Tuesday, February 12, 2008

Bipolar Disorder: Onset and Treatment

As many of you who read my blog with regularity know, the event that triggered my first depression almost 40 years ago was going away to college. In retrospect, I know it was too big of a change for me. The university was huge. It was 1968, and the buzz words were "sex, drugs, and rock 'n' roll."

Overnight I felt like a generational outcast. I suspected I was the only virgin on a campus of 40,000 people. I didn't do drugs, and I liked folk music.

While no therapist or psychiatrist ever paid attention to the triggering event, it was very important for me to understand the causal factor. And it was only within the last five years that I read that stressful life events can trigger a depressive episode. Had I been told this years ago, I probably could have stop ruminating on what happened and why, and moved on with my life.

It is only recently that researchers are asking people about the history of their illness. Dependent upon whom you believe, the average age of onset for bipolar disorder is either late teens or between 19 and 21. Yet, I have never read any explanation of why this is so.

When you think about it, most people's lives dramatically change between 18 and 21. They leave home for the first time--either to go to college or to work--and they have a host of new adult responsibilities. For many of us, this is the first real break from childhood.

If I were a bipolar researcher who knew this information, I would suggest that every health teacher in every high school in the universe teach a segment about the stresses that may be caused by the transition from high school to life. I would list depressive and bipolar symptoms, and provide basic information on how to seek help.

According to Dr. S. Nassir Gaemi, director of the Bipolar Disorder Research Program at Emory University, on average there is a 20-year-lapse between diagnosis and treatment. Most patients do not learn they have this illness until they are 40. In his practice, the divorce rate for bipolar disorder is 90 percent.

My feeling is that if more 18-21 year olds knew the causal factors and symptoms for these illnesses, they would seek help earlier (if there was no stigma attached to it). And I believe it's quite possible that if fewer people had to experience prolonged depressive (or manic) episodes without treatment, there would be a better outcome--in terms of their health and happiness.

Questions of the Day: What caused your first depressive or manic episode? How long did it take you to get a diagnosis? (Brevity will be rewarded although I'm not sure how.)

13 comments:

Tony C. said...

I was sent to boarding School aged 11. My parents were living 4000 miles away at the time. I was bullied. I started seeing a psyciatrist 15 years ago, and was diagnosed bipolar january 2007. I am 53 years of age now!

Bipolar Wellness Writer said...

Dear Tony,
As a parent of an only child, the thought of sending him to boarding school at the age of 11 is inconceivable to me. To imagine that you were so far away from home and bullied makes me want to cry--for you.

But it's also inconceivable to me that you were seeing a psychiatrist for 15 years and were only diagnosed as bipolar a year ago.

I'm so sorry for the pain you must have suffered, both as a child, and an adult who had to live with this illness for so long--without a proper diagnosis.

Susan

marja said...

I was 19 when I became psychotic. My diagnosis was schizophrenia. It wasn't until 25 or so years later that a doctor changed the diagnosis to bipolar 1 disorder.

I agree totally with you, Susan, that it's the stress of entering adulthood that probably brings the symptoms to light. I've always felt that as well.

Bipolar Wellness Writer said...

Thanks for your comment Marja. I'm always heartened to know when we share the same perspective.

Meredith said...

According to my mother, I've always sort of had the personality types, but going off to college really triggered it for me. I go to an "elite" school and was in a long-distance relationship and started drinking and partying while stressing over grades. I had what I see now was depression, then mania, then a huge depression a year ago that forced me to seek help at age 20. They thought it was unipolar depression, put me on Zoloft, I went manic, was hospitalized, and then diagnosed. Now, 10 months later, there have been bumps in the road, but I'm way better off than I used to be. I know I'm very lucky in that sense with this story. It helps that I have pretty much textbook bipolar I.

Bipolar Wellness Writer said...

Dear Meredith,
Thanks for sharing, and I'm really glad to hear from you. I hope that college is going well this year, and that your illness is under control!

Susan

My Life with Bipolar Disorder said...

Susan, for me stress is also my main triggering factor. In my early 20s I left my hometown in Malaysia to come to Singapore to work, all on my own. I went through a lot of stress at work and adjusting to new environments. I became severely depressed and experienced another 10 or so episodes. I was diagnosed only last March, after almost 20 years. Regards, Nancie

JayPeeFreely said...

I would say shortly after my father went to prison at age 15-16. I began to act out wildly...got suspended from school for taking on male authority. Started drinking abruptly, then stopped. Gave up on a further life in baseball. But went to college and further continued the downward spiral, only to regain some sanity at crucial moments, during my early 20's. The rest you know about.

Bipolar Wellness Writer said...

Dear Nanci,
What a huge change to make in your life. The idea of moving from Malaysia to Singapore by yourself is unimaginable to me. And I can certainly see how stressful that would be! My husband and I live five blocks from where I grew up. Thanks for telling your story!

Susan

Bipolar Wellness Writer said...

JayPeeFreely,
What's interesting about all these comments is how everyone's stress is so different. I can't imagine how difficult it was for you to have that happen to your dad. And then to give up baseball--which is such a passion for you! Thanks for being so candid in my blog!

Susan

Bipolar Wellness Writer said...

Dear Nanci,
What a huge change to make in your life. The idea of moving from Malaysia to Singapore by yourself is unimaginable to me. And I can certainly see how stressful that would be! My husband and I live five blocks from where I grew up. Thanks for telling your story!

Susan

Dirk said...

My grandfather's suffering with manic depression was well known as I grew up. And I think I started showing symptoms in my teens. But my first serious clinical depression came at 19 after my mother's death. I was in college at the time.

Bipolar Wellness Writer said...

Dirk,
I'm so sorry about your loss. You know that my mother died recently and I'm 57. I can't imagine how difficult that was and is for you. There are these lists that rank stressful events. Death of a parent must be near the top.

Susan