50 Years of Bi-Polar Disorder: 1956-2006

This is an update of a posting here some two years ago. One's perception of a problem seems to change with time.
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MY BI-POLAR DISORDER--A 50 YEAR STORY IN CONTEXT: 1956-2006

My experience both long and short term with manic-depression, or bi-polar illness as it has come to be called in recent years, and with other maladies; as well as my personal circumstances at home in relation to my wife’s illness should provide you with an adequate information base to evaluate my situation, make relevant comparisons and contrasts to your own predicament whatever it may be and thereby gain some helpful knowledge or understandings which may be of use to you in personal terms. This wider experience which I outline here will place my bi-polar disorder in context and should provide others with what I hope is a helpful perspective on their own condition and situation. This essay of a little more than 3000 words and a little less than six A-4 pages, is primarily written for internet sites on mental health and bi-polar disorder. Originally written in 2003, it has been revised several times after feedback from various internet respondents.

1. Manic-Depression: Preamble


After half a dozen episodes, varying in length from several days to several months, and many experiences on the fringe of normal manic-depressive symptoms between 1956 and 1980, I was treated with lithium carbonate in Launceston by a psychiatrist, Dr. Glinka. In some ways names are not that important but I will include two or three here in this account. Those whose names I mention are not troubled by their inclusion. Their professional work has been much appreciated and readers should not be concerned in any way by the addition of their names in this short essay.

I have been on lithium now for twenty-six years about half of the total time I have experienced this significantly/partially genetic disorder. My mood swings, now in 2006, take place, for the most part, after midnight with the death wish still part of the experience. The symptoms that affect my daily working capacity are fatigue and psychological weariness, sometimes after a night of light sleeping, tossing and turning and/or sometimes late at night after many hours of intellectual activity. Dryness of the mouth and short term memory loss also seem to affect my daily life as a result of (a) lithium treatment and (b) in the case of memory loss, perhaps due to the eight ECT treatments I had as far back as the late 1960s. My current psychiatrist, Dr. Eric Ratcliffe of Launceston who specializes in treating people with bi-polar disorder, has been providing his professional advice for the last five years.

It seemed appropriate to outline this detailed statement for several purposes since the issue of this bi-polar illness is a complex one, varies from person to person and has come up many times over the fifty years that I have had to deal with its symptoms in my personal and working life. It is difficult to characterize my condition and it is for this reason that I have written out this somewhat long statement. I hope the account below, in both long and short term contexts, will explain adequately my reasons for not wanting to work in any employment position or participate in any demanding social context. This account may also provide those interested with some useful information for their own problems.

2. Manic-Depression: Long-term 1956-2002

There seems to be a process, one that I have experienced on a daily basis for some 50 years. The details, the symptoms, the behaviour has, of course, varied with the years, with the decades. I cross from some normal behavioural constellation to an abnormal one. The abnormal extreme position has, as I say, varied from year to year in content, texture, tone and intensity. At the moment it is characterized by a tedium vitae attitude and behaviour as I have come to call it. Due to this "process" over the last fifty years, due to the part of the process which occurs in varying degrees in various accentuated forms, it has often been difficult to define just where I was at any one time along that 'normal-abnormal' continuum. This was true at both the depressive end and the hypomanic end of the spectrum. It is difficult, therefore, to actually name the number of times when I have had major manic-depressive episodes, perhaps as many as eight, certainly as few as four, in my whole life, until the last brief episode in 1990 when I went off my lithium for between one and three months.

Since the 1990s I have no longer had any difficulty knowing where I was in this process, this swing of mood and feelings. Total acceptance of the nessessity of taking lithium was a critical variable in this process. At the hypomanic end there were experiences like the following: violent emotional instability and oscillation, abrupt changes and a sudden change in a large number of intellectual assumptions. Mental balance, a psychological coherence between intellect and emotion and a rational reaction to the outside world all seemed to blow away, over a few hours to a few days, as I was plunged in a sea of what could be variously described as: emotional heat, intense awareness, sensitivity, sleeplessness, voluble talking, racing mental activity, fear, excessive and clearly irrational paranoia--and in 1968 virtually total incoherence at times--at one end of the spectrum; or intense depression, melancholia, an inner sense of despair and a desire to commit suicide at the other end. The latter I experienced from 1963 to 1965, off and on; the former from 1964 to 1990, on several occasions.

