MRI of the brain during "normal", manic and depressed moods
There are several stock responses when I tell someone I’m bipolar. “Oh, my dear, I can just imagine the hell you go through.” Or, “Oh sweetie, talk to me anytime. My great-aunt/mother/brother/wife/ daughter has it. I know all about it.” Well meaning but it’s pure horse hockey.
Another is: “We all get blue sometimes.” True, “we all” do just that. Someone dies, we lose our job or our kid gets sick. Or our house burns down while the firefighters stand there and do nothing. Any of these things alone is enough to depress anyone. But . . .
That is a situational depression. It is nowhere nearly as extreme in intensity or longevity. It isn’t so debilitating that you don’t want to get out of bed for weeks or months at a time. It doesn’t cause you to self-mutilate, or worse, to kill yourself. It may even last for a couple of years but not for a lifetime. And you can’t just talk yourself out of it.
Another is, “Well, gee, I have periods when I’m more energized than at other times.” Of course and that’s perfectly normal. You just got a raise, won some money, moved to that farm you’ve always wanted. Or, maybe it’s something simple like the sun shining and it’s a beautiful spring day.
But . . . This feeling of elation is thousands of miles away from the intensity and destructiveness of a manic episode. You don’t lose your judgment. You don’t make reckless decisions, spend boat loads of money you don’t have, or dance naked in a fountain, or self-medicate with drugs and alcohol.
Oh, there’s one more: “Well, I’m sure if you pray and talk to the Lord, you’ll be just fine.”
So what is this thing called manic depression anyway? What causes it? Is it contagious? Can’t you just take a pill to get rid of it? What are the symptoms?
According to the National Alliance on Mental Illness: “Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic and typically vary greatly over the course of a person’s life as well as among individuals.”
Too clinical. Too cut and dry says I. What are missing here are all the complexities of mood disorders, all the varieties which come in all sizes, shapes and even colors and the multitude of symptoms which overlap. There’s major depression. There’s manic depression. There’s schizophrenia. Each of them presents themselves differently and all of them have similarities, making diagnosis a complicated affair.
Even manic depression has variations on a theme. One is rapid cycling where moods go up and down like a roller coaster ride. The other is mixed states where mania and depression are experienced at the same time. Mixed states are bad enough. Rapid cycling is pure hell and they're both hard to control because just the tiniest dose of a medication, too much or too little, can send a person spiraling in the other direction. And there are even a few more, but that’s really getting too technical for this blog.
Scientists have been trying to find a genetic link to bipolar for decades, but so far it has eluded them. There was a huge study of the Amish about 15 years ago because they have such a high rate of bipolar and not a small amount of inbreeding. The study was a dud, unfortunately. But clinical trials continue at Columbia, John Hopkins, Duke and other major universities and centers. It is well documented that manic depression, and related mood disorders, is passed down through the generations.
A few cut and dry, but revealing, statistics from NAMI:
- Approximately 20.9 million – or 9.5 percent - of American adults over the age of 18 have some form of mood disorder.
- Manic depression affects about 5.7 million adults in America, or about 2.6 percent.
- The median age of onset is 32. (Note: children as young as six or seven are being diagnosed. More about this later).
- Ninety percent of people who commit suicide have a diagnosable mood disorder.
As mentioned earlier, bipolar is such a complex disorder that it is impossible to do it justice on a blog. What you’ve seen here and in my previous post (HERE) is a superficial look at best. But I think readers need this tiny bit of information to understand what follows.
Everything we experience is an extreme. There's no such thing as smooth sailing. It’s a stormy sea with periods when a body, mind and soul can be pushed to the depths, raised up in turmoil and only occasionally have peace and calm.