We've been talking a lot about mental illness during this early part of May, which has been designated as Mental Health Awareness Month. Nurses and students with all sorts of psychiatric conditions have been coming "out of the closet" and sharing their stories with candor (and not a small amount of courage). We've welcomed several new members who joined in order to comment and, in some cases, tell a little about their own experiences. And so far, readers have been very gracious and even curious about the various disorders presented here.
As many Allnurses members are aware, I've been very open about my battle with bipolar disorder, formerly known as manic-depressive illness. But how much do you all really know about this complex condition? Here are a few statistics for you from the National Institute of Health:
Bipolar disorder affects some six million people in the U.S.
That's somewhere between 2 and 7 percent of the population who suffer from the illness at any given time. This includes patients with classic manic depression, which is called bipolar 1, and those with what's called the 'soft' bipolar diagnoses of BP 2, cyclothymia (AKA 'bipolar lite'), and BP-NOS, which is a provisional diagnosis meaning "We know it's bipolar, we just haven't figured out yet what kind you have".
Most people with bipolar disorder are also affected by addiction issues
Some experts estimate this number to be as high as 60-70% of all people diagnosed with the disorder, making it one of the most common co-morbidities. It is thought that the over-use of alcohol, drugs, and other substances is a form of self-medication. Even compulsive shopping can be a symptom of the illness. And almost all bipolar patients overdo something---even if the activity is ordinarily healthful---such as excessive exercise, attention to diet, volunteer projects, and church attendance.
A scary thought: Bipolar disorder carries the highest suicide risk of all the major psychiatric illnesses
That's 15-20% of all people with the condition who attempt suicide each year. The completion rate averages around 10-12%, but even that number is astronomical.....and tragic.
There are more statistics provided by the National Institute for Mental Illness, the Depression and Bipolar Support Alliance, and other trusted organizations for anyone interested in learning more, and I highly recommend Psych Central and the Healthy Living websites for articles and blogs written by bipolar individuals. But now I'd like to turn the reader's attention to the following list of signs and symptoms as they are experienced by real patients, including myself.
Mania is characterized by feelings of being "speeded-up"---speech becomes rapid-fire and incessant, much to the annoyance of others. Sometimes speech is also pressured and tangential, as if the person is afraid he'll forget what he needs to say next, or because ideas are coming so fast that the 'conversation' sounds like a string of totally unrelated topics.
Someone experiencing mania will often have bursts of physical and mental energy that enable her to create, to perform at a higher level, and to produce great quantities of work. (For example, one time during a manic episode I pressure-washed the front porch. For four hours.) But as good as it feels, this can be very dangerous, as the person may literally stay awake for days at a time and work or exercise to the point of exhaustion.
Unfortunately, mania is a siren song for those who spend more time in depressive episodes, because we feel GRRRRRRREAT! We think grandiose thoughts and experience a heightened awareness of sensory stimuli: I'm the king (queen) of the world! I can do anything and everything I want! And wow, look at all the COLORS!!
There is also a dark side. Some people with BP 1 will experience psychosis along with irritability and even rage, paranoia, and hypersexuality, which can ruin relationships and threaten health. Those with BP 2 experience a condition called hypomania, which contains most of the symptoms of mania but not at the same intensity. The dysphoric symptoms include irritability and irrational bouts of anger, distractibility, restlessness, and psychomotor agitation (which I can best describe as a "jumping-out-of-my-skin" feeling, or like I just can't find a place for myself). And common to both types of mania, we have NO insight that anything is wrong, and wonder why everyone is looking at us so strangely.
Depression is, of course, mania's "polar" opposite (hence the name of the disorder). This can encompass feelings of sadness, hopelessness, despair, and a desire to crawl inside ourselves to shut out the world. Some sufferers sleep or eat too much, others too little; some experience agitation while others can't get out of bed or off the couch. It's like a fog that creeps in until it envelops us in its cold, damp gloom, and sometimes it feels like the only way out is to end it all.
This is by no means a full analysis. Our symptoms and experiences are as different as we ourselves are; but as strange as it may sound to those outside our circle, bipolar disorder often confers on its victims the gifts of creativity and an extraordinary appreciation of life's beauty and grace.
We see the vivid colors of the world and smell its exquisite aromas; we thrill to the sounds of great music and sob inconsolably when a favorite pet passes on. And, as a friend of mine once put it, we see the world and everything in it as poetry: the highs, the lows, the joys, the pain, the wonder, the sheer intensity of it all......sometimes overwhelming, but almost always worthwhile.
