Bipolar disorder (manic-depression) is a neurological disorder influencing mood. Without treatment, people afflicted by this disorder demonstrate extreme emotional fluctuations throughout their lives. Yet despite (or perhaps as a result of) the unusual intensity of the bipolar emotional roller coaster, many people with this disorder have been widely regarded as leaders and high achievers in a variety of fields of endeavor. A closer look at bipolar disorder seems to reveal a cycle of extremes from almost "superhuman" endeavor to utter voids of activity or motivation.
Emotional states associated with this disorder differ in magnitude and severity when compared to "normal" emotional states. "Happy" and "sad" do not seem to be the appropriate terms to describe what a person with manic-depression feels. A person with this disorder can swing from profound feelings of elation (mania) to feeling a little less elated (hypomania) to desperate feelings of hopelessness and helplessness (depression). Usually, there is a period of "normal" mood in-between peaks and valleys of mania and depression. However, the exact nature and severity of symptoms differ from individual to individual. Some people with this disorder experience more depressive episodes than manias, others experience the reverse. While some experience a few days of depression or mania, others experience weeks or months. Typically, depressive feelings tend to last longer than do manic feelings. And, a person who has this disorder can expect, on the average, ten episodes of either mania or depression within the span of their lives.
During my search for information on the Web, I found some vivid descriptions of the experience of bipolar disorder at an NIH web site (5). These testimonials regarding what it is like to experience the emotional states of manic-depression helped me understand the intensity of the disorder from the perspective of those who suffer with it:
DEPRESSION: "I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless....[I am] haunt[ed]...with the total, the desperate hopelessness of it all... Others say, "It's only temporary, it will pass, you will get over it," but, of course, they haven't any idea how I feel, although they are certain they do. If I can't feel, move, think, or care, then what on earth is the point?"
HYPOMANIA: "At first when I'm high, it's tremendous...ideas are fast...like shooting stars you follow until brighter ones appear...all shyness disappears, the right words and gestures are suddenly there...uninteresting people, things, become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria...you can do anything...but somewhere this changes."
MANIA: "The fast ideas become too fast and there are far too many...overwhelming confusion replaces clarity...you stop keeping up with it-memory goes. Infectious humor ceases to amuse. Your friends become frightened...everything now is against the grain...you are irritable, angry, frightened, uncontrollable, and trapped."
Estimates of the prevalence of this disorder within the general public range from between one and two percent. The disease, as a whole, affects men and women equally. There are also remarkable rate similarities between cultures and countries. Usually, people with this disorder experience their first episode of depression or mania in their twenties, though the age of first episode can occur later in life.
There are two separate classifications of bipolar disorder: Bipolar 1 and Bipolar 2. Bipolar 1 is typified by manic episodes followed by depressive episodes. Bipolar 2 is typified by hypomanic episodes followed by depressive episodes. Thus, people with Bipolar 2 never experience an all-out manic episode. Women are more likely to suffer from the Bipolar 2 form of the illness. I found a web site posted by Glaxo Wellcome Research & Development itemizing symptoms associated with bipolar disorder (1). Some of the symptoms of mania include:
1. increased energy, activity, restlessness, racing thoughts, and rapid speech 2. excessive euphoria 3. extreme irritability and distractibility 4. decreased sleep requirement 5. uncharacteristically poor judgement 6. increased sexual drive 7. denial that anything is wrong 8. overspending 9. risk behavior Some of the symptoms of depression include: 1. persistent sad, anxious, or empty mood 2. feelings of hopelessness, pessimism, guilt, worthlessness, or helplessness 3. loss of interest or pleasure in ordinary activities, including sex 4. decreased energy, feelings of fatigue 5. difficulty in concentrating, remembering or making decisions 6. change in appetite or weight 7. thoughts of death or suicide
There is still debate as to the cause or causes of bipolar disorder. Some argue that a virus is the cause of the disorder. However, very little evidence supports this theory. Others argue that the episodes associated with the disorder are triggered by stressful events in life.
The theory that has garnered the most support maintains that bipolar disorder is caused by a "chemical imbalance" in the brain. Levels of the neurotransmitter norepinephrine are quite high during episodes of mania and quite low during episodes of depression. Differing levels of the neurotransmitter serotonin have also been theorized to play a role in bipolar disorder.
Because Bipolar disorder seems to have at least some of its causative roots in biological "imbalances," there are a number of effective drugs now available to treat the symptoms and ease the problems associated with the disorder. For mood stabilization: lithium carbonate, divalproex sodium, and carbamazepine are effective. The action of lithium is unknown. It is hypothesized that the anticonvulsants like valproate and carbamazepine work because they have an effect on what is referred to as "kindling," a "process in which the brain becomes increasingly sensitive to stress and eventually begins to show episodes of abnormal activity even in the absence of a stressor" (2).
