Manic Depression

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Lori felt her life was always swinging out of control. From the day she was born, she was unhappy. She excluded herself from the outside world and hid within the confines of her bedroom for hours on end. Her self-esteem was low; she was insecure, paranoid and suicidal

When she started high school her condition got worse. After bouts of overindulging on Tylenol and diet pills, one of her friends began to get worried and finally approached Lori's parents.

The young girl was taken to her family doctor who prescribed lithium for depression. Lithium didn't work for Lori so she was referred to a psychiatrist who started her on different medications. After a year of seeing her psychiatrist, Lori started to have manic phases.

At the age of 15, Lori was diagnosed as a bipolar manic- depressive.

Healing Depression & Bipolar Disorder Without Drugs features Gracelyn Guyol’s own story and those of thirteen other people around the country who have cured their depression and bipolar disorder using only natural therapies. In-depth research and the expertise of alternative health-care professionals are included in this landmark guide for patients and caregivers seeking responsible, safe alternatives to psychiatric drugs.

Manic-depression or "bipolar mood disorder" is a disturbance of a person's mood, characterized by alternating periods of depression and mania. The term bipolar refers to the "two poles" of the continuum of mood, with depression or feeling down at one end and mania or feeling high at the other. Switching from one mood to another is referred to as a mood swing. The intensity and frequency of the mood swings vary with each person.

"When I was manic, I felt like I was on top of the world," says Lori. These episodes of mania usually bring increased mental speed, elation and easily aroused anger. At first, such a mood may make the person appear more socialable, but later their behaviour can involve potentially dangerous lapses of judgment, impulsive actions, and in the most severe forms, it can involve extreme agitation and loss of reason. Manic depression can send a person plunging from a high state in which one may believe one has superhuman energy and ability, into a pit of endless despair, where it seems the only escape is suicide.

"When you hit a manic stage, you always have a crash. When I crashed I felt helpless and incredibly depressed. I remember, at one point, lying out in the middle of the road wanting a car to come and hit me. Friends of mine had to carry me off the road because I wouldn't get up," says Lori.

Helplessness, sadness, loss of interest in daily activities, lack of self-confidence, anxiety and suicidal thoughts are some of the symptons experienced when dealing with depression.

"I also experienced massive anxiety attacks; I would feel claustrophobic, my heart would begin to beat really fast and I would start rocking back and forth," says. "I would become crazy. People would have to hold me down while I kicked and screamed. I felt like there was a demon inside of me ripping me apart."

Depression or mania is diagnosed if a person demonstrates a certain number of symptoms.

Interestingly, a mood change is not a necessary symptom for the diagnosis of depression or mania. Because feelings of sadness, disappointment and frustration are a part of normal living, the diagnosis is made only if such states are intense, pervasive, persistent and interfere with usual social and psychological functioning.

The causes of manic depression are uncertain. However, it is known that you can't develop the disorder from wearing black clothing or reading too many depressing news articles. You won't catch manic depression from the man sitting next to you on the bus. And you can't make yourself better by wishing it away or trying to "snap out of it."

There is no room for shame, blame or misinformation. Manic- depressive illness has been with human beings since the beginning of recorded time, yet it is only recently that certain discoveries have shed more light on the causes and effects.

Here are some factors known to play a role in the cause of manic depression:

- Heredity -- manic depression runs in families and may be carried by a gene inherited from one or both parents.

- Chemical changes -- manic depressives have chemical changes in the brain that are being studied to determine cause and effect.

- Stress -- situations that cause unusual stress, such as physical illness may trigger a manic-depressive episode.

"The first signs of being depressed are suicidal thoughts," says Lori. "Many people do experience such thoughts at some point in their lives but few people actually act on them. I would go to the extent of planning everything. Where and how I would kill myself, how my hair and make-up would be done, what I would be wearing."

In Grade 12, Lori attempted suicide.

"My mother always hid medications but she never locked them up. One night I took over 200 pills. I woke up in intensive care and then was admitted into the psychiatric ward because I was a harm to myself."

