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Bipolar Disorder and Suicide Risk

Physical Proof and a Big Shocker – Bipolar Disorder and Suicide Risk

Bipolar HeadI read a lot of news about bipolar disorder and other psychiatric disorders (OCD, ADHD, chronic depression, borderline personality disorder, etc.).  In my reading, I came across an article that describes brain scan abnormalities in teens and young adults who have attempted suicide but I found a lot more.

A study conducted at Yale School of Medicine examined brain scans of 26 young adults and teenagers with bipolar disorder who had attempted suicide.  These were compared with scans of 42 bipolar patients who had not attempted suicide and with 45 non-bipolar subjects.  The results were not really surprising – as many research studies are not.

The bipolar patients, who had attempted suicide, showed abnormalities when compared to the other two groups, specifically in the  which showed “less integrity”.

Frontal lobe animationThis means that the frontal lobe (which controls impulses) is not as “connected” to areas that control emotion, motivation and memory.  Researchers indicate that the brain abnormalities may disrupt the ability of the impulse control mechanism to filter emotion and motivational messages appropriately.

In short this means that those patients can’t stop negative emotions and impulses to do something drastic… like attempt suicide and not surprisingly, less integrity or more abnormality – likely means more suicide attempts.

While it is good that they are discovering some physical proof of actual defect, eventually to move bipolar disorder into a category that can be scientifically documented, it doesn’t offer a lot of real-life solutions.  Most of us who are bipolar or know someone who is bipolar, know that there is something wrong or at least different about our brain…and it only makes sense that a person, who is trying to kill himself, is probably a little worse off.

As usual, I found myself thinking “…and… the point is…” which I often do when I read a synopsis of a largely inconsequential research study but then something caught my eye.  It was something that was a lot worse than I thought – statistics.

About 4 percent of Americans are afflicted with bipolar disorder, though sometimes we feel like it is others who are afflicted.  That is not surprising either.  Some groups show a slightly lower percentage at about 2.6 percent of the population.

Bipolar SuicideWhat surprised me was the statistic regarding suicide.  The article – that is from a reputable source – indicates that 25 to 50 percent of people with bipolar disorder are likely to attempt suicide and that 15 to 20 percent are likely to succeed.  Wow.  I didn’t know that.  Funny thing that I didn’t know since of the 20 or so bipolar people I have been close friends with at one time or another – at least four of them are dead.

When searching for confirmation (which I found from the NIH that about 1 in 5 bipolar patients complete suicide), I also found a number of additional shocking statistics:

  • Bipolar disorder results in a 9.2 year reduction in lifespan
  • Bipolar disorder is the 6th leading cause of disability, worldwide
  • Bipolar disorder is found in all races, ethnicities, ages, genders and socioeconomic groups
  • A child with one bipolar parent has a 15-30% chance of having the disorder
  • A child with two bipolar parents has a 50-75% chance of having the disorder
  • There are 3.4 million CHILDREN with depression in the US but up to one-third of those kids may actually have bipolar disorder
  • Bipolar disorder criteria have likely been met for at least 1 percent of all adolescents

Maybe these aren’t shocking for you.  Maybe you already knew all this – but maybe you didn’t.

I have known I had bipolar disorder for a long time – and have known a lot more people with bipolar disorder and I didn’t know all this stuff or maybe like everything else, I chose not to remember.

Food for thought; Take your medicines!

Melissa Lind

What NOT to Say to a Bipolar Person

Stupid things said to people with bipolar disorder

Bipolar Disorder has become a bit more recognized lately, most likely due to the “coming out” of celebrities with outrageous behavior.  This has been good in raising awareness about bipolarity somewhat, but it has been bad because a lot of people think they know all about it.

In addition to not completely eradicating the stigma – it is also highly annoying when someone says something mean, wrong, funny, or even just plain stupid about bipolar disorder.  If you aren’t bipolar – don’t give advice to people who are.  Here are some of the things you should not do:

Don’t try to “join in”

Soo DepressedDon’t try to tell me you “know how I feel”.  Don’t relate your stories about how you were soooo depressed when your dog died.  Don’t try to tell me about how bad your insomnia is.  Don’t try to tell me about how you seriously almost destroyed a poster once or how embarrassed you were when…. Don’t.  Unless you are bipolar, you cannot understand the depression, the agitation, the anxiety.  I can understand that you want to show concern and make me feel “normal” but don’t.

Don’t tell me I should do better

Don’t tell me I can fix this.  Don’t tell me that I brought this on myself.  Don’t tell me to try harder.  Don’t tell me that it could be worse.  Don’t tell me that only religion can make me better.  I am doing the best I can; I didn’t want this disease, and frankly, I don’t want to hear it.

