Bipolar Disorder Management

Story of a Bipolar Disorder Woman

Recently, a young woman with bipolar disorder died of an apparent suicide. She had been in a Yoga class where she had excelled in the practicum. Her limber movement, her style and her meditation technique were flawless. She was extraordinarily proud of her achievement and displayed a glow more brilliant than her classmates.

When it was time for the next course, her attendance was erratic. She was late to class on several occasions which was not her norm. Her mood swings were abrupt and she would interrupt sessions at odd times with bizarre statements. Eventually, she dropped out completely.

Her parents notified the Yoga teacher that their daughter had been hospitalized and would not be returning. Later, they learned she had taken her own life.

It was subsequently relayed that she felt so healthy with Yoga that she stopped taking the lithium that she had been taking for years to control her moods. Yoga had become her new “friend” and her obsession, replacing her other old “friend”, medication. She had descended into a deep depression from which she could not emerge.

Symptoms of Bipolar Disorder

Bipolar Disorder is a disease one cannot see at first glance: there are no missing limbs, no limp, no bandages, no outside scars. It is a condition that often emerges in early adulthood – at a time when the sky is the limit – only to find out that the disease burden is not only incurable, but must be “managed” for a lifetime. At a time when a young adult barely knows their own way, the way forward is now predetermined and confined – and, worse, the success of the journey is squarely on the individual. Their compliance is absolutely necessary to keep their moods level and help the physician decide if changes must be made. No deviating from the center line. At a time when a young adult is just gaining full control of their life, he or she is faced with losing it. There may be no screaming on the outside, but there is plenty of screaming on the inside.

The difficulty of maintaining medications is the single most difficult treatment challenge facing physicians and bipolar patients. The level mood periods and the “high” of the manic phase can easily lure a bipolar individual into believing that the medications are no longer necessary – “I have control over my life now” – only to discover that the slide into depression is steep, precarious and uncontrollable.

Even restarting medication seldom results in a leveling off. Research has shown that the medication necessary to maintain a mood is not sufficient to enable a patient to recover from a depressed state. The medication needed to maintain again is often greater than the earlier dosage.

The lucky patients understand the ground rules from the beginning. They regard “losing control” as “gaining control”. They may be able to maintain a job and a life independent of close supervision. Unfortunately, this is not the case with most, for whom the lure of the “high” is seductive and the drive to control their environment is overwhelming. It is forgivable and very human to feel this way, but also hurtful to family members and dangerous for the patient.