Is bipolar disorder the cause of great madness or great genius? The symptoms of this mental illness may also be considered as the driving forces behind some of the most gifted and talented people to grace our society. Although individuals with this illness may have some obstacles to overcome, it can be accomplished. With all of the treatment programs that are widely available, people have many options and methods to turn to for help.
Bipolar disorder, also referred to as manic depression, is a mood disorder. A person with bipolar disorder will have extreme mood shifts between mania, a state of highly elevated euphoric feelings, and depression, a state of despondency and despair. These shifts can take weeks, days, or even minutes to happen. The period between shifts will vary for each individual, depending on the severity of the disorder (Williams & Wilkins, 1999, pp. 5-35).
Approximately two percent of adults have this mental illness, and about fifteen percent of those adults will attempt suicide. Bipolar disorder affects both men and women and the affected rates are similar between different cultures and countries. Most people with bipolar disorder experience their first mood episode in their twenties, although it is not uncommon to experience the first episode during childhood or in late life (Bi-polar Disorder: Innovative Research in Health, 2000).
Bipolar disorder is not a curable disorder, although it is treatable. Bipolar is “among the most treatable of the psychiatric illnesses” (Manic-Depressive/Bipolar Disorder, 2000). It is important for people who believe that they may need help to seek it as soon as possible because the earlier that bipolar disorder can be diagnosed the earlier treatments can start.
Even after experiencing an episode, even after sensing that something may be wrong, individuals who seek help may not initially receive the correct diagnosis from a medical professional. Because of the similarity of symptoms, bipolar disorder may initially be misdiagnosed as panic disorder, schizophrenia, or attention deficit disorder (Bi-polar Disorder: Innovative Research in Health, 2000). Bipolar may also be difficult to diagnose because the person seeking help may not be telling the doctor everything the doctor needs to know to correctly identify the problem. Medical professionals may only diagnose a person as having depression because they have no knowledge of the excessive enthusiasm that the patient feels. It is important for individuals seeking medical help to be accurate and thorough in describing their feelings or symptoms (Manic-Depressive/Bipolar Disorder, 2000).
A person experiencing a manic episode may have increased energy and/or racing thoughts. Feelings of euphoria and/or an increased pressure to talk may also be symptoms. A person in this stage of the illness may have uncharacteristically poor judgement and/or may be involved in some type of high-risk behavior, such as uncontrollable spending sprees, habitual reckless driving and/or participating in unusual sexual encounters and behaviors. Usually the individual denies that anything is wrong when in a manic state (Manic-Depressive/Bipolar Disorder, 2000).
A person experiencing the depression state of bipolar disorder may have feelings of worthlessness and/or guilt. Decreased energy and/or loss of interest in once pleasurable activities may also be symptoms of clinical depression. A depressed person may have trouble concentrating and/or have trouble making decisions. Depression may also leave individuals contemplating suicide (Manic-Depressive/Bipolar Disorder, 2000).
There are two classifications for bipolar disorder, bipolar II and bipolar I (Williams & Wilkins, 1999, pp. 5-35). The combination and degree of mania and depression determine the type of bipolar illness. It is also determined by how long each stage lasts and the time frame of euthymia, having normal moods, between stages. The cycling of stages may overlap, which is referred to as a mixed episode. The diagnostic system that is currently being used by mental health professionals is the ‘Diagnostic and Statistical Manual of Mental Disorders’ volume four, also known as DSM-IV (Manic- Depressive/Bipolar Disorder, 2000).
A patient diagnosed as having bipolar II disorder has or has had at least one episode of major depression and is experiencing or has experienced one or more episodes of hypomania. Hypomanic episodes have the same symptoms of mania only to a lesser degree. It is important for treatment to start now, to attempt the disorder from developing into bipolar I disorder (Bipolar Treatment, 2000).
Bipolar I disorder is the most severe form of bipolar disorder. Patients with bipolar I have full-fledged episodes of mania and experience major depressive states. These patients also have mixed episodes. In addition, some bipolar I patients may experience psychotic episodes. The symptoms of bipolar I severely affect the patients’ social and/or occupational functioning (Bipolar Treatment, 2000).
There are numerous treatment options for people with bipolar disorder. The patient and the patient’s doctor decide which treatment or treatments are best (Bipolar treatment, 2000). The options are chosen based on the degree of the disorder and the current circumstances surrounding the patient (Manic-Depressive/Bipolar Disorder, 2000).
