Bipolar Disorder: Two-Sided Trouble

The public's understanding of bipolar disorder is often flawed, especially when it hits celebrities.

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The Anatomy of Inner Turmoil

According to the American Psychiatric Association (APA), people with bipolar disorder, commonly known as manic depression, usually suffer extreme mood swings, cycling from mania to depression.

In the manic phase, they usually feel invincible, euphoric, hyperactive, and very productive. This could lead to excessively risky behavior, grand delusions, uncontrollable thoughts and actions, irritability, rage, and insomnia. In the depressed phase, they can experience intense sadness, despair, fatigue, insomnia, difficulty concentrating, changes in appetite, and constant thoughts of suicide.

Robbins once described his problem as 'a battle within your head.' Spector explained his as 'devils inside that fight me.' These are two examples of the emotional challenges affecting the lives of millions of people. The Depression and Bipolar Support Alliance (DBSA) reports that 2.5 million adult Americans suffer from the chronic disease; other countries reportedly have similar rates.

The good news is that effective treatments exist for manic depression, including medication, counseling, and sometimes a mix of both. The bad news is that many people don't take this life-altering remedy because they are either in denial about their illness, think nothing can help them, or they're misdiagnosed -- usually with depression. It is also common for those who are on drugs to relapse because they stop taking their prescription, often because they think they're getting better.

The stigma attached to psychiatric illness doesn't help either. Many people think only violent and insane-acting individuals could possibly have a mental disorder. Though it is true that mania could cause someone to become more aggressive and do illegal things, most of the time, people with serious psychiatric problems end up to be victims of crime.

"They are not as good at defending themselves because they tend to be loners, and vulnerable," says Robert Hirschfeld, MD, chairman of the department of psychiatry and behavioral sciences at the University of Texas Medical Branch in Galveston. He says many tend not to know what manic depressives go through unless they experience the disorder themselves, or know someone close to them who is suffering.

Otherwise, most people think sufferers can 'pull it together,' when that's not usually the case, says David Dunner, MD, director of the Center for Anxiety and Depression at the University of Washington in Seattle. He explains that mental illness isn't usually viewed in the same vein as the flu, pneumonia, heart disease, or broken bones. Yet, he says, "The same kinds of physical things are wrong when someone has depression or a manic episode."

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Medical experts aren't yet certain of the exact cause of bipolar disorder, but a biological cause is the prime suspect since it seems to run in families. APA figures indicate that 80% to 90% of individuals with manic depression have a relative with either depression or bipolar disorder, a rate 10 to 20 times higher than in the general population.

A person's environment can also contribute to the disease, says Hirschfeld, pointing to both early and current experiences as possible factors.

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