Don’t minimize

Don’t tell me to “snap out of it” or “get off my ass.”  Don’t give me platitudes like “this too shall pass” or “cheer up.”  Don’t tell me Not to Bipolar People“tomorrow will be better” or “everyone has a bad day sometimes.”  My disease, my experience is as bad as it is.  You can’t make it go away by acting cheerful or sympathetic.

Don’t try to shame me into being better

Don’t tell me that I am a real downer or that I am “dragging you down.”  Don’t tell me all about my bad behavior and how being around me is so painful – like “walking on eggshells.”  Don’t tell me about life not being fun…I already know.  If you don’t like it, it would be better if you just leave.

Don’t blame every disagreement on my disease

Don’t say anything about bipolar “shit” in the middle of an argument.  Just because I am angry doesn’t mean I am off my meds.  It doesn’t mean I am crazy.  Using my illness to win an argument is just plain wrong.  I have a right to be angry sometimes, and sometimes I am.

These are just a few things you should not do.  We have a lot of rules – some of which change just like us.

Happy Day!

Melissa Lind

Bipolar Disorder and Facebook – To Tell or Not to Tell

To Tell or Not to Tell – Bipolar Disorder on social media

I am an avid Facebook user.  Mostly I use it to amuse myself, keep up with old friends, get to know people who should be old friends but weren’t, update family on my kids and such… But, I also enjoy reading “pages” … pages about funny things and pages about serious things that only “we” understand are funny.  I am talking about bipolar” pages.

Facebook - Like PagesBecause Facebook lists updates of what pages you have “liked”, my relatives, who know I am bipolar, have been able to see that I am not keeping my disorder as a big secret from my social group.  Most everyone who is on my Facebook page already knows (or would guess) that I have bipolar disorder.  To them, it is not a big deal, it is just part of who I am, and in some ways actually explains part of who I am – manic-depressive, why I am the way that I am.

I bring this up because one of my “relatives” actually sent me an email “warning” me that I should “be careful” about what pages I frequent, referring to the bipolar pages.

That was one bit of unwelcome advice.  Another bit of advice might be to “unfriend” him or hide my activity from him.  I am NOT Bipolar - I have Bipolar DisorderHe is a close relative so “unfriending” him might cause problems.  I could hide my activity but have made a personal policy that if you are my “friend” then you can see my page.  I haven’t taken advantage of the “close friends”, “friends”, “acquaintances” – feature of Facebook – but then I don’t let anyone on my page unless they are actually someone I know.

The last bit of advice would be to ignore him.  Luckily, he is such a close relative that I have made a practice of ignoring his advice, as a child would ignore a parent.  I did just that – ignore him.

This situation was easy for me to solve under these particular circumstances but can be a lot of trickier.  I also belong to bipolar pages on LinkedIn, Google+ and other sites, and I sometimes wonder about the impact.  Fortunately, I happen to be a writer, and I am not in a situation where an employer (or potential employer) can make an objection to my diagnosis.

For others that are not the case – and it was not always the case for me.  There is still a huge stigma against bipolar disorder.  Technically, making an employment decision based on a mental diagnosis is illegal – it is against the ADA.

Technically, the employer could be in trouble for violation of federal law, but how many times do employers say outright” “I am not hiring you because…(insert problem here)”?  Likely they will not say anything – they just won’t hire you.  In some states, they can fire you for no reason (“at-will” employment states) or “not-for-cause”.

Technically, they should not hold this against you – if you are stable, and if you remain stable.  The question is – will you?  Hopefully, I will, but I can’t guarantee that.

Bipolar BearsIf I were looking for a job – a “real” job, I would seriously consider curtailing my social media and public announcements of “I am bipolar“.  As a writer – I shouldn’t do that, and I don’t.

You have to evaluate your particular situation.  Know that it is against the law to be discriminated against.  Know your history and likelihood that you will remain stable in your bipolar disorder and be able to do your job.  Decide whether a legal fight is worth it to you.  It may be; it might not be.  Decide whether you really want to work for someone who will hunt you down and discriminate against you based on the information they find.

For me, I am happy not being in a “real job “.  The same relative, full of warnings, is not happy about my lack of “real” employment – but I can just ignore him.  Either way, I am still Bipolar.

