Well, not really. . .but I thought that title would grab a few readers. Most of my adult life I would have described myself as “depressed”–deep in the throes of the life-long illness labeled Dysthymic Disorder in DSM-IV, the APA’s official diagnostic manual. Dysthymia is almost more a lifestyle than a diagnosable illness–it’s a life-long sadness and hopelessness–in religious terms acedia. . .look that one up. In German its weltschmerz (world weariness). Dysthymia is characterized by sadness, shyness, irritability, low self-esteem, excessive guilt, brooding, fatigue, etc.–you get the picture. Most dythymics get by without any treatment. They don’t realize they have an illness–its more likely seen as just a bad case of “life sucks.” Many self-treat by becoming alcoholics or inhabiting various other addictions. The 300-lb woman shuffling thru the buffet line at the all-you-can eat restaurant is medicating her dysthymia with food. Dysthymic Disorder is the mild to moderate depression that goes on and on and on and on.
The other major mood disorders are Major Depressive Disorder and Bipolar Disorder. Major Depression is more severe than dysthymia, much more commonly diagnosed, but also much shorter lived. It is often a reaction to life’s stressors, or losses such as divorce or death. Nearly one person in five (20% of the population) at some point in their life will experience enough symptoms to qualify for a diagnosis of one of the primary mood disorders: Major Depression, Dysthymic Disorder, or Bipolar Disorder.
In the past couple years I’ve more and more come to the realization that I’ve inherited my parent’s bipolar illnesses, and coping with that has been much more challenging than dysthymia. Both of my parents were seriously bipolar. My mother had many episodes and hospitalizations–probably a dozen or more. My father held it together–but barely. His illness precluded him from ever living up to his level of talent. He was an exceptionally bright man, gifted in many ways, who at various times was interested in becoming an attorney and then an electrical engineer. He did study both–law thru Lasalle University’s extension program and engineering briefly at Toledo Univ. and Chicago Tech after WWII. However, coping with his illness condemned him to a quiet life and mediocre jobs in the small town in which he grew up. In 1943, he was drafted into the Navy and sent to Great Lakes NTC near Chicago. He returned home a little over a month later with “emotionally unsuitable” stamped on his discharge papers.
Bipolar Disorder, once referred to as Manic-Depression, is a much more serious illness than dysthymia. Only about 1 to 2% of the general population is Bipolar, and we know from studies with identical twins that it has a genetic basis. About 15% of those diagnosed bipolar end up committing suicide–sometimes referred to as “successful” suicides–now there’s a mind-bending melding of words.
Interestingly enough, a diagnosis of “Bipolar” has been appearing much more frequently amongst my clients in the past five years. Psychiatry is not immune to fads and at first I thought that’s what was happening–that bipolar was a diagnosis whose time had finally come. I found that many primary care doctors, and others who did not specialize in mental health, were throwing out this rather serious diagnosis willy-nilly. A condition of less severe moodiness, Cyclothymic Disorder, was a diagnosis hardly ever employed. However, what most practitioners, even those in mental health, do not recognize is that everyone has a mood cycle, an individual rhythm that goes from high to high and low to low on a fairly consistent basis. Some folks (like me) have short cycles, a matter of a few days and others have a rhythm that extends over many months (my father). Sometimes I think some folks with slightly higher highs and lower lows are mistakenly diagnosed as Bipolar, when Cyclothymia, Adjustment Disorder, or no diagnosis at all would be more appropriate. However, I’ve become convinced, that in my case, over the past decade an inherited bipolar condition has emerged–come out of the closet of mere depression so to speak.
