Bipolar Disorder: Managing the Balancing Act
Bipolar disorder symptoms include dramatic shifts in mood and the ability to function. Successful bipolar disorder treatment requires a careful course of medication, psychotherapy, and discipline to stay on track--and avoid an emotional crash
The 'Learning Curve' continued...
Regardless of the downsides, the mania can be compelling. "I felt like
God was talking through me at one point, and I bought lavish gifts for my
girlfriend [now wife]," Bernard recounts. "It's the feeling of being
high and feeling like you are the messiah." In an upcoming story on
General Hospital, his character Sonny -- who also has bipolar
disorder -- will traverse the manic stage of the illness.
"You feel like you are on top of the world and nothing can stop you. And
then, of course, the real problem is having to deal with the crash," says
"I understand that patients who feel elated [also] feel wonderful ...
it's like being on cocaine and can be extremely attractive and very
seductive," says Joseph Calabrese, MD, a professor of psychiatry at Case
Western Reserve and director of the Mood Disorders Center at the University
Hospitals of Cleveland, Ohio. "There is one problem," he adds. "One
hundred percent of people have a depression after a high.
"There are short periods of productivity on the way up, but once the
highs get more severe, they are less productive," Calabrese says. And
"once you are ill, you have to be able to stay on your medication for life,
since in most instances when medications are stopped, people will
"It's a human phenomenon," agrees Gary Sachs, MD, an associate
professor of psychiatry at Harvard Medical School and director of the Bipolar
Mood Disorder Program at Massachusetts General Hospital, both in Boston.
"There is a willingness to take a treatment when you're acutely ill, but
then when symptoms are no longer [obvious], it's hard to get your arms around
the idea of taking a drug forever when you are not perceiving any
Just as with Bernard, "as patients experience more and more relapses,
the wisdom to take medication becomes clearer," says Sachs. Some people, he
adds, may get the message after three lapses -- and for others it can take
James E. Rosenberg, MD, director of neuropsychiatry at the Sports Concussion
Institute at Centinela Freeman Hospital in Marina del Rey, Calif., says that
people with bipolar disorder think, "'I am going to finally write the great
symphony or make some brilliant discovery.' But in the long term, people with
untreated mania may find they no longer have family, are HIV positive from
engaging in risky, thrill-seeking activities, are in jail, or are bankrupt.
There are horrible consequences that affect the rest of your life."
For Molliner, the repercussions were mainly social. "I lost my identity
as a 16-year-old adolescent girl. I didn't take final exams [the year] I got
diagnosed because I was being treated, and everybody I went to high school with
knew why, and the shame that went with that was the biggest repercussion,"
she says. "I felt like I didn't fit in and never would."