I-Search Paper
By Tessa Krog
April 7, 2006
BIPOLAR DISORDER
One minute I am as high as the sky and nothing can possibly ruin my day. The
next minute I feel as though the weight of the world is crushing my body to pieces. After
months and months of these ups and downs I decided to seek professional help and see
what was wrong with me. One thought that filled my mind was that I must be sick and
there had to be medication to fix it.
When the doctor informed me of the possibilities I listened closely. She told me it
could be stress, anxiety, depression, or a form of bipolar disorder. I had heard of bipolar
disorder before and thought that it had to be the cause of my ever-changing moods. After
a check-up and a short interview, I was relieved when the doctor told me that I was not
bipolar, but simply stressed like most teenagers are during this time of their lives.
It made me wonder how to tell the difference between stress-induced mood
swings or a serious disease. If I would have answered questions differently on my
interview could I have been misdiagnosed with something I really didn’t have? All this
scared me and set me on a path to find out.
By sheer coincidence, I came across an article in the newspaper advertising a
bipolar support meeting at a local church that evening. This was the perfect opportunity
to learn about the disorder from people who really knew about it. I called the leader of
the group and asked if I could sit in on their discussion. She seemed reluctant at first but
then said that I was welcome. On March 28th I walked timidly into the meeting and was
greeted by a very quiet group. The leader, Peggy Flynn, handed me a nametag, a
pamphlet on the organization, and a sheet explaining what bipolar disorder was.
We then went around in a circle and introduced ourselves and stated why we were
there that evening. Although it was a public meeting and I was not specifically asked, I
have chosen to keep the group members anonymous to protect their privacy. The group
members ranged from early twenties to late sixties and all were there for a different
reason. Some had bipolar disorder, severe depression, or both. A few were there as
moral support for their friend or spouse, while others, like myself, were there to be
educated on the subject and hear from real people what it was like to have this disorder.
On this night, guest speakers were invited to inform us about bipolar disorder and
discussed available treatments. Counselors Jim Pabst and Karen Griffith, of Black Hills
Counseling Services, tried to define bipolar disorder as easily as possible. Often referred
to as manic depression, bipolar disorder can be spotted by a number of symptoms. Loss
of interest, extreme weight fluctuation, and changes in sleeping patterns may all play a
part in bipolar disorder. Other symptoms include the inability to stay focused, working
on many different things with extreme detail, but not finishing them. The most
recognized symptom of this disorder would be the elevated mood or mania. Having an
elevated mood would mean that you are excessively happy and feel on top of the world
and can take on anything at any time. Some people express this mood by feeling as
though they can write a detailed novel overnight or plant 100 tomato plants at two
o’clock in the morning. Other times, the person may feel so down that they have suicidal
thoughts and behavior. In comparison with what Griffith described as a “normal” mood
curve, a bipolar mood curve has extreme ups and downs that need to be treated.
Pabst told me that treatment can come in many different forms like medication
and psychotherapy. Because bipolar disorder is often associated with depression, an antidepressant is prescribed as well as a mood stabilizer. Psychotherapy comes in many
different forms because every person is different and requires different treatment. “The
best way to describe it would be to say that your life is like a truck that drives on a road
with many ruts,” Pabst explained, “those ruts represent depression that you are often
sucked into because you have no control. Medication will lift that truck out of the rut and
psychotherapy will give you directions to stay away from them in the future.”
The only problem with prescribed medication would be giving them the proper
medication. Many people with bipolar disorder are often misdiagnosed because their
physician does not see everything he should be seeing. One group member stated that he
was actually diagnosed with schizophrenia and it took a number of years until they finally
found out that he was bipolar. Many patients are given only anti-depressants because
they are thought to be suffering from mild depression. The problem that arises from this
is that the physician does not see the excessive happiness that may also be associated
with their depression and the anti-depressants will only increase that mania, making it
worse than it was before.
Griffith stated, “We have to ask the right questions because bipolar disorder is
symptom-driven.” This means that certain symptoms and behavior, like those formerly
mentioned, come in clusters which distinguish it from depression.