The longest depression I had was in 1963 and 1964 with perhaps two six month periods from June to November and July to December, respectively. The longest episode of hypomania was from June to November 1968. This episode was also given the name of schizo-affective disorder with the adjective mild placed at the front of the term. The episodes of hypomania in 1978, 1979, 1980 and 1990 were treated quickly with medication, although the 1978 episode, beginning in January, seemed to last for at least three or four months and had a mostly depressive component. It was treated with stelazine and the side effects were horrific. I wanted to get under the bedclothes every night after getting home from work due to paranoia and depressive symptoms. Only the 1980 episode required hospitalization in this case for one month.

I had no experience of this variously characterized illness in childhood although, beginning in 1956/7 at the age of 12/13, on the puberty cusp, I manifested symptoms which, in retrospect seem to me examples of a lack of control of my emotions and far too intense an activity threshold. It was not until much later in life that I began to see these behavioural aberrations at puberty and during adolesence as having, possibly, a link with my future mental illness. It was not until I was 19 in 1963 that any characteristics of this illness became quite clearly apparent in my day-to-day life. They did not receive the required medical attention. I was just given lots of advice from religious to common-sensical varying from diet to exercise, etc.

My episodes over the years seemed to exhibit quite separate and distinct tendencies and patterns; hypomania was always characterized by elation and depression was always characterized by varying degrees of very low moods. In the 1978 episode, elation and depression followed each other alternatively within a two to three month period. Clearly, in the episodes in the late '70s, fear, paranoia and the extremes of depression seemed to be much less than those of the 1960s.

This account above has none of the fine detail that I could include like: (a) mental and mostly auditory hallucinations, (b) specific fears and paranoias, (c) electroconvulsive therapy, (d) psychiatric analysis and diagnosis, (e) the many years of dealing with suicidal thoughts and the death wish, (f) experiences in and out of half a dozen hospitals, unnumbered doctors’ clinics and the advice from more people than I care to think of and (g) adjusting to medications that varied from ones which put me to sleep to ones which made me high; and (h) the affects of these swings on my employment, my relationships and my attitude to life. Many of the situations, looking back, were humorous and the contexts absurd. And there was much else but, as I indicate, I hesitate to go into more detail. I want to make this as short as possible but as detailed as I can to give a longitudinal perspective.

There are a variety of manic-depressive profiles, different typicalities, from person to person. It is bipolar because both ends of the spectrum, the moods, were experienced over the period 1956 to 2006, 50 years. Thanks to lithium the extremes were treated by the time I was 36 years of age, by 1980. It took another ten years, until 1990, for me to fully accept the lithium treatment. From time to time in the 1980s I tried to live without the lithium. Such, in as brief a way as possible, is the summary of my experience over the years. I have written more extensively of this in my autobiography which is readily available on the internet if anyone is interested. I would like, now, to focus on my more recent experience of the last decade and a half and especially the last several years.

3. Manic-Depression: Short-term 2002-2006

In 2002 Dr. Eric Ratcliffe, my supervising psychiatrist in Launceston, suggested I go onto fluvoxamine in addition to the lithium treatment. Fluvoxamine is an anti-depressant. The fluvoxamine removed the blacknesses I had continued to experience at night, from late in the evening until early morning when I was awake or partially awake. The death-wish has always been associated with these blacknesses. With the fluvoxamine, gradually the blacknesses, the depressions, disappeared or virtually so with only residues of a lower mood remained. The death wish remained as did sleeping problems, but in a much milder form. Like so many things in life, the death wish and mood swings have varying degrees of intensity and coping is the key question—and one not easily or always answered.

