Daily Health and Medicine News

Bipolar Doesn’t Make You Stupid, You Make You Stupid

I am sick and tired of people using their diagnosis, or alternatively their med’s side effects, as excuses for their rotten behavior.

Unless you are currently in the throes of the psychoses of mania or the delusions of depression, you do have control over your behavior – even if you are moderately depressed or hypomanic, because in these states, you are still in touch with reality. You may really want to break that window or abandon your family or tell your boss off or jump off a bridge, but you do have the capability to stop yourself. It may be very difficult, but you’re not too far gone to no longer have free will.

While the moods that come with bipolar disorder can make rotten behavior really tempting, that rotten behavior is not in and of itself the symptoms of bipolar. It’s the moods that make bipolar what it is. It’s what you do with those moods that ruins your life and signals to you and other people that perhaps you need to see a doctor or spend some time in the hospital.

Bipolar is a mood disorder, not a self-control problem. True, there are some people with bipolar who have pathological self-control problems, and if that’s the case, they should be alarmed by this lack of control and go get some help. Maybe they have attention deficit disorder. If you’re not seeking help, you either don’t think it’s a problem, and someone really should tell you so, or you don’t care – and not caring is not the same as a pathological problem with self-control.

I am now convinced – putting aside breaks in reality that come with Bipolar I – that there are stupid people with bipolar and there are smart people with bipolar. Bipolar doesn’t make you stupid; your choices make you stupid, or smart.

I’m not going to elaborate on what brought me to this conclusion, although if you really want to know, you can ask my husband. He knows. And he knows that he had the ability to make different choices than what he made. People do not need to do everything they feel like doing, at the time that they feel it. So, it makes you uncomfortable to not follow through on what you’re feeling? It may make your skin crawl, like you want to claw it off yourself, but you do have the ability to stop. You have the ability to walk away from the temptation, perhaps go for a jog. Better yet, call your doctor.

Not taking the opportunity, no matter how extremely difficult it is and I understand how difficult it truly is, is your problem – not bipolar’s problem. You cannot understand how truly strong you can be until you try to stop yourself from acting on every whim in your hypomania or every lethargic and self-hating urge in your depression. Truly, and I know I will infuriate some with this accusation, if you do not learn to stop yourself in those mood states – or head off the mood at the beginning with meds, therapy, or lifestyle changes, which is infinitely easier than trying to ride out the mood without doing any damage to you or your family – you are all those bad labels being thrown at you: You are lazy, you are selfish, you are a jerk.

After being stable for two years, at first on meds and later with just lifestyle changes and cognitive-behavioral therapy (CBT), I’ve had a return of the mood swings this past month. It scares the crap out of me, so I swallowed my pride and saw my doctor today. Which brings me to this point, again…what do smart people with bipolar do when their symptoms worsen? They do something to try to get back to stable.

They amp up their CBT and lifestyle changes, comb through their mood charts for clues, go to the doctor, try new meds. The likely culprit for me is a hormone issue, so says my doc, so I got my blood drawn and will start a trial of progesterone supplements. They may work, or they may not. The point is, I didn’t feel well, so I sought help. Here’s another way people with bipolar look stupid – they settle for feeling unstable, they blame other people for their problems, they aren’t concerned enough by their symptoms to GO GET HELP.

You don’t want to feel stupid, and you don’t want others to think you’re stupid. No one does. So, empower yourself by taking charge of your life, your actions, your mood. Learn to assess your mood and then be able to feel your emotion without acting upon it. You are not bipolar; you are you, and you have bipolar. Bipolar is not your identity. Stop the rotten behavior that comes with your bipolar, whether you’re doing it by your own iron will, which I admit is exhausting, or much better yet, by meds and therapy and lifestyle changes. You have the full ability to make smart choices, even if you have bipolar disorder.

$3.7M program targets bipolar Hispanics

Mental health professionals with UT Medicine San Antonio and collaborating institutions are designing bipolar disorder treatments that will be relevant and culturally sensitive to Hispanics, thanks to a $3.7 million grant from the National Institutes of Health. Three research programs will target Mexican Americans, who represent the majority of U.S. Hispanics.

UT Medicine is the clinical practice of the School of Medicine at The University of Texas Health Science Center San Antonio.

“We will test for specific cultural factors that affect the response and engagement of Hispanics who have bipolar disorder,” said the study principal investigator, Dr. Charles L. Bowden. He leads a large group of experienced psychiatrists, psychologists and other scientists who will conduct the comprehensive program of research over the next five years.

Bipolar disorder, the sixth leading cause of disability worldwide, is a chronic condition characterized by rapid mood swings.

According to the National Institute of Mental Health (NIMH), bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks.

These shifts in mood and energy levels are more severe than the normal ups and downs that are experienced by everyone.

Annual prevalence of bipolar disorder among American adults is 2.6 percent, according to the NIMH. Prevalence of childhood-onset bipolar disorder is not well established.

The National Institutes of Health provided an Advanced Center award that is the first ever made for bipolar disorder research. One of the studies will test a novel design that has the potential to provide much more practical information to clinicians.

“This will aid clinicians in selecting specific treatments most likely to help an individual patient, rather than resorting to a trial-and-error approach that is currently often applied,” Bowden said.

Investigators will assess participants’ acceptance of treatment, their perception of side effects and their awareness of the illness. Innovative and culturally sensitive treatment approaches will be explored.

“The goal is to optimize treatment outcomes of bipolar disorder by considering characteristics of the communities in which people live,” Bowden said.

Two investigators will address the personal experiences of study participants. This will provide a biographical sense of the challenges that confront these patients in relationship to bipolar disorder and its impacts on their lives, families and community experience.

One of these investigators, Bryan Bayles is a cultural anthropologist, and the other, John Phillip Santos, is a nationally acclaimed writer on Hispanic migration to the U.S. Santos is a San Antonio native and faculty member of The University of Texas at San Antonio.

The research program involves collaborative work with the Center for Health Care Services, which is the primary organization charged with treatment programs for medically indigent persons with severe mental disorders in Bexar County, and the bipolar disorder research programs at the Texas Tech University Health Sciences Center at El Paso and Case Western Reserve University School of Medicine in Cleveland, Ohio.

Dr. Mauricio Tohen, a native of Mexico, is associate director of the overall program, which is titled “Optimizing Outcomes in Bipolar Illness Interventions in Hispanic Communities.” Jim Mintz, leads the statistical unit, and Dr. Vivek Singh and Jodi Gonzalez lead the major treatment studies.

Bowden recently was the sole North American author on a large international study that showed bipolar disorder features were more frequent in patients with major depressive episodes than indicated by existing criteria used by psychiatrists.