Perhaps the most interesting of my findings while I was researching this paper on the Web was the fact that so many famous and successful people have and have had this disorder. Some of those who are "no longer with us": Ludwig van Beethoven, Ernest Hemingway, William Faulkner, Samuel Clemens (Mark Twain), Charles Dickens, G.F. Handel, Peter Tchaikovsky, Irving Berlin, Cole Porter, T.S. Eliot, Victor Hugo, Michelangelo, Georgia O'Keefe, and Jackson Pollack. It was, however, sad to see that so many of those who had this disorder had taken their own lives. Of those listed above, Hemingway committed suicide late in his life. For a more complete list of people with bipolar disorder who have made noteworthy contributions to our world, see web sites such as http://www.pendulum.org/pwbpd/famous.htm ( (3). Rosemary Clooney, Dick Cavett, Kitty Dukakis, Peter Gabriel, Charlie Pride, and Ted Turner are some of the successful and famous people who are currently living and have stated publicly that they have bipolar disorder. Hopefully, with the treatments now available for their illness, they are able to lead less traumatic lives than other people with the disorder who were born before such treatments were around.
WWW Sources1) Glaxo Wellcome Research & Development, description of bipolar disorder page
01/03/2006, from a Reader on the Web
You have a nerve to say that Mark Twain had bi-polar disorder!
Thank you for your article. It was most insightful. I recently was diagnosed with Bipolar 2. I have had all these symptoms since I was a child. I wish that I had, had tx. earlier. It would have made my life more enjoyable. Lisa
I want to thank you for your fine job writing about the illness. You've done an excellent research and presentation of the disease. Testimonials you've included accurately captured the pathos of the illness; and most important to me personally, you thoroughly defined bipolar 2, a grossly unappreciated variation of bipolar.
For 20 years I've been diagnosed with bipolar/manic depression, seven years ago it was amended to bipolar 2. Until recently, I doubted bipolar 2 was a valid illness. My bipolar 2 symptoms were never quite the same as those of bipolar 1, and there was little information to be found about the inconsistencies.
The charismatic and bizarre mania identified with bipolar 1 is titillating. Because of notorious bipolar sufferers like Mary Key Letoureau, bipolar 1 gets all the media attention. In actuality, bipolar 2 is the more deadly. Individuals with bipolar 2 generally have hypomania, as opposed to full-blow mania of bipolar 1, but those with bipolar 2 experience longer and more severe depression increasing the risk of suicide. My psychiatrist forced me to understand that I had a fatal illness. Bipolar 2 is a subtle lethal disease.
Thank you Ms. Grosselink. I hope you won't mind that I've taken the liberty of copying your paper to my SU blog. Your work needs to be disseminated. Unfortunately, due to limited space, I have had to do some editing of your article that was not accredited, however I assure you the context is faithful.
Finally, to the creators of Serendip- thank you for your support of work like Ms. Grosselink's. You are doing a tremendous service ... Andrea Krueger, 7 April 2006
I have had depression since I can remember. The 1st time was when I was 4. It was the middle of the night. I heard a train, + it was sooo sad to me. I do\'t know why, but I cried all night because of it. Strange but true. Next time, my brother left his music on, again at night, I heard " A walk in the Black Forest" , a song,musical,which again was at night. I again cried + cried. I to this day, at age 52, cannot go to Funeral's or make it through a wedding song w/out sobbing!HMM?Ok,till my 1st. child, "baby blue's" for 4 month's. Mom had to stay w/ me the whole time. Went on Valium's. Got better there ever. Father died when I was 16 ,after a 7 year illness w/Cancer. Very devastasting. Then many problem's w/ marriage. Stuck it out for kid's. Did not want to hurt them w/ Divorce. Wrong, but oh well.Put myself 2nd, went on w/ my life. Kid's graduated. Life was good, Mom became ill w.COPD for another 7 year's,very davastating again.Watching the SLOW death of 2 parent's was almost too much for me! I was VERY suicidal for years, yes years. It is against my belief's ! I didn's want to go to HELL! But what + where was I to go ? My husband,of 35 year's+ ONE true friend was alway's there for me, but enough was enough. I had an Aunt who was an Alcholic, who had killed herself on Mother's Day! So I knew Gene's were playing a big role on both side's, Mom + Dad's side's. GOD, PLEASE HELP ME !! What am I to do??I know not what to do? I was in the deepest hole after the death of my Mom in 2004. Completely blew my world apart!! No one REALLY understand's this illness. I have lost MOST friend's + even some family memeber's find me too strange. Everything is great in my world, WHY SHOULD I BE DEPRESSED?? It is tireing trying over + over to try to explain it to NON- open minded people who just don't get it! So I just pray some day more people will understand it so I + so many other's will be more excepted for who we are. This illness can't be seen, therefore, no one really believe's. I swear I would rather have an outword illness , so people would at least know how ill we really are. But Mental Illness is almost seen as a FAKE thing, JUST GET ON W/LIFE! What's the problem? That's what people say? You have it SOO GREAT! Not SO!!!!! Please, people, get information be4 you judge the Mentally Ill. We are sick, not RETARDED!!!!!!! (nothing against retarded, they have their own problem's also.) Thank~you.P.S. I have tryed EVERY Med . from A~to~Z, ,now on Cymbalta 60mg's + Tryliptal 150~2 time's per day.Working great 4 me. Pulled me out of the dept's of HELL! PeGGy ~ GOOD LUCK TO ALL WHO ARE SICK OUT THERE! My prayer's are w/ EVERYONE! ... Peggy, 19 April 2006