Frequent urination, periodic nausea and memory problems related, in part and perhaps to the shock treatments I had back in the 1960s, were new problems by the year 2000. But the dark and debilitating feelings, I had experienced for so many years, were at last removed. After fifty years of bi-polar disorder and/or manifestations of bi-polar disorder in varying degrees of intensity, with periodic totally-debilitating episodes, most of the worst symptoms seem at last, at least in the last four years, to have been treated and removed.

4. Other Physical Difficulties:

Four years ago in 2002 I was diagnosed with chronic obstructive pulmonary disease(COPD) or emphysema which gives me a shortage of breath when I exert myself even mildly. Many 100s of thousands of people have died from this illness in the last several decades; I’ve seen various statistics. My form of COPD is not a serious one. I also suffered from RSI which I have treated with exercise, thus lessening the effects. These two conditions exacerbated the remaining bi-polar symptoms by making it difficult to engage in an activity for more than short periods of time. The memory problem also contributes, as you can appreciate, to many practical problems in day-to-day life. I mention these things because, although my bi-polar disorder is largely treated, there is a constellation of physical and psychological difficulties remaining.

For the most part in community life I rarely talk about these things and most people who know me have no idea of my medical history or the difficulties I live under physically. I have for many years regarded these difficulties as part of my own spiritual battles that I must face. And they are difficulties that have largely slipped into a low gear in the last several years and do not trouble me significantly. I should mention that a spiritual attitude which has been part of my belief system since the 1950s has helped me more than I can appreciate. This is especially true of the attitude to tests and difficulties in life which the founder of my religion says are often “like fire and vengenace but inwardly light and mercy.”

In the last decade or two there has developed in psychiatry what has been variously called a Recovery Model for treatment and care. This model puts the onus on the person with the disorder to work out what is his or her best way to cope, to survive, in society given the conditions of their illness. Such an individual must work out the techniques and strategies for day-to-day living. With each individual the disorder is idiosyncratic; individual consumers of mental health services must work out what is best for them in terms of these services and in terms of what activities are appropriate for them within their coping capacity in life’s day-to-day spectrum. It is my hope that my story may help others work out their own particular regimen of treatment programs and daily coping tools.

5. My Wife’s Illness:

My wife Christine, now 60 years of age, also has not been well for many years--since we moved from Tasmania north of Capricorn in Australia’s Northern Territory in 1982, nearly 25 years ago. Although she, too, has a long history of different kinds of problems which I won’t go into here, it is the more recent ones that I mention below and that affect our life-style in more ways than one. The doctors do not know what the cause or causes of her physical problems is/are, but they are problems that make life difficult for her and our life together. Her symptoms include: dizziness, nausea, back-ear-and-eye ache, headache, among some two dozen or more maladies that I have put down on paper to try and monitor on a dialy basis and try and find some pattern. Sometimes, with the aid of steroids or some new drug, or some alternative medical treatment, she seems to recover for a time, but her symptoms eventually return, sometimes mildly and sometimes not-so-mildly.

Perhaps the one advantage my wife’s ill-health has, if there are any at all, is that it allows me to focus on her problems, to talk about her problems, when the subject comes up in our personal and community life. This keeps the focus off of my own disability. Consequently, people have little idea of the physical problems I face and much more of an idea of hers. I don’t mind this for I am not particularly interested in talking about my disability. After 50 years it has become somewhat tedious in the telling. As I say, such a situation has the disadvantage that people have little idea of the battles I face in my personal life and, in the end in life, we all face our battles alone—hopefully with a little help from our friends as the inimitable Joe Cocker used to sing over forty years ago. And I have a core of friends with whom I can share a broad range of intimacies. Mostly, though, these friends do not tend to inquire and I do not tend to expose these battles any more. I have little need to open up as the saying goes. Not after 50 years anyway. On occasion and with encouragement I do.