Melissa Lind

Living with Someone Who is Bipolar

Living with someone who has Bipolar Disorder can be difficult

Living with Bipolar DisorderI try (like many others I am sure) to keep Bipolar Disorder from wrecking my family.  I don’t always succeed.  In a lot of cases, it comes down to taking my medication on a regular basis (which historically I have not always done).  Even at the best of times, living with someone who has Bipolar Disorder can be difficult.  In some ways, it is probably harder to live with someone who is Bipolar than it is to be Bipolar yourself.

Having Bipolar disorder is just part of who I am.  It isn’t “good”, it isn’t “bad”, – it just “is”.  There are good days and bad days, but I expect that.  Just because someone else thinks I am having a “bad day” doesn’t mean that I experience it that way.  I don’t really know what it is like to live with someone who is Bipolar.  I only know what they say and how they seem to react.

InsaneLong before I was diagnosed, a roommate said to me, “living with you is like walking on eggshells”.  That kind of made me mad – and my response was something like “Well at least I wash my clothes”.  This had nothing to do with anything – except that she didn’t wash her clothes.

My husband once said, “Living with you is like waking up with a rabid animal.”  My thought was, “Then don’t talk to me when I wake up”.  In either case, I still believe that I wasn’t doing anything particularly wrong – unpleasant for them maybe – but normal for me.
There are some things that you can do to help yourself deal with a household member that is Bipolar.  Know these hints will not solve the problem, but they may make things better.

•    Don’t say things like, “I am not putting up with this Bipolar shit!”  First you will make them angrier than they already are. Second, you obviously are putting up with it, and they may feel compelled to remind you that you both live there, which will make you angry.
•    Do keep an eye on whether they are taking their medicationNormal and MiserableIf you can check on it in a prominent manner – do so, but likely you will have to sneak around them.  You can’t easily force them to take their meds, and subtle reminders will probably create an explosion. But you have to decide if the explosion is worth it – or just be prepared in case it is not.
•    Educate yourself so that you can see what “the disease” is, and what the person is.  Know that the disease is also a significant part of a person. Also, know that a lot of what you like about them is because they are bipolar.  While Bipolar Disorder makes things difficult, it also makes things interesting.
•    If you can watch for disruptions, try to be there to compensate.  Meaning; make sure children and other responsibilities are taken care of.  It does not mean that you must do all the work but remember you aren’t necessarily doing it for “them” but for the others that depend on them.
•    Try not to be angry at them for being who they are.  Again, part of what makes them interesting is the disorder and for a lot of use – we like who we are most of the time.  If you don’t like us, then leave.
•    Lastly, and most importantly – if you can, be there to pick up the pieces when it breaks – because with most of us, it usually will.

Whether it is a spouse, child, a sibling or roommate, you will have to make a decision.  If you can put up with the mental disorder, that’s great.  You can help them, but you can’t change them.  They can’t change being Bipolar, and criticism never helps.

Melissa

Living With Someone Who’s Living With Bipolar Disorder:

Living with someone who is living with bipolar disorderA Practical Guide for Family, Friends, and Coworkers is an essential resource for anyone who has a close relationship with a person who has Bipolar disorder.
This book provides a much-needed resource for family and friends of the more than 5 million American adults suffering from bipolar disorder. From psychotic behavior that requires medication to milder mood swings with disturbing ups and down, this book offers a warm and often humorous user-friend guide for coping with bipolar loved ones, colleagues, and friends.

The book includes Guidance for identifying bipolar disorder symptoms and how to get the diagnosis confirmed Strategies for dealing with rants, attacks, blame, depression, mania and other behaviors. The book includes crucial information on medication and its effectiveness, potential side-effects and techniques for dealing with attempts to self-medicate with drugs and alcohol.

How many people with bipolar disorders can care for themselves, get help, feel supported and go on with their own lives? This important book contains real-life illustrative examples and a wealth of helpful strategies and coping mechanisms that can be put into action immediately.

Bipolar II – Really?

Is it Bipolar II – or just plain Bipolar Disorder not yet recognized?

Google “Bipolar” on the “news” tab and see what you find.  It is astounding how many semi-celebrities have come out and said “I have Bipolar Disorder”.  Unfortunately, the story is often about Bipolar II, which somehow makes it “better”.

Bipolar Disorder is still a serious stigma – prevents people from getting jobs and such.  Technically, as Bipolar Disorder is considered a disability, an employer who did not hire or fired an admitted bipolar patient based only on that fact would be in violation of the American Disabilities Act, but few people are willing to go to the carpet on that.  Plus there is the little issue of being “able” to perform one’s job.  I can perform a job if I am taking meds.  If I am off of meds, I become highly unreliable with a lot of other liabilities – risky behavior that I have decided not to discuss.

