Bipolar Disorder: Life Can Turn Tragic when Patients don't Take their Medicine

(March 14, 2006) -- Despite years of therapy, despite knowing that guilt and self-blame are futile, that what happened to one son, what still is happening to another, can only be explained by the stark vocabulary of a medical diagnosis, Linda Pardo wrestles always with a mother's grief, remembers with a mother's heart.

"I would lay in bed at night, and I would imagine these horrible things happening," she says. "Somebody stabbing Aaron, somebody raping Aaron. . . . None of that happened, but he still died a worse death."

On a summer day in 1994, Pardo's 23-year-old younger son, soaring on an arc of manic euphoria, climbed up a pole on an Amtrak platform in Philadelphia and, with emergency personnel hovering and news cameras whirring, inexplicably reached out and grabbed a power line. He was badly shocked. Still, says Pardo, "somehow he stood up and took the fireman's hand, and they helped him down and got him on the stretcher." Aaron hovered at the dim edges of life for 10 agonizing days, his skin seared black, his ears burned away. At 15, he had been diagnosed with bipolar disorder, a long-term brain illness that causes unusual, severe shifts in mood, energy and ability to function.

The disorder, which affects more than 2 million U.S. adults, must be carefully managed. When it is not, or when it cannot be because, as often happens, patients do not take the medicine that helps smooth their emotional peaks and valleys, families unravel, careers implode and life may turn violent, even deadly.

Bipolar patient Rigoberto Alpizar had not been taking his medicine last December when he allegedly made bomb threats aboard a plane. Federal air marshals shot him to death on the plane at Miami International Airport. In January, another bipolar patient, Troy Anthony Rigby, jumped from the cabin door of a plane in Fort Lauderdale and ran toward a terminal. Authorities stopped him with a Taser gun. He later died after a heart attack. Rigby's sister said he had not been taking his medicine.

"It's a very sad disease," says Pardo, 57, an addictions counselor who lives in Kendall. The Miami Herald has written about her before, in a 1995 story that chronicled the impossible choices and conflicting emotions of her doomed struggle to keep her family, and her sanity, intact, to save her children and, finally, when she eased away from them and moved to Miami in 1993, to save herself.

A petite woman with short, red-streaked hair who projects a compelling, often amazing sense of calm, Pardo is a recovering alcoholic who has been dry for two decades, and a two-time divorcee after marriages riddled with physical abuse and emotional instability. It took her years, she says, to understand that the definition of her life was "trauma all the time," to reach "a point where I knew I couldn't make it better."

Pardo's older son, Eric, now 36, was diagnosed with bipolar disorder when he was 19. He now lives in a facility in Miami. The condition often develops in the late teens or early 20s, occurring equally in men and women. "Many of us have different ideas about the cause," says Dr. E. Fuller Torrey, a psychiatrist and board president of the Arlington, Va.-based Treatment Advocacy Center, whose mission is to help people get treatment. The disorder's hereditary basis -- Aaron and Eric's paternal grandmother also was affected -- "is still very much in dispute," Torrey says. But, he adds, "None of us doubts there is a genetic aspect."

Diagnosis usually follows at least one episode of mania or hypomania, which is accompanied by a range of symptoms: insomnia that lasts for several days; a tendency to think and speak much more quickly and erratically than usual; a spate of irrational extravagance, buying things one cannot afford or does not need. The disorder has levels of intensity, and manic episodes may be framed by periods of severe depression.

Aaron and Eric, with four suicide attempts each, were regarded by their physicians as "severely bipolar," an unofficial category Torrey says "usually means bipolar disorder with psychotic features and reasonably resistant to treatment."

Torrey, who has been researching the condition for 35 years, says the vast majority of bipolar cases manage quite well: "I know successful people who stay on their lithium, and they're doing beautifully."

But Pardo's sons did not stay on their medicine. Its side-effects were unpleasant. It tamped their moods and impressions; it made their hands tremble.

"Medication compliance is a huge problem," Torrey says. "Being manic can be very pleasant. You think you're the smartest person in the world. You don't need sleep. . . ."

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At 17, Aaron enlisted in the Air Force only to receive a medical discharge six weeks later. Shortly before his 21st birthday, he cut up all his ID cards and left home. Police found him in Indiana three months later. As for Eric, Pardo will never forget the day they were driving in the car, and she pulled over to buy him ice cream. "He takes the car and puts it in drive," she says, "and he's laughing . . . , and he slammed into [another] car that was parked there, still laughing." At home, the young men would chain-smoke and gulp down cups and cups of coffee, cans and more cans of soda.

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Source: Miami Herald

Last updated: 3/06

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