By Stephen Brockway, M.D.
Former Staff Psychiatrist for Inpatient and Outpatient Services at The Meadows
A college student whom we’ll call Jim is experiencing a profound sense of despair. Dragging himself out of bed is becoming increasingly more difficult. Brushing his teeth is a tall order. Fixing himself a sandwich seems insurmountable, and doing his homework is too much to ask given his bleak emotional state.
As his symptoms progress into a downward spiral and become more debilitating, Jim discovers through trial and error that taking a potpourri of uppers such as cocaine, speed, and self-prescribed amphetamines helps to ease his depressive symptoms. In his quest to devise a creative solution to his dilemma, he never considers that he could be facing a psychiatric illness such as bipolar disorder.
The Effects of Untreated Bipolar Disorder
Months later, Jim’s mood shifts and he becomes restless and agitated. Thoughts of leaving college to become a racecar driver sound appealing and reasonable. Sleep isn’t on the radar. Jim feels ecstatic as if he’s the big man on campus and believes he’s the quintessential heartthrob. He spends excessive amounts of money on women he barely knows and is on the path to financial ruin.
Soon though, his thoughts begin racing so fast he can’t concentrate or focus. He’s unable to sit still and it’s unnerving. Jim figures out that a cocktail of alcohol and Valium can calm him down. He starts to need more alcohol and substances to achieve the desired effect, so he begins spending an excessive amount of time and money at bars or at home with bottles of pills and alcohol.
There’s a saying that goes, “All of our problems started out as solutions”—and this scenario fits the bill. Jim’s attempts at creative problem solving have gone awry. As Jim continues to self-medicate in an attempt to balance out his highs and lows, he needs more of these ups and downs to regulate his symptoms. Jim believes he’s doing himself a service by self-medicating and spends a good deal of time trying to keep his fluctuating moods in check.
At the same time, Jim’s life is passing him by. He isn’t enjoying his precious youth, his peers, potential love interests, and the invigorating atmosphere of college life. The abundance of beauty in the world escapes him. Genuine laughter, the kindness of others, and the miracle of feeling truly alive aren’t in reach.
Recognizing the early signs of bipolar disorder is instrumental in securing an accurate bipolar diagnosis.
Bipolar Disorder Misdiagnosis
The severity of his depressive symptoms finally brings Jim into the medical clinic on campus where he is diagnosed with depression. This sounds like a reasonable diagnosis. The symptoms conveyed by Jim to the physician on campus certainly fit the criterion for depression. What the physician doesn’t know is that Jim has a family history of bipolar disorder and has also experienced manic symptoms in the past. The physician only captures a fragment of Jim’s medical picture. It’s important to note that individuals with bipolar disorder may suffer from hypomanic and depressive episodes (which are indicative of bipolar II disorder.) Hypomanic behavior is not as severe and pronounced as the full-scale mania associated with bipolar I disorder.
After his doctor’s appointment, Jim is handed a prescription for antidepressants and his depression soon lifts but is followed by a manic episode. He believes the antidepressants have done their job, so he figures he doesn’t need any more medications. Jim now feels energized, invigorated, and ready to conquer the world. Once again, he is the big man on campus. He believes this is the way life should be, and it feels good.
Depressive Symptoms
This scenario plays itself out over and over again during the next ten years. Unfortunately, depressive episodes tend to worsen with age and persist for longer periods of time. One reason for this is that people experience more losses —deaths of loved ones, health problems, and employment issues—as they age.
During Jim’s manic episodes after graduate school, he accumulates major debt causing friction in his current relationship and stress on the financial front. His life is unraveling and his dependence on drugs and alcohol escalates. Life has become unmanageable.
The grim reality is that Jim is not alone. Many people—especially young adults—with undiagnosed bipolar disorder become addicted to drugs and alcohol in an attempt to self-treat a wide range of symptoms. Unable to thrive, it’s the only way they feel they can survive. What once seemed like a perfectly logical solution to these mood swings is now its own problem. Drug and alcohol addiction is no stranger to people suffering from bipolar disorder.
Ten years after college graduation, Jim finally consults with a seasoned psychiatrist and is accurately diagnosed with bipolar disorder. He is put on an appropriate medication regimen and now must also seek help for his drug and alcohol abuse.
The Impact of Undiagnosed Bipolar Disorder
Jim’s story is not uncommon. A common struggle for psychiatrists is how to diagnose bipolar disorder. One of the greatest tragedies of bipolar disorder is that many people who are afflicted with this serious and debilitating condition are often diagnosed ten or more years after the initial onset of their symptoms. It’s estimated that people with bipolar disorder are 15 to 20 times more likely to commit suicide than the general population. Many people with bipolar disorder are great talents in the art world—writers, painters, and comedians. Such individuals add flavor, color, and a sense of style to the world. It’s sad to hear about all the hardships they’ve endured during their lives. What’s more, Abraham Lincoln and Theodore Roosevelt are said to have suffered from bipolar disorder.
What’s most unsettling is that bipolar disorder is treatable. Recognizing the early signs of bipolar disorder is instrumental in securing an accurate bipolar diagnosis. Family history is an integral component in the process, along with obtaining a complete medical history. Looking at just one piece of the picture can result in a faulty diagnosis leading to untreated bipolar disorder.
Unfortunately, depressive episodes tend to worsen with age and persist for longer periods of time.
Bipolar Disorder Treatment at The Meadows
The Meadows psychiatrists and other members of our clinical team help individuals with bipolar disorder, many of whom also struggle with substance abuse. The good news is that bipolar disorder treatment is available. There’s no reason why such individuals have to miss out on all the beauty and splendor in life—falling in love, doting on newborns, exploring foreign lands, forging life-long friendships, and learning to love themselves for who they are no matter how many struggles they’ve endured over the years.
Contact The Meadows, we’re the most trusted name in treating addiction, trauma, and co-occurring disorders. Give us a call if you or a loved one is in need of the best available care. We’re here for you.