One of the older women asked if there was any way to overcome the disorder and
Griffith answered, “If you’re talking about complying with your treatment and living
with it, then yes, but if you mean getting rid of it, there is no way to completely abandon
it. People with diabetes can’t simply wake up one morning and say, ‘I’m not going to
have diabetes today,’ because they have a medically-based problem just as you do.”
She added that treatment does not have to do with only prescriptions and therapy.
Talking with and educating friends, family members, mentors, and coworkers about the
disorder can help keep you inside what she called a “safety net.” The net is there to keep
you from drowning in the water of sadness that lies below. This group of people has to
remember, though, that the person they are protecting is not the illness, they have an
illness.
On April 5th, I met with Charlie Larson. A friend revealed to me that his father
had bipolar disorder and I thought it would be very interesting to talk to someone who
lived with a bipolar parent. He immediately began to speak of all the crazy things his
father attempted to do during his manic episodes and he even felt the urge to laugh at a
few of those instances.
Charlie’s father, Ivan “The Terrible” Larson, was believed to have a Bipolar II
disorder and was labeled as a manic depressive. There is more than one form of bipolar
disorder; the different categories include Bipolar I – Full-Blown Manic, and Bipolar II –
Hypo-Manic. Both types of bipolar disorders are very serious and patients experience the
same symptoms, but Bipolar I individuals experience more intense manic episodes than a
person with Bipolar II.
It was over seventy years ago when Ivan Larson would skew off
into a depressive state for more than a year and then feel as though he could be a celebrity
in a matter of minutes, and no one knew for sure what to do about it. In the late 1930’s,
he was diagnosed with a general mental illness by doctors. “But everything in the thirties
was called a ‘mental illness,’” Charlie bluntly stated, “because they weren’t sure what it
really was.”
Charlie grew up in Clark, SD with his mother, father, and four other siblings.
When his father was acting out of the ordinary, the family went about their days and
didn’t pay attention to the situation. They did not know about bipolar disorder or its
symptoms so they did not know exactly what afflicted the head of the household. To the
best of his knowledge, his father had been medically treated since he was a teenager, but
not specifically for bipolar disorder.
In the early 1950’s, Ivan Larson began receiving shock treatment at Fort Meade
Hospital in Sturgis. Although the shock treatment may have temporarily helped the
receiving patients, Charlie actually thought it could have hurt his father in the long run.
He said that his father described his shock treatment sessions as a conscious dream in
which the devil was chasing him while throwing lightning bolts through his head, and up
to eight months after a session, his father would be like a wandering robot with no feeling
or emotion to speak of.
Then, in the 1970’s, doctors started prescribing patients, like Ivan Larson, with
lithium to help with their constant ups and downs. Charlie said that the lithium did help
for up to two years, but his father’s “tough Norwegian blood” would soon get the best of
him and he would throw the medicine out. Soon after trashing the medication, something
emotional or stressful would spark another episode and Ivan Larson would have to be
hospitalized.
It was not until 1977, when his father came to stay with him, that Charlie found
out the truth about his father’s condition. Ivan Larson was committed to another hospital
at that time and was put into a room with another manic depressive. Charlie met the wife
of his father’s roommate and they began to talk about the similarities in their loved one’s
conditions. She mentioned that his father may also be a manic depressive and supplied
him with plenty of resources to educate himself on the subject.
While his father was hospitalized, Charlie and his four siblings would often be
sent to their grandparents’ house. When I asked if he felt that having to stay with others
created a burden for their family, he chuckled and said that he never thought of it that
way. When the kids were growing up, staying with relatives was like going away to a
miniature summer camp and they never thought twice about why they were really there.
During some of his manic episodes, Ivan Larson did many crazy things. As I
mentioned before, manic depressives have periods when they feel as though they are
invincible. Charlie said that this describes his father perfectly to a point. “When he was
‘normal,’” he stated, “everyone loved him and he was a lovable guy. But when he was in
a manic state, he HAD to be the center of attention and would do anything to be it.” One
incident in particular would be the 4th of July Parade in 1992. Charlie was enjoying the
festivities when, out of the blue, he saw his father sitting in a recliner that he had duct
taped to the top of a car, waving as though he was the star atop a Christmas tree.