The most predominant form of treatment is through psychopharmacology; the use of drugs that affect the patient’s the mood and behavior (What is Bipolar, 2000). Mood stabilizers, which are anti-depressants, anti-anxieties, and anti-psychotics, may be used alone or in combination to achieve and maintain a level of mental stability for the patient (Psychopharmacology Tips by Dr. Bob, 1999). These medications can significantly improve the patient’s disposition and demeanor (What is Bipolar, 2000).
Anti-depressants, used to treat clinical depression, come in two different chemical compounds, selective serotonin reuptake inhibitors, known simply as SSRIs, and monoamineoxidase inhibitors, also referred to as MAOs. SSRIs include the medications Zoloft and Prozac while MAOs include the medications Nardil and Parnate. Other anti-depressants are lithium (JAMA, 1999, v.281 pp. 23-32) and Depakote (Psychopharmacology Tips by Dr. Bob, 1999).
Some patients may experience abnormal apprehensions, in which an anti-anxiety drug may be needed to suppress the unnatural trepidation felt by the patient. Ativan and Valium are two of the most common anti-anxiety medications that are currently being prescribed to these patients (Psychopharmacology Tips by Dr. Bob, 1999).
In severe instances, usually patients diagnosed as having bipolar I disorder, an anti-psychotic medication such as Haldol or Risperdol may be needed. These medications help to control the excessive paranoia, uneasiness, and mistrustfulness that some bipolar patients feel (Psychopharmacology Tips by Dr. Bob, 1999).
Patients typically respond well to drug therapy. Psychopharmacology may be used alone or in conjunction with other treatments. One of these other treatments that may be used in combination with psychopharmacology, or used independently as treatment, is psychotherapy.
There are three major types of psychotherapy. They are insight therapies, cognitive therapies, and behavior therapies. Mental health therapy, by definition, is “the professional application of techniques intended to treat psychological disorders and reduce stress” (Rubin, Peplau & Salovey, 1993, p.492).
Insight therapies involve getting patients to discuss problems they are having and emotions they are feeling, which are thought to be the cause of their psychological dilemmas (Rubin, Peplau & Salovey, 1993, p.494). One such insight therapy is psychoanalytic therapy, developed by Sigmund Freud, which helps patients discover their unconscious motives and develop insights about how to adjust to them (Psychotherapy, 1990).
Cognitive therapies takes Freud’s therapy method one-step further. These therapies focus not only on what patients think, but also center on how and why patients think the way they do (Psychotherapy, 1990). Albert Ellis, a clinical psychologist, developed one type of cognitive therapy known as rational-emotive therapy. This therapy focuses on the irrational beliefs of patients and the techniques used to replace those beliefs with more realistic ones (Rubin, Peplau & Salovey, 1993, pp. 501-502).
Behavior therapies help the patients identify and change inappropriate behaviors (Psychotherapy, 1990). Systematic desensitization, a type of behavior therapy, seeks to replace negative thoughts with positive thoughts in relation to a specific fear or anxiety (Rubin, Peplau & Salovey, 1993, p. 502).
Psychotherapy may be conducted in private sessions, group sessions, or family sessions. Private sessions involve the patient and the doctor, group sessions include the patient and his/her peers, and family sessions are comprised of the patient and his/her loved ones. The benefit of any type of therapy treatment and/or any type of therapy session is the relationship that is created between doctor and patient. This relationship is built on trust, thus allowing the patient to feel more comfortable about discussing future problems or issues that may arise (Psychotherapy, 1990).
Hospitalization may be an element of treatment needed for patients under particular circumstances. Patients may be experiencing a severe bout of depression or a full-fledged manic episode. In these instances, hospitalization may be required to formulate the patient’s needed medication, adjust current doses of medications and/or to hold the patient in a secure environment to minimize the chance of self-injury (Bipolar Treatment, 2000).
Another method of treatment is through self-help This is when the patient endeavors in groups or research, outside of a doctors care, which help the patient maintain or even improve his/her mental condition. There are many support groups worldwide for people suffering from bipolar disorder, as well as an almost infinite number of resources available through local libraries or over the Internet. Self-help treatments are becoming more widely available because of the convenience of nearby support groups, updated libraries and personal computers (Bipolar Treatment, 2000).
Individuals with bipolar disorder may also turn to several alternative therapies for treatment. Some of these methods, while not openly discussed by mental health professionals, have statistical findings, which may lead patients to consider as usable methods of treatment. These methods include, but are not limited to, the ingestion of omega-3 fatty acids and magnet therapy.
