Bipolar Disorder

Bipolar Disorder

My twenty-six year old brother, Anthony, has bipolar disorder. He was also diagnosed with other disorders, such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder and Conduct Disorder, Antisocial Personality Disorder, and Depression. It was not until Anthony was twenty-one and facing a prison sentence that he was finally diagnosed with bipolar disorder by his family physician. This is a very up close and personal view of his life, and mine, as well as the clinical picture of bipolar disorder. Because of its multifaceted effects, bipolar disorder can be very destructive to a person's life if not diagnosed or treated properly.

Anthony's early years were a series of counseling sessions, teacher evaluations, doctor visits, and medication follow-ups because of his ADHD diagnosis in the first grade. Anthony's ADHD followed him into his high school years with a vengeance. Even after all the counseling, all the therapists, and hard work by our parents, Anthony's high school years proved to be very difficult for him. It was near the end of his ninth grade year that Anthony became involved with drugs and alcohol. He used marijuana, cocaine, speed, ecstasy, acid, ketamine, zanex, vicodin, darvocet, and others. By the end of high school, Anthony was an addict who self medicated. He went through a period of cutting himself, because he said it made him feel better. After seeing more therapists, Anthony was then diagnosed with ODD and CD. Anthony's inability to control his behavior and his total disregard of consequences landed him on probation for one year. After graduating high school, he was diagnosed with Antisocial Personality Disorder. Anthony said this disorder mirrored his life and behavior. He once told me, "A psychiatrist told me that two roads were ahead of me...one that would take me far in life which I would succeed and the other would land me in jail or dead. You have the intelligence to succeed." Anthony was never able to keep a job or sustain healthy relationships. He frequently spent time at mental health in-patient and substance abuse treatment facilities. In 2002, Anthony was arrested and sentenced to nine months in York County Prison. Prior to going to prison, Anthony's family doctor finally diagnosed him as having bipolar disorder and was put on medication.

Bipolar disorder causes unusual shifts in a person's mood, energy and ability to function. A bipolar person goes from a manic episode to a depressive episode. Bipolar disorder has two distinct symptomatic breakdowns. The first one being a manic episode and the second is a depressive episode.

In a manic episode, a person may experience elevated moods or extreme irritability. Symptoms of a manic episode include: increased energy, feeling very anxious, excessively "high", overly good, euphoric mood, extreme irritability, racing thoughts, talking very fast, cannot concentrate very well, reduced need for sleep, unrealistic belief of one's abilities, poor judgment, spending sprees, increased sexual drive, abuse of drugs, provocative, intrusive, or aggressive behavior and denial that anything is wrong. For a manic episode to be diagnosed, the elevated mood needs to occur with three of the symptoms for one week or longer and almost every day.

A more moderate level of mania is called hypomania. Someone who is experiencing hypomania may feel unusually good and cheerful. Friends and family learn to recognize the warning signs of hypomania and the person may insist that nothing is wrong with them. If hypomania goes untreated, it can escalate into a severe mania or switch into depression.

In a depressive episode, a person may be overwhelmed with feelings of emptiness and sadness. Symptoms of a depressive episode include: lack of energy, loss of interest in things, trouble concentrating, changes in sleep and appetite, thoughts of dying or suicide, feelings of hopelessness, feelings of guilt, irritability, lasting sadness, anxiousness or empty mood. For a depressive episode to be diagnosed, five or more of the symptoms must last almost every day for a period of two weeks or longer.

Sometimes a person with bipolar disorder can experience a mixed episode which is a mix of manic and depressive symptoms. Symptoms of the mixed episode include: agitation, trouble sleeping, a change in appetite, psychosis, and suicidal thoughts. For some people with bipolar disorder, the mixed episode is just a transitional state as the manic episode switches to the depressive episode.

Sometimes, a severe episode of mania or depression can include symptoms of psychosis. Psychotic symptoms include: hallucinations and delusions. The psychotic symptoms usually reflect the extreme mood at the time. Some people with bipolar disorder who have these symptoms are incorrectly diagnosed as having schizophrenia.

Because my brother is bipolar, I have a unique perspective of the manic depressive cycles. Anthony has all of the clinical symptoms of manic depressive episodes. He would go through periods of uncontrollable rage to being over-the-wall happy. He could never complete any task and would always bounce around from one thing to another. Anthony would deny that anything was wrong and just blame it on someone else. Anthony also experienced periods of isolation, depression and suicidal thoughts. Perhaps if he would have been diagnosed earlier, Anthony would have been able to deal with his addiction, his impulsive behavior and been capable of making better decisions resulting in a positive impact on the quality of his life.

Anthony's maniac-depressive episodes were hard to be around. Anthony would exhibit extreme bouts of rage and irritability. He would actually punch holes in walls. His depression included self-isolation which was intolerable. You could not speak to him, or have any interaction. He would stay in his room for days or on the flip-side, not come home for days. The more out-of-control his life became, the more his substance abuse increased. When Anthony would take his medicine and refrain from illegal drug use, you would see such an improvement in his thoughts and behavior. It was like having a different person around. His bipolar disorder has taken a toll on the whole family. It's like living in an emotional nightmare and not being able to wake up. I would bet that most people know someone, a friend or a family member, that has bipolar disorder. It is a disorder that is not talked about much because of the disastrous effects it can have on the person and the family. Many people will spend a lifetime in trouble with the law, will not be able to maintain relationships or keep jobs, and will continue with substance abuse all because they are not