Lori was lucky to be alive and was fortunate enough to get help. People with manic depression often don't recognize that they are ill and because of this have not received proper treatment.

Manic depression can be controlled but cannot be cured.

It is essential that manic depressives find the medication that best suits him or her. It took Lori four and a half years to find the right medication.

"When you are depressed, your depression is your best friend," says Lori. "I was so scared to let it go because without it, I didn't know who the real me was. With the right medication I've come to realize that the real me does not need depression as a security blanket and I'm finally starting to feel happy."

Another key to successful treatment of manic depression is the person with the illness.

"If you start to have symptoms, get them checked NOW. If the illness goes untreated, it will only worsen your condition," says Lori. "When you see a doctor you have to listen to what the doctor tells you. You can't expect a quick fix. You have to keep strong while trying to find the right medication." Counselling and therapy can be helpful and support groups can offer important opportunities for people who suffer from manic depression, as well as their families, to gain emotional support and to learn about the illness and the mental health care system.

Such groups offer a chance to interact with people who have suffered from manic depresssion and have found ways to cope with the illness and overcome it.

Families and friends also play a vital role by offering encouragement and reinforcement. Family members should be supportive, be able to recognize the symptoms of manic depression and know how to obtain professional help, especially if the person has threatened suicide.

"I want some attention brought to the public about this illness so they can try to understand the pain and anxiety that manic depressives go through every day," says Lori. "I have met more than 20 students of all ages at my high school who are suffering from the same illness and are not getting anywhere. They feel like outsiders as well as myself."

Manic depression affects more than two per cent of the general population over a lifetime. Unfortunately, due to the stigma surrounding the illness, misdiagnosis and the tendency of parents and those with manic depression to deny that anything is wrong, only a fraction of these people ever receive treatment.

"I want the main attention to be focused on parents. Parents are scared and are ashamed. I want them to know that manic depressiveness is not an illness that will just go away. It is their responsibility, as parents, to get their children help. I am so tired of hearing parents say that it is just a phase and will go away."

It is also important that people with this illness remember that they are not alone, she says.

"I want teenagers to know that there is help out there. Teenagers have to realize that if you don't consider your family your family, then there is always someone or somewhere else to turn. You have to get up no matter how hard it is and want to get better. There are doctors for you to go to everywhere."

Identify Through Screening

DEAR ANN: I have been coping with manic depression for 14 years.

Most people understand how harmful depression can be, but it's difficult for some to believe that feeling good - actually ecstatic - could be bad for you. If you have manic depression, however, this euphoric state can have serious consequences.

Manic depression sets off a roller coaster of mood swings, alternating between the paralyzing lows of depression and the erratic peaks of mania. Manic episodes are often mistaken for drug- induced highs. The distinguishing feature is the feeling of "specialness."

This can include a sense of power, an irrepressible outpouring of generosity, bursts of creativity and boundless energy.

These feelings can produce hyperactive and risky behaviour, rapid and chaotic thinking and speech, bouts of insomnia, excessive eating, drinking and athletic activity, money-squandering and sometimes religious hallucinations.

All this activity took its toll on me. I had to deal with damaged relationships as well as bank accounts. These manic episodes culminated in intense depression and suicide attempts.

There are treatments that can control manic depression and help people cope. Please tell your readers the free screenings on National Depression Screening Day can help those who suffer from manic depression, as well as other forms of depression.

Monica in Boston

Dear Monica: Thank you for sharing your story. Manic depression affects almost 2.5 million American adults every year. Depression and manic depression often have their onset between 25 and 44 years of age.

Symptoms of depression include persistent sad, anxious or empty moods; feelings of hopelessness, guilt, worthlessness or helplessness; a loss of interest or pleasure in ordinary activities; decreased energy or a feeling of fatigue; difficulty concentrating or making decisions; restlessness or irritability; inability to sleep or oversleeping; changes in appetite or weight; unexplained aches; and thoughts of death or suicide.