Your research was very helpful to me. I was diagnosed with Bipolar II a few years ago. It sure explained my past back to my teens, I am 48 now. It also explains all of those suicide attempts. I've lost all of my friends and spend most of my time alone.I take a lot of medication. Sometimes I think the pills are making me sick and taking away my good days, but experience tells me otherwise ... Debbie, 22 April 2006
the first response "you have nerve,saying mark twain had bipolar" is exactly why people do not talk with their doctors or get help. the implication is that by saying Mr. Twain had this illness he was being insulted. It is still so prevalant to believe that a disease that is not seen (in your head) is a weakness, a character flaw. In America we are only a few generations away from when we used to lock women up in the mental wards for going through the change, where having a seizure was an abduction of spirit by the devil. I have recently been DX with bipolar 2, and feel the burden of this belief system painfuly ... Tonia, 16 May 2006
Great information...to bad some people can't take the truth, however funny they should refute such a strong article simply because of their reading preferences and ignorance ... Reader on the web, 7 September 2006
I was diagnosed with bi polar 1 about three years ago. I found your article to be a good representation of my illness. Thank you for writing such a helpful article. I am on medication that helps my life tremendously. I would encourage anyone with this illness to take every bit of help they can get. Although, some professionals can only try to understand what a person with Bipolar feels. It is nice to know that people like me have so much support. Alot of very talented people have bi polar disorder. They are of obvious worth. I feel that people that don't understand the illness seem to judge the people with bi polar through fear. It is my hope that people will educate themselves on the illness before they let themselves have preconceived notions about the individual. I usually don't tell alot of people that I have this illness because of the judgment that comes along with that confession ... Angelia, 13 September 2006
This article is very helpful and inspiring to me. Thanks ... Rachel, 25 September 2006
I am a 42 year old woman. I have suffered from manic depression since I was 16.
In the last 3 years I have been put on on 5 different drugs. I have suffered major reations and the poop out effect. If you are unaware that means it stopped working. I suffer from atypical reactions to the meds.I would like to know if you have any insights into cutters that does NOT invovle teens. I realize that cutting is not part of being bi polar. I also know that the risk of me committing suicide is high.I am am in the group that is very unpredictable. If you have any questions you can contact me at email@example.com ... Jackie Merritt, 1 October 2006
I found the resources and basic information you gave about Bipolar Disorder to be really helpful in the construction of my research paper. It was enlightening...to a point. You did not stress enough the effects of the disorder on society, a crucial point in my opinion. However, from a medical standpoint, it was excellent. You rock! ... Reader on the web, 9 November 2006
I have the manic and depressive episodes alternating all the time. I am waiting for a period of normality to click in as oppossed to others who have maybe only 1 -2 episodes a year. I am Lithium Intolerant - which landed me in hospital for 4 days when I lost control of my legs, hands and bladder, I lost my hair due to the side effects of Depakote, I have lost 2.5 stone, a quarter of my former weight. Olanzapine made me gain so much weight I had to be taken off that as well. The illness was only diagnosed after I tried self treatment - alcohol - even though I didnt know what was wrong with me. I spent a week in hospital after a blood test that showed my gamma level as one thousand six hundred. Normal acceptable liver gamma reading 18 - 78. I nearly died and would have except for my GP who, thankfully, had me hospitalised immediately. With that reading I should be dead. I was diagnosed over three years ago and now been told that I am treatment resistant. Medication is the only answer and those that say they can treat by diet and yoga etc. are just fooling themselves. This illness does not go away - it is a brain disorder which lasts for life. I had 14 cousins on my fathers side , two of which committed suicide and my father was hospitalised three times, albeit for depression. One of the other cousins is under psychiatric care at the moment. I would advise anybody diagnosed to take the drugs prescribed. They have controlled episodes in so many peoples lives. I'm just hoping that they can find a mixture of chemicals to treat my own disease. People need to know and accept that this is a chemical imbalance in the brain _IT DOES NOT GO AWAY! It can only be controlled by a combination of drugs and psychiatric care. Sorry this is so wordy but I felt I had to let people on the forum know my own experience. Still I havent given up hope - must be in manic state today or I wouldnt be writing this.