6. Concluding Statement:

This brief and general account summarizes both my long history of this illness and where I am at present in what has been a life-long battle. I think it is important to state, in conclusion, that I possess a clinical disorder, a bio-chemical, an electro-chemical, imbalance having to do with brain chemistry. The transmission of messages in my brain is simply overactive, not smooth. One to three percent, depending on what study you read, suffer from this illness. The extremes of this illness are now largely treated by lithium carbonate and fluvoxamine, but a residue of symptoms remains which I have described briefly above. The other factors that describe my personal situation I have also outlined and need to be taken into consideration as well to provide a thorough overview of the present context.

I have gone into the detail I have above because I wanted to give you some idea of the extent of this illness and its subtle and not-so-subtle affects. I really feel quite and quietly exhausted from the battle with this illness and would prefer to continue to live my everyday life in ways that my health allows. In 1999 I gave up full-time work; in 2003 part-time work and in 2005 most of my volunteer work, except for some Baha’i work largely involving writing.

In the years 1999 to 2005 I took part in a wide range of volunteer activities from holding a radio program, to singing in a small choir, to teaching in a school for seniors here in George Town. Now short bursts at writing are about as much as I want to handle. I take on various domestic and social activities in my home and elsewhere here in northern Tasmania, again involving short periods of time. These activities are all within my capacity for short time periods, periods also necessitated by my chronic obstructive pulmonary disease, but that is a separate issue which I do not want to overemphasize here.

In three years I will be 65 and will go off the Disability Pension and onto the Australian Pension. I have not worked in full-time employment for seven years for reasons associated with this illness. I have been on this Disability Services Pension(DSP) for five years. Although I have been treated for the worst side-affects of manic-depressive illness, I have little energy, enthusiasm or capacity for full-time employment or demanding social and community activity that entails many hours of interaction. It is for this reason I have been granted the DSP.

My short-term memory loss often feels like the beginning of a dementia condition, although I had a memory test administered in 2001 at the Medical Services clinic in George Town and it did not indicate the beginnings of dementia. My wife, though, who knows me well and experiences the affects of this memory loss, has been very concerned and often frustrated by my behaviour associated with memory loss for several years now. All of this adds to my present incapacity although, again, I do not want to give emphasis to this memory problem because it is really a peripheral aspect of the bi-polar disorder.

I trust the above outline provides an adequate information base for you to evaluate my situation. I apologize for going on at such length, but I felt it was essential to place my illness in context, so to speak. I’m sure there are many, indeed millions, who have problems worse than my own. But this is my story, my disability, briefly stated. I look forward to hearing from anyone in the weeks, months and years ahead should my experience be relevant to your own and should you want to discuss these issues further.

Ron Price
July 2006
Age 62
No of Words: 3195
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Thank you Mr. Price for you contribution here.

It has enlightened me to a future with bipolar.

I have suffered for 27 years this year. But I note that as I too grow older it is easier to manage, maybe because it's all I know now.

The depressions are however never easy, and I cannot take AD's due to a rapid cycling response.

I hope we hear more back from you. Don't be a stranger.

Thanks Ron,

I enjoyed your description of your life with bipolar illness. You thought your message was long. I'm also a retired teacher who lived a lifetime suffering from bipolar illness. The description of my battle is book length--it is on my website along with a number of links and articles.
Jim S

Jim, do you feel there is a link between eating disorders and bipolar, not that all those with bipolar have eating dx, or vice versa, but I see that you and both have that combo?

Do you think it has something to do with our dopamine, considering we both have a hx of alchohol and drugs as well?

(contemplating a theory*)

Thanks, Jim. I'll have a look at your story. I know what you mean about length. I put my bi-polar story in context. You can read it at the website: HealthyPlace.com under bi-polar. I wrote the story in 22 instalments. The story is more autobiography than bi-polar focus only.-Ron.

I had a look at your story and you list of resources. Your site there is an excellent resource for bi-polar sufgferers and I will add it to my list. My story, my approach, is quite different than yours. Yours is much more focused on the disability. Mine is more autobiographical-literary-interdisciplinary. Indeed, it took me 22 years to write and I am going to keep working at it into my late adulthood and old age.