Over this past summer I spent about two months in a hypomanic state. I was sleeping only 3 to 4 hours per night and yet on most days had terrific energy. I was unnaturally optimistic and occasionally had racing thoughts. I was unusually talkative and cheerful in my demeanor–obvious, to those who know me, the most “joyous” I’d been in years. Because I knew what was happening I did not seriously over-spend or become delusional–though, I must admit, at times my thoughts likely treaded the edge of reality. I even endured several weeks of hyper-sexuality–feeling far more horny than a man my age should. The good thing is that this hypomanic reaction propelled me into making several lifestyle changes which are permanent. I knew that I’d spent several years sinking into a dark place–not so much depression, but cynicism and worldliness–and I knew I needed to repent and change my life. I apologized to God about this and resolved to be “born-again” again. I changed my eating habits and lost about 20 lbs, and I also stopped feeding my mind irrelevant junk and amusements. I began exercising a lot more and became more disciplined in my prayer life. The mania was the impetus for some positive change. And so in a sense, I was “Bipolar and lovin’ it”–at least for a while.
I have a cousin on my father’s side, one of my few living relatives, who for several decades has battled her bipolar demons. She take a bunch of medications and presently is coping rather well. But she has struggled immensely trying to find the right medication and the right dose while trying to minimize the meds side-effects. Also, several of my closest friends have adult children who are diagnosed bipolar. So other than just affecting me personally, the bipolar demon hits pretty close to home. My friend’s adult children have remarkably similar stories, and scenarios that closely mirror those of many of my clients. The ingredients are learning disabilities and attention deficit hyperactivity disorder (ADHD) as kids that morphs into low self-esteem and drug use as adolescents. The drug use, especially marijuana or stimulants, sets off an underlying bipolar process that lying dormant in their genes. Pretty much every bipolar person enjoys the high of mania and seeking that high thru drugs (both street drugs and prescription) complicates the picture immensely. Some bipolars would develop the symptoms without drug abuse. However, I believe that many would have gotten along reasonably well if they hadn’t been led into drugs in attempting to escape the pain of low self-worth. Of course, living thru their children’s drug use and depression-mania continuum becomes nightmarish for most families.
However, the saddest thing to me, the thing which precludes effective coping and eventual healing, is denial. Most bipolars simply can’t admit that they have this life-altering condition. It’s particularly difficult for males to admit there is something “wrong” with them. Also, in some cases even the parents can’t admit it. They’d rather see their kids as willful, selfish, sinful, etc–you name it–rather than see them as sick with something that may have come thru their genes, or their family environment. The other complicating factor is that when high–when in mania–you just feel so damn good you don’t want it to end–you don’t want meds that will alter that or even to admit that there’s something unnatural about feeling so good. It just feels so right; it feels the way life should be. Though I ran with that feeling some back in July and August, I was always wary that some measure of my joy was a hypomanic reaction. I knew it would end, and sure enough after Labor Day I could feel the sadness and despair returning: “Hello darkness my old friend, I’ve come to be with you again.”
The higher the high–the more devastating the low, and it’s not difficult to see why 15% of those diagnosed bipolar choose to end the pain. Fortunately, I’m a Jesus-follower and that’s not an option. I see my bipolar demon as just another of life’s challenges allowed by the Lord for ones growth–another potential path for praising Him and blessing others. I know that will sound odd to many–but believers are called to give thanks and rejoice in every circumstance (I Thes. 5:16-18). Because of that I just know there is a pony somewhere under all the horse-crap. And I feel compassion for those who do not have that option. I’m also fortunate, that because of my education and clinical experience, I know what’s going on, and thus have some control over it. All bipolars would do well to stop the denial and educate themselves as much as possible about their condition. Thorough knowledge of the illness gives one at least a bit of power over it. Also, knowing that it is cyclical and time limited is helpful (at least to me).
In my book The Unwelcome Blessing I write about the contrasting stories of David and Saul. I believe they both had bipolar tendencies. Saul appears bipolar due to his raidly changing moods, and David appears so due to the dramatic shift in mood in many of his Psalms, and the hubris he displays in dancing naked before the Ark and in pursuing Bathsheba. The point I make is how they did or didn’t cope. Saul ends up taking his own life. David is thoroughly open, honest and contrite to the point of brokeness (Ps. 51), and he is described as the man after God’s own heart (Acts 13:22). So it looks to me like God can bless, and at times use, those with moods far beyond the norm.
One can only hope.