Dr. Lilian Gonsalvez, vice chair of the Cleveland Clinic Department of Psychiatry and Psychology; Photo by: M. LaVora Perry

Bipolar disorder is characterized by moods that swing between two extremes: super high and super low.

People with bipolar disorder can experience severe depressions. They also have episodes of hypomania, the abnormally “up” moods that typify bipolar II disorder, or mania, the WAY-over-the-top moods that occur with bipolar I.

Dr. Lilian Gonsalvez, vice chair of the Cleveland Clinic Department of Psychiatry and Psychology, said: “To be bipolar you have to at least one episode of mania. Most of the other [abnormal mood] episodes are depression.”

“Some researchers say it runs in families,” Gonsalvez added. “If there is suicide in a patient’s family, unless otherwise proven, that is suggestive of bipolar disorder.”

Gonsalvez also provided a somber statistic from the National Institute of Mental Health: Twenty percent of bipolar patients commit suicide.

However, she added, “Treatment minimizes suffering.”

In fact, research shows that bipolar patients who take appropriate medication, get therapy and avoid substance abuse are less likely to fall prey to suicide.

Gonsalvez stressed that diagnosing bipolar disorder takes time.

“The best diagnosis is made by following [a] patient over time,” she said. “It’s hard to make this [bipolar] diagnosis just by meeting a patient once.”

Angela Wiles, LPCC (R) with Dr. Gary Wilkes, MD; Photo by: M. LaVora Perry

Angela Wilkes, of Wilkes Mental Health in Beachwood, counsels bipolar clients at the office she shares with her husband, psychiatrist Dr. Gary Wilkes. She agreed that diagnosing bipolar disorder takes time.

“A person who is in a manic or hypomanic phase is not going to go to a doctor,” she said. “They feel good. They think they’re on top of the world … so why should they go [to a doctor]?”

“Often what is treated is depression,” Wilkes said. “At that point it may be the crash and burn of ‘I’ve lost yet another job;’ ‘My spouse or partner has left me;’ ‘I’ve disappointed my children again;’ ‘I’ve borrowed all the money I can.’ They’re depressed and they may go for counseling or treatment.”
She added: “A person may tell you they have a history of three to five treatments of antidepressant medications and none of those worked.”

“Well, that would be correct,” Wilkes said. “That’s typically not the appropriate treatment, alone, for a person with bipolar (disorder).”

Wilkes encouraged people with bipolar disorder to notice when they are entering hypomania or mania territory. So, if you’re bipolar and can’t resist the urge to rush outside and belt out the lyrics to Katy Perry’s “Firework”, according to Wilkes, you need to “scale it back two or three notches.”

Knowledge gives you power over bipolar disorder.  So whether you’re bipolar or your child or another loved one is, make it your lifelong habit to read and learn about the condition and how to maintain good health overall. Some ways to do that are: learn about the human brain — an organ that can be affected by illness just like the heart, lungs, kidneys and other organs can; watch television journalist and bipolar disorder survivor Jane Pauley’s interviews with experts at http://www.webmd.com/bipolar-disorder/bipolar-tv/default.htm; or visit the National Institute of Mental Health website at http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml.

Your practice of good mental health habits teaches others — including young people — how to be healthy, too.

Read M. LaVora Perry's October 2011 feature on bipolar disorder here and online at these NV links:

My Health Victory
http://www.neighborhood-voice.com/columns/perrys-perspective-my-health-victory/