Symptoms of mania include extreme irritability; excessive "high" or euphoric feelings; increased energy, activity, sexual drive and restlessness; racing thoughts and rapid speech; a decreased need for sleep; unrealistic beliefs in one's abilities or powers; abuse of drugs or alcohol; reckless behaviour and hallucinations.

Those who suffer from manic depression might go on shopping sprees and max out their credit cards, or gamble away their life savings. They might think they can read other people's minds. They might have sex with people they don't know or take a trip without making any plans.

If you see yourself in today's column, please follow through. It could make a huge difference in your life. If you have a friend or loved one who you believe may be depressed, do whatever is in your power to get that person to a screening site on National Depression Screening Day. It could be the greatest gift you will ever give.

Sick, but no one gave me flowers

TWENTY-EIGHT years ago I became very sick. I was in hospital for a total of 10 months. But no one gave me flowers or get- well cards. I received few visitors. This is because I had a mental illness, an illness some people thought of as shameful.

They did not say in so many words that it was something to be ashamed of, but people's unwillingness to discuss it and the tendency to hide its existence suggested it. Some people felt illnesses of the mind were brought on by the patients themselves. They felt sheer willpower could overcome it.

I had done nothing wrong. I was a ``good'' girl of 19, maybe a bit too innocent for my age. I worked hard at school and earned above-average marks. I had a small but good circle of friends. My dream since kindergarten had been to become a teacher. But something went wrong and it was not to be. I became ill. The feelings and thoughts I experienced were very scary. I ended up at Riverview. For a kid like me that hospital was a very depressing, disturbing place.

In recent years I have been diagnosed as having manic depression. Another word for this illness is bipolar mood disorder or simply, mood swings. In a nutshell this disorder is characterized by intermittent episodes of emotional highs (mania) and lows (depression). There is a lot of suffering with the lows and the highs can cause impaired judgment.

To have a mental illness means there is something biologically wrong with some aspects of how your brain is functioning. Appropriate medication can do a lot to help. People with manic depression function normally most of the time. Psychotic episodes only occur as a result of periods of extreme stress or because of insufficient medication. Manic depression has even been found to have some positive aspects. In some people it can bring about much creative activity. This has been the case with me. I thrive on art projects. I'm an accomplished photographer and I like to write.

You may remember the stigma that was at one time attached to cancer. People who had cancer were talked about in hushed whispers. Society has grown up and will now face this disease and its realities. There is a rallying of support for patients' welfare and for research. It is time this attitude was brought to the problems of mental illness.

People with mental illness are not unlike you; we have feelings, aspirations and ideals. We in ourselves are not different. It is our illness that makes us appear different and hard to understand at times. Understanding our disease would make us easier to accept.

I believe there will soon be a better awareness of what mental illness is. Support networks are growing stronger. They are doing a good job of educating the public. More research is being done than ever before. I can see the stigma gradually being stripped away. I now dare to write this article and reveal what I've for so long kept secret from all except a few.

Maybe the generation growing up today will create a better world for those with mental illness. Maybe my grandchildren, should they inherit my disease, will be supported by a caring community. And maybe, if they are sick and have to go to the hospital, someone will bring them some flowers.

Gene linked to manic-depression suspected by scientists

The largest study of its kind has found the approximate location of a possible gene for manic-depression.

Scientists found evidence that a gene somewhere in a particular portion of chromosome 21 promotes the disease in at least one of the 47 families they studied.

While investigators are reasonably confident that such a gene exists there, nobody can be sure until other research teams confirm the results, researcher Dr. Miron Baron said Monday.

Baron is director of psychogenetics at the New York State Psychiatric Institute, which is part of the Columbia University College of Physicians and Surgeons in New York.

Baron and colleagues at Columbia and in Israel report their findings in the November issue of the journal Nature Genetics. They said their study was the largest yet reported that sought a statistical link between manic-depression and a gene.

Dr. Wade Berrettini of Thomas Jefferson University in Philadelphia, who reported evidence in June that a manic-depression gene lies on chromosome 18, agreed that confirming studies will be essential.

