolar depression, antidepressants can cause a bipolar individual to cycle rapidly between depression and mania, and lead to an increase in suicide attempts for bipolar individuals,” Dr. Marsden said.

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Perhaps the greatest challenge is that most people don’t recognize they have this disorder. It is often necessary for a family member, friend, partner, or doctor to witness the cycling behavior, then convince the person to seek treatment.

Mental health experts also say few people want to seek psychiatric treatment for something they either don’t see as a problem, or because they fear being stigmatized.

James M. Greenblatt, M.D., chief medical officer at Walden Behavioral Carf in Waltham, Massachusetts, told LifeZette that if left untreated, a person’s ability to lead a productive life is impaired. “I have seen financial ruin and relationships devastated by untreated bipolar disorder. Without appropriate treatment, mood swings are more likely to become more frequent and increase in severity.”

Dr. Harland offered words of encouragement: “We all have ups and downs. That’s part of being human. Bipolar disorder is an imbalance of chemicals in the brain that is easily treated with the proper dosage of various medications.”