Bipolar Disorder—The Dis-ease of the Day?


Am I the only one experiencing this phenomenon or are more and more people we know being diagnosed with bipolar disorder (BD)?

Bipolar disorder involves periods of elevated or irritable mood (mania),
alternating with periods of
depression. The “mood swings” between
mania and depression can be very abrupt.
(National Center for
Biotechnology Information, U.S. National Library of Medicine)

In 2002, the World Health Organization produced the Bipolar disorder world map depicted below with the greatest impact of BD occurring in the red regions (as measured by the cumulative number of years lost due to ill health, disability or early death).

bipolar disorder world map

Bipolar disorder world map – DALY – WHO2002.svg

 

 

 

 

Disability-adjusted life year for bipolar disorder per 100,000 inhabitants in 2002.

less than 180

(yellow)              180–186

186–190

(lt. gold)              190–195

(gold)                  195–200

200–205

205–210

(orange)             210–215

215–220

220–225

225–230

(red)                    230–235

 

Whether this rising awareness is global fact or fiction, an increased prevalence of BD diagnosis is emerging in my colleagues and clients.  Some might argue my greater awareness is simply due to a greater willingness on the part of those with BD to shun the stigmatism of mental illness and talk openly about their experience.  Certainly, there is truth in this statement.  For someone who espouses self-compassion as a profoundly transformative healing behavior, I am delighted.  It means we are denting the “conspiracy of silence” pattern that predominated my youth and adulthood by offering ourselves loving kindness and eliminating self-judgment.

However, along with such good news travels some unanswered questions.  In my research on this topic, the general (though understated) consensus appears to be that BD is both difficult to diagnose and to treat.  Likely this correlates with the fact that there are no biological/laboratory tests or x-rays for BD.  The US National Library of Medicine states “the exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder. . .  Treatment strategies for children and the elderly have not been well-studied, and have not been clearly defined.”

Wikipedia counters with “the causes of bipolar disorder likely vary between individuals . . .  [Hereditary] results are not consistent and often not replicated . . . [and] evidence suggests that environmental factors play a significant role in the development and course of bipolar disorder.”

Foremost in my mind, is — if this illness is so poorly understood relative to cause, treatment and prognosis, why is the standard solution drug therapy?  In particular, such potent narcotics as mood-stabilizers, anti-depressants, anti-psychotics and addictive anti-anxiety medications?

I am reminded of the medical treatment many women in the late 60s and early 70s received for their “dissatisfaction with life” and “emotional depression” — valium.  When I was 16, I stayed with one of these women while she was medicated.  She was barely able to walk or talk while awake and slept 20 of the 24 hours in a day.  I had to wonder which was worse — the treatment or the disease?  The medical profession had its knuckles publically rapped for that faux pas.

Does this propensity for our medical model of illness to “deal drugs” to an already over-medicated society still prevail?  This is not to say that many drug therapies aren’t necessary and welcomed treatments but they are not the only healing tools available, and they typically are short-term interventions not long-term cures.  More importantly, when there is no identifiable biological connection, then what is being treated?  Just as when I was 16, are medical professionals administering drugs because it makes it easier for the rest of society to deal with mental illness?

The data suggests environmental stressors (recent life events, interpersonal relationships, traumatic/abusive experiences in childhood, post-traumatic stress disorder) significantly increase one’s potential for experiencing BD.  These stressors are on the increase globally and will not be going away in the near future.  They are typically treated and relieved with psychotherapy, which begs the question – Why isn’t psychotherapy a standard treatment practice for BD rather than merely a support methodology, as appears in most of the literature?

Why not use meditation, yoga, naturopathy or other holistic treatment approaches as well?  Countless research studies show the many benefits of these so called “new age” methodologies in relation to handling a variety of stressors.  Why aren’t these less invasive strategies prescribed first and pharmacology provided as a last resort?  Does it feel like the traditional healthcare arena still has an iron-clad grip on how we receive treatment?

 

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2 thoughts on “Bipolar Disorder—The Dis-ease of the Day?

  • April 5, 2011 at 11:20 am
    Permalink

    I am over three years into Long Term Disability for what was eventually a diagnoses of Bi-Polar Disorder. I started the three years following dibitating sports injuries including a fractured sternum. I also worked in a repressive, unstimulating job, with a conservative superior. I am gay and my work place was not a comfortable environment.

    My initial diagnosis was clinical depression. I began drug therapy and sought councelling. I went through several councellors and was unable to find one that fit. One issue with councelling is, it is very expensive to see experienced therapists (Dr’s of Psychology) and secondly, it takes at least an hour per visit; a long time in our $/service world. This is a major reason why psychtherapy is often only a supplemental option.

    Shortly after I started drug therapy with my doctor, I attended a HSC Program that included groups, meditation, nutrition, relaxation techniques and advanced drug therapy. In being seen on a daily basis, side effects and development could be watched and altered fairly quickly. Contributing personal factors were also realized and brought to the forefront as comfortably as people allowed. It is an excellent program.

    I use some of the techniques I learned in the HSC program. I believe they are very good at alleviating many symptoms of mental illness especially anxiety (which then reduces other symptoms).

    Normal psychiatric drug therapy provides a quick version of psycholcological review (family, environment, experiences), a check of symptoms, and a prescription. Normally it takes less than half an hour. It has taken three years of a very wide variety of drugs to get to the mostly stable state I am in now. It would be extremely difficult and scary to turn back. Services are provided by Manitoba Health although it is very difficult to get into see a psychiatrist unless you are admitted to hospital.

    My biggest pychological challenge is admitting I am bi-polar and therefore, have mental illness. At different times I have been extermely productive, hostile, unable to function, and suicidal. I am uncomfortable with the stigma and I certainly never thought it would have anything to do with me. I held many of the common beliefs about mental illness. My current councellor, a grad student, has worked extremely hard, through many sessions of my stubberness and refusal to hear, to bring me to the understanding that bi-polar/mental illness is part of my life, for life. This acceptance (sort of) has allowed me to talk about my (hard to say) mental illness. As a leader in the GLBT community, often standing front of hundreds of people while I was in an altered state, I have struggled and hidden the side effects and symptoms of mental illness for years.

    Now, I am comfortable sharing and even presenting, with the goal of opening the minds of others, my personal experience. I am willing to contribute in anyway to the work you and others are doing. I truely appreciate your efforts.

    Barb

  • April 7, 2011 at 10:35 am
    Permalink

    Thank you, Barb, for sharing the courageous details of your bipolar experience. I know many who will feel grateful to know there is a light at the end of the bipolar disorder (BD) tunnel. As you know, both those who experience the illness as well as their friends and family are often overwhelmed with feelings of helplessness and hopelessness.

    Your story is not the first in which a medical professional has said that BD is a life-long experience. Given that no biological or other cause has been found for this disorder, I question how anyone can state that its effects are permanent. In fact, I know an individual who, with committed “self-awareness” work, gradually and carefully weaned herself off the medication. I share this belief that “we can heal ourselves.” With patience, self-compassion and an understanding that BD took time to develop and so will take time to heal, we can create our own well-being.

    Peace, love and joy,
    Helen

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