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What do Shelley, Lord Byron, Coleridge, and Blake have in common? Yes, they were all poets and creative individuals.
And according to Kay Redfield Jamison Ph.D., they all probably had Bipolar Disorder. Kay is a professor of psychiatry at John
Hopkins University School of Medicine. She also has Bipolar Disorder. She has studied this disorder in the population of writers
and artists in her book, Touched with Fire: Manic Depressive Illness and the Artistic Temperament. This book is helpful
to understand that this illness has been present for a long time and has not stopped many from creating significant works
of art. It also demonstrates the tragedies of untreated Bipolar Disorder. There is a high rate of suicide linked to this disorder.
So
what is it? Bipolar I requires a manic episode and usually depressive episodes. Bipolar II requires a hypomanic episode with
depressive episodes. There are cycles of mania or hypomania alternating with times of depression. There is also Cyclothymic
Disorder which has hypomania and depression (not as severe as the depression in Bipolar Disorder). The determining factor
then is mania or hypomania. Mania requires three or more symptoms like grandiosity, very reduced sleep, talking fast, having
trouble focusing, ver active, and having very poor judgment. Hypomania has the same symptoms but the degree of impairment
in functioning is less.
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Bipolar Disorder is not usually easy to diagnose. It can be confused with ADHD (Attention-Deficit/Hyperactivity Disorder),
substance abuse, and thyroid disorders. According to the Mayo Clinic, certain medications such as corticosteoids and those
used to treat Parkinson's as well as anxiety and depression can cause mood swings. It is more difficult to diagnose in children
and adolescents due to some variation in the classic symptoms and poorer ability to report symptoms and events.
Diagnosis
requires a very good history and report of mood swings over time that are not accounted for by other factors. There is also
a genetic factor. Usually other family members have the disorder as well. Other disorders that have similar symptoms need
to be ruled out. Psychiatrists and psychologists are best trained to do this type of evaluation.
Once a diagnosis is
obtained, treatment usually requires medication prescribed by a psychiatrist. Lithium has been the standard in the past. Now
there are more alternatives, mainly antiseizure medications. Antidepressants may be added to control the depression. Antipsychotics
may also be added to control more severe symptoms. Information on medications can be obtained from the Mayo Clinic (www.mayoclinic.org) and the National Institute of Mental Health (www.nimh..nih.gov).
Psychotherapy is important also to help maintain stability. Cognitive-behavioral therapy helps to identify patterns
leading to episodes so that triggers can be identifed and controlled. Therapy also helps with stress management. It is critical
to successful treatment that stress be managed. A therapist can also help with adjustment to the disorder and with developing
healthy interpersonal relationships. There is no doubt that with good treatment individuals with Bipolar Disorder can lead
happy and productive lives.
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