One study compared omega-3 fatty acids, found in fish oils, with an olive oil placebo in individuals diagnosed with bipolar disorder. The preliminary findings indicated that patients receiving the fish oils “had longer periods of remission and performed better than the patients receiving placebos” (Archives of General Psychiatry, 1999, 56: pp. 407-416). This study is proclaimed to be a “landmark attempt in drug development” (Archives of General Psychiatry, 1999, 56: pp. 407-416).
According to a double-blind study at the Technion-Israel Institute of Technology, findings indicate that “magnetic stimulation of the brain eases severe depression” (Bipolar Treatment, 2000). Magnet therapy for mental illness can now be “backed up by scientific evidence” (Bipolar Treatment, 2000). Magnetic stimulation of the brain is capable of lessening the degree of depression in patients and “may become an alternative to electroconvulsive treatment (ECT), which causes painful convulsions and memory impairment” (Bipolar Treatment, 2000).
ECT is one of the most controversial treatments in psychiatry. The nature of the treatment itself is compounded with its history of abuse, detrimental media presentations, and powerful testimonies of former patients, giving it a negative reputation. This form of treatment is not administered lightly. The decision to offer ECT to a patient is based on his/her severity of disorder and nonresponsiveness to other forms of treatment. Although ECT does have some severe side effects, such as memory loss and identity confusion, it may still be an effective and needed form of treatment in some bipolar patients (Electroconvulsive Therapy BackGround Paper, 1988).
Another treatment method, psychosurgery, is also considered controversial. Psychosurgeries of the past included lobotomies, which bring to mind images of post-operative patients in an inanimate state of being. “The psychosurgery of today bears little resemblance to the grossly destructive technique” (Psychosurgery redux, 2000) that was once used in procedures such as lobotomies.
One of the procedures performed today, known as cingulotomy, uses a tool referred to as a stereotactic frame. With this new tool, surgeons can accurately burn away targeted brain tissue, causing “neither cognitive loss nor disturbing personality changes” (Psychosurgery redux, 2000) to the patient. Diagnosed bipolar patients, who have not responded well to other forms of treatment and/or those patients who are considered at high risk for suicide, may be candidates for psychosurgery (Psychosurgery redux, 2000).
Science and technology have made significant advances since the times of the ancient Greeks, when depression was thought to be caused by excessive black bile and mania to be caused by excessive yellow bile (Mondimore, 1999, p. 61). Today’s bipolar patient may receive proper and expedient treatment and may make use of any number of treatment options. Diagnosing bipolar disorder has become easier with the use of medical manuals such as the DSM-IV. Various treatment options have become more widely accepted since medical studies have provided convincing statistical findings. Today’s world provides bipolar patients with the opportunity to have long, productive, creative and happy lives.
People diagnosed with manic depression and those who suffer from it but have not yet been diagnosed, can be found in any social status and in any place. They may be a president, an artist, a homemaker, an actor, a homeless person, an author, or a neighbor. The simple fact is that they are all people. People with emotions, people who experience highs and lows, people just like every other person on the planet.
These people may have more difficulties coping with their surroundings. They may need help and support through medications, therapies, family, and/or friends. However, most of all, they need to be appreciated for their individuality, generativity, and creativity that they can offer to the world.
Two of the many productive and creative individuals suffering from bipolar disorder are George, a former student at Fernwood’s Devereux Center (Brandywine Programs Case Studies, 2000), and Joy, a homemaker, poet, and webmaster (Bipolar Disorder, 2000). These individuals have had to overcome many obstacles in their lives, but they have prevailed. They are now both enjoying happy, productive and creative lives.
George was sent to Fernwood, an all boys program, after being expelled from school for destructive behavior. An assessment found George to be suffering from bipolar disorder. At first he was frightened about the diagnosis, but now George educates others about bipolar, is involved in the community, and works at the local YMCA (Brandywine Programs Case Studies, 2000). He is just one example of a bipolar patient leading a productive life.
A fine example of a creative bipolar patient is Joy. She is the creator of a website entitled Bipolar, which can be found at www.frii.com/parrot/bip.html. Joy has educational materials, as well as fun facts and poetry, on her website. She uses her creative side to help educate others about her illness (Bipolar Disorder, 2000).
There are also a number of famous people with bipolar disorder. Edgar Allen Poe, Vincent Van Gogh, Abraham Lincoln and Marilyn Monroe, and all had bipolar disorder (Bipolar Disorder, 2000). These people are thought of as being exceedingly gifted and talented. Millions of people, across the world, would probably agree that these bipolars have definitely left their mark on the world.