People try to relate to your illness. They havent a clue,no-one does unless they experience it. I could swing for people who glibbly use the term "Oh I am so depressed". If only they knew!
And on another cheery note I
had to give up work - I had a fairly good job and have been advised
that I will never be in paid employment again. When I saw this in
black and white it really brought it home. I already knew but couldn't
admit it to myself. With my loss of memory and lack of
concentration, irritability,lack of interest, anxiety and temper
outbreaks or my superwoman abilities, I wouldn't be safe left alone
managing a toaster. The only time I knew I was cooking something was
when all the smoke alarms went off all over the house!
It was something that I realised myself about a year ago (or it could have been two) unfortunately you lose time. I try and cheer myself up by thinking that the hours and the years are only time.
A question asked of me was "what do you do all day?" That had me stumped, I couldn't answer it, still can't.
I wish good luck to all sufferers.
There's a light at the end of the tunnel, yes you guessed, its a fire! ... Lori, 25 January 2007
my father suffers from bipolar 1 disorder. or at least he suffered before he got his medication. the medication has done wonders for him and my family. when i was little, before he was treated and diagnosed, he had manic episodes extremely often. he was very abusive and violent because of the disorder. it was very upsetting. being actually diagnosed made all the difference because before he started treatment my life and his was not easily lived day by day. thanks to various medications prescribed to him, he no longer shows any episodes of mania. he shows maybe the occasional depression episode, but its not severe ... Kay, 19 March 2007
This comment is for the first comment on the page. There are people out there suffering from this disorder and all you can think about is Mark Twain. Get over yourself. Also, to the person who started this site, I just wanted to say thank you for the insight. It helped me to better understand myself ... Christann, 24 April 2007
I was diagnosed with Bipolar 1 over three years ago and I lead a relatively normal life. I learned to "feel" when a depressive episode was about to hit and a most of the time I can stop it before it takes control of me. In my case my MP3 player is the one thing that can distract me away from the bad feelings and thoughts. I just grab my MP3 player and go for a walk around the block. The manic episodes are alot harder deal with though. If you examine your thoughts you can sometimes understand that you are not behaving normally but its very hard to stop yourself from doing these things. Its like someone has temporarilly high jacked your brain and you're just sitting there as a helpless bystander. I don't know if this helps anyone but I really hope it does. Bi-polar's not the end of your life ... Rosie, 29 May 2007
This article fits me. Now that I have a diagnosis, are there serious treatment centers out there that help a person manage this disorder. I've had 5 episodes. I stopped taking my medication when the mania set in. I believe I had breakthroughs with my medication because "it wasn't working anymore". Please write. I seriously need your help ... Patricia, 25 June 2007
i live with bi-polar one and your article was very insightful. it's so hard everyday to fuction normally. someone that does not suffer from the disorder cannot realize it's magnatude and should just keep quiet. You're article helped my husband to somewhat understand but he is still very much in the dark. i wish more people would try and open their mind otherwise they show their stupidity. to knock the illness just shows their lack of ability to understand something beyond their comprehension. They are naive and if they don't see it or feel it it doesn't exist. How can there be so many unintelligent people in the world ... Kristina, 13 November 2007
I was diagnosed with Bipolar 1 when i turned 17...my episodes happen on a daily basis. While i am on meds i have miniscule episodes, every once in a while I will have a little wobble however it is correctable by meds. It took me a long time to understand this. When I am not on meds I am completey crazy feeling. I cant stop my actions. This website is a basic informative for people who have family members with this disorder or have it themselves. Thank you for making it ...Jennifer, 17 December 2007
I am bipolar2 and feel very strongly that there is a genetic trait for bipolar.Both my Dad and my Grandfather were bipolar as well as my two brothers. There were others in my Dads family afflicted with this disorder..Both my Dad and Grandfather took their lives while in deep deprssion..I am 80 years old and am stabilized with the help of Lexapro and Depakote, although I still have mild episodes of depression. One odd thing about the times I was in manic mode is that I never overspent money. Perhaps this was because I grew up during the depression. I have no idea.However I did want to be around people and had ideas so fast that I could hardly express them. The other side of the coin was that when I was depressed, I wrote poetry and it simply flowed out of somewhere inside of me so fast that I could hardly get it on paper fast enough ... Bill Wisenbaker, 3 January 2008
My youngest child who is 27 with 4 children has just been diadnoised with bipolar 2. Some information on how to deal with it would be great ... Elaine, 5 January 2008