Community Magazine July 2009

72 COMMUNITY MAGAZINE R ECOVERY FROM BIPOLAR Most people will have two to four extended family mem- bers and friends with bipolar disorder. The following list of recommendations compiled by Dr. Martin Keller, of the Department of Psychiatry and Human Behavior at Brown University Medical School, provides guidance for facilitat- ing optimal recovery from bipolar disorder: Get the correct diagnosis since many are misdi- • agnosed with schizophrenia or “just borderline personality”. Get effective treatment and ensure it is faithfully • continued for a lifetime. Fifty percent need only a mood-stabilizer, but the other 50 percent require the combination of a mood-stabilizer and an antipsychotic medication. Encourage adoption of a healthy lifestyle: regular • sleep and exercise, abstention from alcohol and drug abuse, low stress. Schedule regular visits with a supportive physi- • cian who is knowledgeable about the psychiatric management of bipolar disorder. Be sensitive to factors which seem to predict • the return of symptoms, and what additional “rescue” medication should be taken. Trust the warnings given by family and friends • when they see early signs of relapse. Learn as much as possible about the illness from • therapists, the web, books, or support groups. Depression is far from rare, affecting ap- proximately 19 million American adults at any given time and an estimated 6 percent of children ages 9 to 17 according to the Na- tional Institute of Mental Health (NIMH). Men and women experience and cope with depression differently. Men are more likely to acknowledge symptoms such as fatigue, irritability, loss of interest in once-plea- surable activities, and sleep disturbances. Whereas women are more likely to report feelings of sadness, worthlessness and/or excessive guilt. Men are more likely than women to turn to alcohol or drugs in response to depression, and to become frustrated, discouraged, irri- table, angry and sometimes abusive. Some men throw themselves into their work to avoid talking about their depression with family or friends, or engage in reckless, risky behavior. BIPOLAR DISORDER “Being labeled manic depressive was very hard for me. I felt ashamed and less than all other people. No- body understood me – heck, I didn’t understand myself.” “When I am depressed it seems like the world is grey and lifeless and that nothing good will ever happen again. But when I swing into manic mode the world is a place where I can make anything happen because I am king!” Bipolar disorder (also known as manic de- pression) is a mood disorder where a per- son’s mood alternates between the “poles” of mania (high, elevated mood) and depres- sion (low, depressed mood). With a preva- lence rate of 1.2 percent of the population, about 2.3 million adult Americans are af- fected by bipolar disorder according to the NIMH. Behavior during the manic phase is often irrational and inappropriate, with the patient unaware of his own behavior. These changes in mood (“mood swings”) can last for hours, days, weeks or even months. Like depression and other serious illness- es, bipolar disorder can also adversely af- fect spouses, family members, friends and coworkers. Dr. Paul Keck, professor of psychiatry at the University of Cincinnati College of Medicine, suggests that fam- ily members educate themselves as well as the patient about the condition. “Education helps people understand what is and is not within the control of an individual who has this illness.” This allows them to have more patience and compassion when dealing with the patient, and also aids them in recogniz- ing the pattern of extreme mood shift. Significant progress has been made over the years in the treatment of bipolar disorder. Dr. Keck asserts, “There has never been a time of greater hope for people with this ill- ness. There have been substantial advances in treatment in the last ten years. Twenty years ago, lithium was the only medication widely regarded to be effective. There are now a number of alternative mood stabi- lizers; there is a whole new generation of antidepressants for depression and another group of medications that may, over time, improve upon older mood stabilizers.” Next Issue: Postpartum and Teen Depression