Bipolar Disorder: It's more than Highs and Lows
By Tom Williams, LPC, LISAC Clinical Administrator, Banner Behavioral Health Hospital

Connie is visiting the neighborhood payroll loan shop where she has leveraged her wages again for the twelfth time in six months to compensate for her gambling losses. Her rent is a month late and she doesn’t answer her phone to avoid the collection agencies who hound her because she can’t come close to making payments on her $20,000 credit card debt. She vows she’ll never go to the casinos again— but there are those days and nights when she is filled with energy and an overwhelming compulsion to win the "big one", then her money problems will be solved.

 Brent walks through life with moods that alternate between crystal clarity and tireless enthusiasm with the numbing gray fog of depression and shame. He divorced his third wife six month ago. Like his wives before, she couldn’t cope with his unpredictable moods, drinking, and times when he didn’t come home for days. When Brent was home, he rarely spoke to her or the children.

 Bob was a full blown alcoholic by the time he was 17 years old. He was amazed at how alcohol made him feel "normal". At 19, while at a college party he was introduced to crack cocaine and a month later he set his apartment on fire while high. Bob entered treatment, stayed sober, yet yearns to have moods that don’t either drive him to bed or keep him awake for days.

 These are very brief summaries of painful lives that thousands of individuals and their families endure. More often than not, deep shame keeps intelligent, creative, people of values in a downward progression of destruction before they will seek help, if they ever do. Their dark path begins innocently as attempts to lift their depression and isolation, respond to uncontrollable impulses, and respond to periods of abounding energy.  

 These are stories not uncommon to individuals who suffer from, not only addiction, but Bipolar Disorder or Manic Depression. At the 1996 U.S. Psychiatric and Mental Health Congress, Kathleen Brady, M.D., Ph.D. an Associate Professor of psychiatry at the University of South Carolina, reported that "substance abuse occurs in 30% to 60% of patients with Bipolar Disorder and is more likely to coexist with Bipolar Disorder than any other acute psychiatric diagnosis" (1996). Overall, Bipolar Disorder affects approximately 3% of the people in the United States. The age of onset is usually in the late teens or early 20s and there is often a history of depression.

Studies also indicate Bipolar Disorder runs in families. Families where one parent has Bipolar Disorder there is a 27% probability the disorder will be passed on to the children and in families where both parents are affected, there is a greater than 50% probability one or more of the children will be affected.

Men and women are affected in equal numbers and it is noted that a woman’s first episode tends to be manic while men tend to experience a depressive episode first.

In the early 1900s, the German Psychiatrist, Emil Kraeplin was the first to formally describe Bipolar Disorder. He used the term "manic depressive" to explain how a person alternates between varying degrees of mania and depression. His work contributed to advancements in the formal treatment of Bipolar Disorder by leading advancements in the classification, treatment, and in predicting the course of this illness.

Generally the two states, mania and depression, are characterized by a few or more of the following symptoms:

• Mania

• Brief exaggerated or unrealistic beliefs about abilities, or powers

• Change in frustration tolerance; quick to become irritated and distracted

Delusions may also occur during manic episodes. An individual in a delusional state does not hold the same perception of reality of those around them. They may believe they possess great power or wealth and are greatly admired. In the most extreme cases individuals experience hallucinations which may pose danger to themselves and possibly those around them.

Many of the symptoms listed above, such as sadness at the loss of a loved one, temporary sleep or appetite problems, or anxieties are normal, just as moments of euphoria, irritation, or hyperactivity are a normal part of being human. When the feelings or behaviors are unpredictable, unusual, and/or are extreme it is important to seek information and support for yourself in addressing your own experience with these symptoms or someone you know.

As with any illness, prompt assessment and treatment are extremely important to help slow the progression of Bipolar Disorder. Although there is no cure, in most cases treatment can stabilize mood and help a person manage their symptoms. Treatment should include a thorough assessment and accurate diagnosis by a Psychiatrist/Physician who is knowledgeable about Mood Disorders, including Bipolar Disorder, and has a strong background in the treatment of these disorders with medication and remains up-to-date with the latest research.

Becoming educated about the illness and seeking, and allowing, emotional support, greatly improves the ability of the individual, with Bipolar Disorder as well as their family and friends, to find and maintain acceptance and stability. Without this acceptance of the diagnosis and use of ongoing support and treatment, many individuals and families experience increasing confusion, embarrassment and shame; and often greater and greater loss. The extreme and misunderstood behaviors associated with this illness can lead to social isolation, drinking and drug abuse, domestic violence, dangerous high risk behaviors such as; impulsive spending, impulsive sexual contact, and thrill seeking. Without treatment the consequences can be alcoholism or drug dependency, losses of jobs, careers, finances, friends, spouses, family, health, and life.

Connie, Brent, and Bob are fictitious people but the lives they portray are too often played out because of attempts to cope with and hope that "things will get better". Disorders such as Bipolar Disorder, Alcoholism, Depression, for example, are often compared to Diabetes, heart problems, and other chronic illnesses in that the conditions are progressive. The good news is with proper diagnosis, treatment, and support individuals with any of these conditions can slow and sometimes stop the progression while they lead fulfilling lives.

If you have further questions about Bipolar Disorder and where you or someone you know can find help, Banner Health system has four locations in the Phoenix area which offer evaluation and treatment. We are located In Scottsdale at Banner Behavioral Health Hospital; Mesa, on the campus of Banner Desert Medical Center; Glendale at Banner Thunderbird Medical Center, and Banner Good Samaritan Medical Center. To make an appointment please call the Banner HELPLINE at 602-254-HELP (4357).