Only a couple of years ago, I was warned by a well-meaning family member against posting too much on social media about Bipolar Disorder – and this in his mind included “liking” too many Bipolar pages.  He was concerned about my ability to obtain a decent job.  I don’t know if I have a “decent “job today – I have made my own way which works out better for me – no boss to annoy, no dress code, nobody else’s time clock.  For the most part, I don’t worry about social media – I don’t think I will ever have a “real” job again – no more frequent flyer miles for me.

Bipolar 2I was once diagnosed as Bipolar II – but really, both the doctor and the therapist thought differently – they both knew that I had regular Bipolar Disorder but wasn’t ready to accept it.  Actually, I am pretty sure my doctor tricked me into taking Lithium for the first time by telling me that it would help boost my antidepressant activity.

In retrospect, I am astounded that I believed him since I know so much about medication – but I took the medication.  How many of these people really have Bipolar I Disorder and just don’t say so.

It is much easier for people to say and accept that they have Bipolar II.  In my opinion (which is obviously vast and knowledgeable – just kidding, no really), Bipolar II is a way of sliding by the real diagnosis.  As in “I have Bipolar Disorder but not really”.  “I have Bipolar Disorder but I am not crazy”.  “I have Bipolar Disorder but I am not dangerous”.  “I have Bipolar Disorder but I won’t embarrass you”.
When it gets down to it…wasn’t that true for all of us at one time?  Or at least didn’t we believe it at one time?  I still fit some of the criteria – I am “functional”, “productive”, “hypomanic” – except when I am not.

I often confuse my doctor when he asks how it is going by saying “good enough”.  What I mean is that I am not manic exactly, I am not depressed.  Actually it works better for me if I am teetering on the edge of mania.  If I am just crazy enough that I know that I am crazy – then I will keep taking my meds.  Because I forget.

I originally sought treatment for severe depressiondepression bad enough that I had to decide whether to kill myself or study (I had a big exam the next day).  In retrospect, I was actually in a mixed episode with plenty of energy but in a really bad mood.  Oh, and then there was the slight issue of the hypnogogic hallucinations which I denied at the time.  See, even if I know that I have Bipolar DisorderManic Depression – I still forget.

It would be easier for me to say that I have Bipolar Disorder but it is “just” Bipolar II.  I thought that too.

Melissa

Bipolar Disorder and Risky Behavior

One of the most attractive facets of the “symptoms” of Bipolar Disorder is “risky behavior”

Even though this symptom irritates me, it is true. Actually, most of the medically described symptoms of the disorder irritate me.

Probably the reason this symptom bothers me is that like many others, I forget or wish to deny my own risky behavior.  I personally have wanted to think that I am, above all, that – and that my activities were justified which my therapist would say is oppositional behavior and really another symptom of Bipolar Disorder.

Not wishing to go into the specifics of risks that I have taken, I will say that upon honest examination, they have been many.  Because of Bipolar Disorder, I feel compelled justify them.  As a Bipolar, I could go on and write in circles about why I did what I did but really coming back to the same conclusion.  Technically, they have been justified, because I was ill.

Dangerious BehaviorExamples of risky behavior include things such as promiscuity, drug or alcohol abuse, shoplifting, gambling, excessive spending, infidelity, putting yourself in physical danger and others.  The obvious examples of this are celebrities who get into legal trouble because of risks they have taken – such as shoplifting, public exposure, public drunkenness, and drunk driving.  There is no logical reason for a celebrity to steal or shoplift as the things they steal “necessities” and that they can clearly afford to purchase.  There is also no reason for a celebrity to drive repeatedly drunk as they can usually afford a driver, and there is hardly ever a reason for public exposure.

Do I feel guilty for any of the risks I have taken?  Really, I don’t.  Were they against my moral values?  Really, they weren’t.  I certainly have regrets but no guilt.  I regret doing those things because of the trouble I caused and sometimes because they were things that others could judge me for.  Still today, even though I am well stabilized on medication, I am not sure they were against my morals.  Intellectually, I know that some of them were considered “wrong” or possibly illegal but that is the judgment of others, and my judgment system is different.

Guilt is defined as knowing that you did something wrong.  Shame is a judgment that others impose upon you to try and make you feel guilty.

Recently I read that bipolar patients wish to avoid feeling, choosing instead to think.  I agree with that (and I feel compelled to justify my agreement) by also adding that I also think that this is because people with Bipolar Disorder also feel too much.

Fortunately, today I am stabilized on medication and usually don’t exhibit risky behavior.  I haven’t had an episode in a few years – since the last time I quit taking my medication.

Melissa Lind