The ups and downs of manic-depressive

by Henrylito D. Tacio 

WHO doesn’t know Oscar-winning actress Vivien Leigh and her equally famous husband, Laurence Olivier? The two stars tied the nuptial knot in 1940 but the marriage was not successful. Leigh’s manic-depression was cited as one of the reasons why it failed. In 1944, while filming Caesar and Cleopatra, Leigh discovered she was pregnant, but a fall on the set caused her to miscarry. Stepson Tarquin Olivier believed that losing this baby “caused her manic-depression to come forward.” The following year, she was diagnosed with tuberculosis.

At that time, manic-depression – as it was then known – was little understood at that time. Lithium was not yet in use, and the only treatment she received was shock therapy, which was not then administered with the same level of care as today. Tarquin saw burns on his stepmother’s temples at times from her shock treatments.

“Manic-depression, known to mental health professionals as bipolar disorder, is a serious, double-edged mental illness,” notes The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments. “In contrast to the sustained bleakness of generalized depression (technically described as unipolar disorder), manic depression is characterized by cyclical swings between elation and despair.”

Symptoms

According to the American Academy of Family Physicians, at times, a person who has manic-depression may feel very happy, full of energy and able to do anything. The person might not even want to rest when he or she feels this way. This feeling is called mania. At other times, a person who has bipolar disorder may feel very sad and depressed. The person may not want to do anything when he or she feels this way. This is called depression. People with bipolar disorder can quickly go from mania to depression and back again.

Other signs of mania may include the following: feeling very irritable or angry; thinking and talking so fast that other people can’t follow his or her thoughts; not sleeping at all; feeling very powerful and important; having trouble concentrating; spending too much money; abusing alcohol and drugs; and having sex without being careful to prevent pregnancy or disease.

Other signs of depression may include the following: no interest or pleasure in things he or she used to enjoy, including sex; feeling sad or numb; crying easily or for no apparent reason; feeling slowed down, or feeling restless and irritable; feeling worthless or guilty; change in appetite and unintended change in weight; trouble recalling things, concentrating or making decisions; headaches, backaches or digestive problems; problems sleeping, or wanting to sleep all of the time; feeling tired all of the time; and thoughts about death and suicide.

Call your doctor if you notice some of these symptoms in a family member. “Manic-depressives often deny anything is wrong, especially in the manic phase,” notes ‘The Medical Advisor.’ “If you are worried about a family member or close friend, a doctor can offer advice on how to handle the situation.”

By the way, bipolar disorder comes in two main forms: bipolar I and bipolar II; both may have separate genetic origins. “In bipolar I, both phases of the illness are apt to be very pronounced,” notes The Medical Advisor. “In bipolar II, mania is often mild (it is termed hypomania), and the depression can be either mild or severe.”

No one is spared from bipolar disorder. “Men and women are equally susceptible,” says The Medical Advisor. Martial arts actor Jean-Claude Van Damme’s bipolar disorder led him into cocaine addiction and charges of spousal abuse. Poet Sylvia Plath suffered from extreme bipolar depression that profoundly affected her work and ultimately led to her suicide at the age of 30.

Manic-depression typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life. Film star and award-winning writer Carrie Fisher’s bipolar disorder first appeared during adolescence, and has manifested itself in drug and alcohol addiction since then – yet she has come back again and again.

Manic-depression sometimes runs in families. If you have a parent who has the illness, chances are you may have it, too. Ben Stiller – best known for There’s Something About Mary – is frank about having bipolar disorder. His parents – Jerry Stiller and Anne Meara – have also talked about being in therapy for depression.

Sufferers say manic depression can lead to job loss, ruin relationships and lead to financial problems. Not only that, though. Experts advise that family members should be on the lookout for suicidal tendencies among sufferers. “Bipolar disorder is not only life-disrupting but can also be dangerous: About 20 percent of manic depressives commit suicide, usually when they are passing from one phase to another and feel disoriented,” The Medical Advisor states. “Some 11 percent of sufferers take this drastic action in the first decade after diagnosis.”

Possible causes

Unfortunately, manic-depression is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. In fact, what causes it is still a mystery. “Scientists are learning about the possible causes of bipolar disorder through several kinds of studies,” points the U.S. National Institute of Mental Health. “Most scientists now agree that there is no single cause for bipolar disorder—rather, many factors act together to produce the illness.”

Because manic-depression tends to run in families, researchers have been searching for specific genes—the microscopic “building blocks” of DNA inside all cells that influence how the body and mind work and grow—passed down through generations that may increase a person’s chance of developing the illness.

But genes are not the whole story. Studies of identical twins, who share all the same genes, indicate that both genes and other factors play a role in bipolar disorder. If bipolar disorder were caused entirely by genes, then the identical twin of someone with the illness would always develop the illness, and research has shown that this is not the case. But if one twin has bipolar disorder, the other twin is more likely to develop the illness than is another sibling.

In addition, findings from gene research suggest that bipolar disorder, like other mental illnesses, does not occur because of a single gene. It appears likely that many different genes act together, and in combination with other factors of the person or the person’s environment, to cause bipolar disorder. Finding these genes, each of which contributes only a small amount toward the vulnerability to manic depression, has been extremely difficult. But scientists expect that the advanced research tools now being used will lead to these discoveries and to new and better treatments for manic-depression.

Treatment

At present, bipolar disorder is treated most often with a combination of the drug lithium and psychotherapy. Lithium carbonate is the principal drug used in treating manic-depression; it can be remarkably effective in reducing mania, although doctors still do not know why.

“Lithium has no effect on normal mood but reduces the tendency toward mood swings in about 70-percent of people with manic-depressive illness,” explains the second home edition of The Merck Manual of Medical Information. “A doctor monitors the level of lithium in the blood with blood tests. Possible side effects of lithium include tremor, fine muscle twitching, nausea, vomiting, diarrhea, thirst, excessive urination, and weight gain.”

Some caution: A very high level of lithium in the blood can cause persistent headaches, mental confusion, drowsiness, seizures, and abnormal heart rhythms. Side effects are more likely to occur in older people. Women who are trying to become pregnant must stop taking lithium, because lithium can, in rare cases, cause heart defects in a developing fetus.

Haloperidol is sometimes given to patients who fail to respond to lithium, or to treat acute symptoms of mania before lithium can take effect (7 to 10 days). “In severe cases, or when a patient does not respond to lithium, other drugs such as carbamazepine and valproic acid, used alone or in combination with lithium, may be prescribed,” says The Medical Advisor.

Psychotherapy is often recommended for people taking mood-stabilizing drugs, mostly to help them stay with their treatment. “Group therapy is often useful for helping people and their spouses or relatives understand the manic-depressive illness and better cope with it,” the Merck manual notes.

No hindrance

Suffering from bipolar disorder is no hindrance to success. “I’ve had this problem since I was in my 20s,” film and stage actor Ned Beatty told Charlotte Observer’s Luaine Lee. “They don’t call it manic depression anymore. They call it a bipolar disorder, and I’m a Type II.”

In the said interview, Beatty – who appeared in such movies as Deliverance – also discussed how it seems easier to perform when manic, but noted that even depression doesn’t really hinder his work. In referring to these episodes of mania or depression, he admitted: “Performing is such a second-nature thing that I can do it in the middle of one of these things.”

With an extraordinarily successful career studded with stage performances, over a hundred movies, and innumerable television appearances, it is abundantly clear the bipolar disorder has not hindered this celebrated actor. — ***

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One response to “The ups and downs of manic-depressive

  1. Pingback: Alcohol Rehab » Blog Archive » The ups and downs of manic-depressive

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