I think your place, your resource, is more useful than mine. Mine exists in some middle ground between "a bi-polar story-resource" and an academic-literary-autobiographical-philosophical overview of life. I've put it at eBookMall and lulu.com-you have to pay to read it there, but it's free at HealthyPages. It's also over 1100 pages which is enough to put most people off.-Ron

ddeehopes,
I'm sorry that I did not reply before this. I was on vacation in Colorado and could not get to a computer. Then, when I saw your post, the library was closing and I did not have a chance to post a reply. But, I needed time to think anyhow. It is a good question.

My first guess is that they must be related at some point and that dopamine is involved. Let me tell you my thoughts on this. Bipolar and addictions of all kinds (alcohol, food, drugs, gambling) are about getting some joy even though there are parts of our lives that at present are painful. An addict will give up everything just to have a few minutes of relief from the pain he/she is in. One thing about addiction is that it seems to involve the idea that if we do such and such a drug we will quickly feel better. Our pleasures are caused by dopamine working in a certain area of the brain (I can't spell it.) Now, I strongly believe that bipolar disorder, at least the mania phase is exactly like the high from addictions. The addict will do anything do go back to that feeling of peace and contentment that drugs bring him. When someone is in a mania phase they are in a high. They want to stay there, or at least return often. That is why, in my opinion, that bipolar is so hard to treat. Why would anyone not want to be happy? We might say we want to get better, but in the back of our mind we really want to get high--some time we think we can handle the mania and not lose everything. We take our medicine for a while, but really we want to get high and the medicine keeps us from getting high. So, we stop taking it and relapse. This need to be in a mania stage is never written or talked about. I think it is central to controlling bipolar illness. When I reached the point where I did not care if I was high, low, or normal my bipolar never knocked me down again. That was decades ago. However, it might me that I'm completely wrong becasue I'm an addict and a bipolar. Maybe a pure bipolar would not be seeking pleasure as much as a dual diagnosed person.

It might me that eating still gives us pleasure so we eat more and more until we have a tremondus weight gain of 50-100 pounds that seems to almost be the rule when taking psychotropic meds. It may also be that the chemical workings of the brain uses a great deal of energy, so that when we have our thinking slowed down by meds, we burn far less energy.

At any rate this is an interesting topic? How do you feel about my theories? Do they make any sense?

Jim S

It makes perfect sense, the other day a woman told me that serotonum* has to do with the stomach, I always thought it ran thru the spinal cord.

Now the dopamine I totally relate to, I become in need of anything that gives me euphoria that is related to the dopamine, thus the word dope.
right?

I have no trouble with anything you say here. Let me add that, after more than 25 years on lithium,and five on the anti-depressant fluvoxamine as well,that I seem to get about as high/relaxed/feeling good(whatever the word is for feelings in the middle range)as I can and avoid the perils of the worst. After playing/dealing with moods now for over fifty years, I'm happy with the situation and have no need to, no desire to, no inclination in any way, to play with the recipe. I want to stay where I am, at last.-Ron Price, Tasmania

maybe for my generation, things are going to be a little bit better, i'm twenty right now and have luckily caught my bipolar disorder, because if i had kept going on and off ad's i would just get more and more depressed eventually, and less a part of society. i still get the "blacknesses" as you put it, and thats what the valiums are for at night, i am on lamictal 300 mgs a day, and it's been wonderful, if i have and episode of depression, it usually doesn't last long, maybe a week at most, and having pyschotic features helps in a way i guess, cause i know that when i start seeing flashes of light, it's time to chill down and let the stress go. i've been really down tonight, thinking about what is this all for anyway? i feel kind of like a piece is missing, u know? like, yea, in life you're supposed to move forward, but why? where's it gonna get ya? don't mind all that, i just needed to get it out, my best friend got fired for stealing from work, and i am mad because she lied to me about it, and more hurt because she's too ashammed to tell me, and i think she was stealing money for drugs, it makes me so sad. i really just need some sleep, when you miss sleep, u know how it is, adds to the stress and can set mood episodes off, anyway, i enjoyed, i guess i could say, reading your story, it was interesting, and it always feels good to know that you are not alone in ones suffering, thank you and goodnight.