Berrettini said he and some other scientists tried to confirm Baron's result in the families they were studying, but found no evidence for it.

If there is a chromosome 21 gene for manic-depression, it may be a relatively uncommon cause of the disease that would escape detection in the few families studied so far in attempts to confirm it, Berrettini said.

Manic-depression, also called bipolar disorder, combines episodes of mania -- which can include euphoria or irritability -- with bouts of depression. About one in every 100 people is thought to have it at some point in their lives.

Past attempts to find predisposing genes have been dogged by inability to confirm initially promising findings.

Baron said the strongest evidence for the apparent chromosome 21 gene comes from one family that includes 67 people whose medical status is known, including 18 with manic-depression or a related disorder.

The evidence for the gene in other families was less clear, he said.

CLUES

Notes on a disease:

Manic-depression combines episodes of mania -- which can include euphoria or irritability -- with bouts of depression.

About one in every 100 people is thought to have it at some point in their lives.

Scientists find that a gene somewhere in a particular portion of chromosome 21 promotes the disease in at least one of the 47 families.

Probing the causes of 'manic depression'

Dear Dr. Donohue: Is manic depressive disorder genetic? What are the chances of this being passed on to the next generation by an otherwise thoughtful, caring man? -- M.M.

Answer: Manic depression, now called "bipolar disorder," is a shift in moods from the depths of depression to a frenzy of limitless energy and unrealistic, grandiose and often foolhardy activities.

Genetics figures into the picture. Fifty per cent of those with a bipolar disorder had a parent suffering from either depressive or bipolar symptoms.

From a different point of view, a bipolar parent has around a 27- per-cent chance of having a child who eventually will suffer from depression or bipolar disorder.

A bipolar disorder is not a character flaw. It is not the result of inappropriate childhood rearing.

It is a brain disorder whereby chemical messengers, communicating information from one brain cell to the next, are in disarray.

Today there are effective medicines for controlling the roller- coaster mood swings of bipolar disorder.

Dear Dr. Donohue: My husband is 40 years old, six- feet, four- inches tall and weighs 225 pounds. He doesn't smoke, drink or take any drugs.

In the 20 years we have been married, he has had three peculiar episodes when he has gotten up to go to the bathroom. He has passed out or fainted.

We're both interested to know what this could be.

-- V.C.

Answer: Micturition syncope -- fainting after urinating -- is peculiar but not such a rare occurrence. Your description of your husband's episodes fits that reaction.

The urge to relieve a full bladder rouses a man -- and usually it is a man -- from sleep. As the bladder empties, it initiates a reflex that dilates arteries and slows the heart. Blood pooling in the legs along with the slow heartbeat robs the brain of its blood supply. A faint follows.

The faint is a protective mechanism. In the horizontal position, blood gets back to the heart and then to the brain.

If your husband sits on the toilet to relieve nature's call at night, he might escape fainting. Limiting alcohol also reduces the chances of micturition syncope.

I can't let your husband off the hook with that diagnosis. He needs to mention the fainting episodes to his doctor. Irregular heart rhythms could be at play.

Dear Dr. Donohue:

Please comment on tinnitus. The article I've enclosed mentions it can be triggered by medications but doesn't say what medications. Can you give me their names?

-- Anon.

Answer: There is a large array of medicines that can cause tinnitus -- ear ringing.

Aspirin leads the pack. The heart and blood pressure medicines verapamil (Calan, Isoptin) and enalapril (Vasotec) on occasion have induced tinnitus. Diuretics, such as furosemide (Lasix) and hydrochlorothiazide (HydroDiuril) have been implicated as well. Many anti-inflammatory drugs, including Indocin and Tolectin, can produce ear ringing. Xanax, a tranquillizer, and some antihistamines also are on the list.

Caffeine, nicotine and alcohol have been implicated as well.

Drugs are far from being the sole cause of tinnitus. There are more than 30 different conditions that can produce it. Ruling out medicines is only the beginning of a search for a cause.