LAST MONTH, a
The truth is that bipolar disorder is more common than many people realize, and there are many families touched by it in some form--whether they've realized it or not.
My first specific awareness that someone in my extended family had long been struggling with bipolar disorder happened in the midst of my first big yard sale. The bizarre way in which those things so trivial can be paired with those things so grave was not lost on me. I had 15 strangers in my front yard, pillaging through a sea of my personal belongings when I got the frantic phone call from a sibling.
"He is just not himself," she said of our family member.
As my neighbors bartered over a lightly used double stroller, I was on the phone listening to a textbook list of symptoms: excessive spending, rapidity of speech, an extremely elevated mood, insomnia without being tired, agitation, some pacing.
It was one of those moments when you suddenly make sense of something that has been right in front
Even as I sold my favorite Barbie for a buck-fifty, pieces of a tumultuous past relationship began to fall into place.
MOOD EXTREMES
In this situation, I was "just a family member." The diagnostic and treatment plan was in the hands of the mental health professionals my family member sought out, and I could not spare our family the hardship of several misdiagnoses and attempts to find the right treatment.
It would take many months before we would manage to get the appropriate diagnosis and medication that would bring our loved one back to himself.
In that time, I learned more than I ever wanted to know about being a family member dealing with bipolar disorder.
Everyone has mood fluctuations. With bipolar disorder (previously called manic-depressive disorder), a person struggles with mood extremes. We call the periods of extreme mood disturbances "episodes."
Between episodes, those who struggle with bipolar may feel and act perfectly normal. During episodes, these extremes occur:
Mania, or a mood that is too elevated. A person can also experience hypo-mania, which is a less extreme version of mania.
Depression.
A mixed episode which involves both extremes is also possible.
By definition, bipolar disorder must involve at least one episode of each mood extreme. So a diagnosis is made, in part, by assessing a person's mood history.
But since a diagnosis of bipolar disorder involves relaying an accurate history of mood issues, someone deeply involved in a mood episode may not be in the best position to give an accurate mood history.
FAMILY INVOLVEMENT
While privacy laws are meant to protect individuals, I believe they can sometimes hamper the diagnosis and treatment of bipolar disorder. Without permission from the patient, a doctor cannot speak to family members regarding treatment.
If you suffer from bipolar disorder yourself, you may know that not all families are supportive, or particularly knowledgeable, about the illness. Sometimes the illness becomes the scapegoat for other family problems.
Even when families are supportive, bipolar disorder can be quite challenging.
One very informative book filled with good advice for people with the disorder, and for family and friends, is "Bipolar Disorder Demystified: Mastering the Tightrope of Manic Depression," by Lana Castle.
Like many, my heart is heavy for those who have lost a loved one to bipolar disorder. Getting the appropriate treatment can be an overwhelming, and sometimes impossible, struggle.
But be persistent. In so many cases, appropriate treatment restores a normal, healthy quality of life, as it did for my relative.
REGAINING CONTROL
In our case, medications designed to stabilize the mood were very effective. We found a good psychiatrist who had a healthy list of requirements for treatment:
A mandatory, ongoing prescription mood stabilizer
Psychotherapy to help learn about the illness and to help monitor mood issues
A signed release of information so that at least one designated family member would be free to communicate with the doctors.
So why do people avoid treatment for bipolar disorder? Some feel that treatment, particularly medication, will take away freedom and control.
But in the case of bipolar disorder, I believe it is the illness that robs people of their freedom, control and perhaps most importantly, their quality of life. Appropriate treatment can be what gives people that back.
Dr. Delise Dickard welcomes reader comments and questions. For contact information, see riversidecounseling .org.
While many people understand and recognize depression, I find that mania is often misunderstood. Mania--one of the mood extremes people with bipolar disorder experience--can involve seemingly positive elements like an elated mood or increased productivity. But it can also manifest as extreme anger or agitation, excessive spending, an unusual level of sexual promiscuity or extreme insomnia without feeling tired. And you don't have to experience all of the symptoms to qualify for a mood episode. Once a person is diagnosed, there still may be, in some cases, symptoms that prevent a person from effectively managing his or her own treatment. On the manic side, people may experience grandiose thinking: "I know better than all the doctors." Or, they may experience paranoia: "If I tell anyone what I'm thinking, they'll lock me away and throw away the key." On the depressed side, a person may be too depressed to do anything--even to drag themselves into treatment. If you think you or a loved one may be suffering from bipolar disorder, please seek professional help. Mental Health America of Fredericksburg (mhafred .org and 540/372-3709) can provide a list of local mental health professionals. If you are unable to see a psychiatrist as fast as necessary, the hospital emergency room is an option. To learn more about bipolar disorder in general, try Web sites including: mayoclinic.com nami.org nimh.nih.gov |
Dr. Delise Dickard a licensed professional counselor, is the director of Riverside Counseling in Fredericksburg. |