Knowing that bipolar disorder is mainly genetic, Charlie realized that his
grandmother acted in the same manner as his father. His sisters also portrayed some of
the same characteristics, but not to such an extreme level. Although it hits close to home,
he is not worried about himself or any of his children developing the disorder, but keeps
an eye on other close family members.
I later verified some information by talking to Dr. Doug Wessel, Department
Chair for Psychology at BHSU. He has an MA and a PhD, in psychology, from the
University of North Dakota and is has taught psychology for over thirty years. Prior to
becoming a professor of psychology, Wessel practiced as a psychologist for thirty-two
years after receiving his Doctorate. He works part-time at the local Spearfish Regional
Medical Clinic.
During his practice as a psychologist, he met with some individuals with bipolar
disorder. He said it is not the most common mental disorder, but it is still out there. “The
general population with bipolar disorder is around 1%,” Wessel stated, “and that is about
the percentage that I saw in my office.” The patients varied in age from late adolescents,
17-18 years old, to adults up to 55 years old.
I asked him what sort of symptoms he witnessed in patients and he had to correct
me in my wording. He said that there is a difference between symptoms, how the person
feels, and signs, visual evidence of the condition. The visual signs depended on what
type of phase the person was in at the time. During depressive phases, the individual
could be tired, isolated, unmotivated, suicidal, not wanting to finish anything and would
most likely not be eating or sleeping. Wessel put it best with his description of the
depressive phase being a black tent that has been placed over that person.
On the other end of the spectrum, during the manic phase, the person would feel
invincible. He described the person as, “Basically euphoric…no sleep, not eating,
massive amounts of energy, and so forth.” Also during this phase, one will often spend
enormous amounts of money over a short time, will go through short term sexual
relationships and will feel as though they cannot lose and the world is on their side. In
fact, Wessel recalls one incident when a patient called him at two o’clock in the morning
with a “hot stock tip.” “Of course the patient had no idea what time it was because day
and night didn’t mean anything to him,” Wessel explained, “Needless to say I did not
take his ‘hot’ tip, and knew he was just feeling over-confident.”
I wondered if, after they did all these crazy things, they suffered the consequences
or at least felt a little sorry about what they had done. I was told that, yes, they do feel
bad, but not until they have come down from their manic state-of-mind, which can take
time.
Although the exact cause of bipolar disorder is still unknown, I had to ask him
what he thought about it. “Of all mental illnesses out there,” Wessel explained, “60% are
genetic just like bipolar disorder.” There is not one specific gene for this particular
illness because it depends on the genetic transmission from parents to offspring. He is
aware that studies are now being done on a molecular level to try and explain exactly
why this occurs in people. Hopefully, with this research, we will find out what can help
those with the illness and possibly even prevent it in the future.
With what doctors, psychologists, and psychiatrists know today, patients can be
treated in more than one manner. At first I thought that the patient had to be referred to a
doctor at a local hospital in order to be treated, but Wessel informed me that
psychologists, like him, are actually the ones doing most of the diagnosing and will often
refer them to a psychiatrist for a medication prescription. A psychologist will most likely
help the patient to manage his stress levels and motivate them to stay on their medication.
Wessel explained that the medication motivation is crucial because, “More often than not
the person will feel overconfident and throw their medication out.” This is very similar
to Ivan Larson because patients do not feel the direct effect of the medicine so they stop
taking them. Then they will spiral downward after stress has caught up with them. By
studying the symptoms and verifying the medication, psychologists can help patients who
battle with this affliction.
In conclusion, I have learned that bipolar disorder is more serious than most
people think. It is important to be informed on the subject so that we may identify
symptoms and provide support for those we love. We must remember what Kathy
Griffith first told us at the support and alliance meeting, “People don’t walk alone on the
Earth--that would be a very lonely walk.”