Question:
Are people with bipolar disorder more dangerous than anyone else?
Answer:
This one made me cry, especially the part where Powers said, "The
assumption is I got sick and I got stupid the same day. . . . We are
never going to erase the stigma of this disorder if we don't stand tall
and say it's OK." http://www.timesdispatch.com/servlet/Satellite?pagename=RTD%2FMGArtic...
Cynthia Power has been bipolar since she was 18. Peter Armetta has had
the disorder most of his life, too. Both say that it's a cruel,
complicated mental illness, but also that it can be controlled and life
can be good.
"You probably know people with bipolar disorder and don't even know
it," said Power, who is 58. "I'm not exactly like someone who doesn't
have the disorder. Life is more difficult like breast cancer makes life
more difficult. But it makes you stronger, too."
"I've wrecked my life," said Armetta, 41, who was only recently
diagnosed as being bipolar. "I've lived in 22 places in 22 years. Never
been married. I ran away from women, though I always make a great first
impression. . . . But now I'm doing well, and I'm hoping to stay that
way."
Power and Armetta are two of about 2.3 million Americans who have been
diagnosed with bipolar disorder, which is also known as manic
depression. It's a mood disorder that's different from the ordinary ups
and downs, instead characterized by periods of extreme elation or
irritability countered by periods of severe depression.
The manic symptoms include overly inflated self-esteem, increased
physical agitation and increased talkativeness. Stress can trigger the
manic phase.
"It's not just moods," said Gary S. Sachs, the director of the bipolar
mood-disorder program at Massachusetts General Hospital and one of the
foremost authorities in the country. "Their thoughts and perceptions
color their entire life experience. . . . It's highly treatable. It's
just not curable."
"It affects men and women equally," said Anita Clayton, professor of
psychiatric medicine at the University of Virginia. The mood changes
are cyclical and "not driven by anything in particular," she said. "It
is biologically based."
The disorder has been mentioned in both state and national news stories
recently, raising questions about the treatment of the disorder and,
perhaps, unfairly stigmatizing those who carry its burden.
On Wednesday, Rigoberto Alpizar was killed at Miami International
Airport after bolting from a jetliner and claiming to have a bomb in
his backpack. He was shot by federal agents after ignoring requests to
cooperate. His wife said her husband was bipolar and had not taken his
medicine.
In Henrico County, Joe Casuccio fatally shot his girlfriend and then
killed himself, writing a note to his mother that "having bipolar took
away the freedom to live. I've been tortured since 99."
Benjamin Fawley, a suspect in the death of Virginia Commonwealth
University freshman Taylor Marie Behl, has been described by his
lawyer, Chris Collins, as suffering from bipolar disorder. He is being
held without bond on unrelated firearms and child-pornography charges.
There are other recent cases, in the state and across the country, in
which men and women with bipolar disorder have been charged with
crimes, but the incidents appear to be more a coincidental series of
events than a reflection on those with the illness, experts say.
Are people with bipolar disorder more dangerous than anyone else?
"In 23 years of treating thousands of patients, there's been no
[physical] incidents," Sachs said. "Not a patient of ours has been
arrested for anything like attempted murder or murder."
Bipolar people have more workplace accidents because of their
impulsiveness during the manic phase, Sachs said, and they are
"over-represented in prison." In part, that is because during the manic
phase "your perception of risk and the downside of things is greatly
reduced," he said. "You take a quick read on something and sometimes
react inappropriately to the situation.
"There is an elevated risk of violence," Sachs said. "But the odds
ratio is only very slightly different" from those without the disorder.
Clayton, who has treated many patients with bipolar disorder, said they
"are no more dangerous than anybody else. Almost no one with
psychiatric illness is dangerous."
Power said she believes that "people with mental disorders are more
likely to be victimized than to do the victimizing. I can't say with a
clear conscience that bipolar doesn't contribute to violence. Having
been there, it's a scary place. I never inflicted harm. It may have
been by the grace of God."
"That guy on the plane [in Miami] seemed to have that anger that some
folks with bipolar disorder have," Armetta said. "I had the peace and
love aspect. . . . The problem with all mental illness is getting the
right treatment. People should be no more afraid of people bipolar than
anybody else. That bipolar people are violent has no credence with me."
Carol G. Cutler, a clinical assistant professor at Virginia
Commonwealth University who has studied bipolar disorder, said the
"stigma is out there, but it shouldn't be. It used to be schizophrenia
was the particular illness that got targeted out of proportion" as
leading to violence. "Most people who commit crimes aren't bipolar."
The irony is that bipolar disorder, which can make life so difficult,
often is borne by unusually creative and talented people.
"They're very talented and exceptional people on the whole," Sachs
said. "They are over-represented at the highest level of corporate
America for example," though often no one knows they have the disorder.
"They are creative and industrious. A controlled bipolar illness makes
a terrific citizen.
"They have great facility with language, music and math," he said,
noting that a number of historical figures are believed to have had
bipolar disorder, including President Abraham Lincoln and writer Mark
Twain.
"Despite the stigma attached to the illness, they're really a
remarkable group," Sachs said. "But that doesn't take away from the
extraordinary cruelty of this condition."
Armetta understands that characterization. In the throes of his
disorder, he would commit to doing more work than anyone else. "I would
run until I dropped," he said.
He now works helping foster children in Charlottesville. "I do a lot of
writing. . . . I am creative. . . . I knew I was not a conventional
person."
The treatment for the disorder, which includes psychotherapy, has
improved over the years with lithium, anti-convulsants and what are
known as atypical anti-psychotic drugs used separately or sometimes in
conjunction, Sachs said.
"We've had effective treatments for decades, but in the last 10 years,
especially the last five, we've had treatments that patients perceive
as less burdensome" because of lessened side effects, he said. "It's
been a terrific boon. . . . Patients still get off their medicine, but
not like they used to."
Power and Armetta take medication. "I'm doing well on meds, but it's
just a piece of the treatment," said Power, who believes family and a
passion for work and other interests make up the framework that
stabilizes her. She works in Charlottesville as a volunteer in the
mental-health field.
"I look over my life and it hasn't been so bad," she said. "In fact, my
life has been pretty good.
"I know a lot of people with bipolar. Some are well-hidden. There is a
community of us. There is a sense of camaraderie," she said. "We live
under a stigma and I see our movement as being a civil-rights type of
movement. You can't characterize us. We're just people like anybody
else."
She doesn't like the condescending attitude that some people have with
those struggling with mental illness. "The assumption is I got sick and
I got stupid the same day. . . . We are never going to erase the stigma
of this disorder if we don't stand tall and say it's OK."
Armetta said his high moods would last over a year "without let up. . .
. I was too happy, too gleeful. My hyper-focus could be a bad thing. .
. . I looked like two people -- this Pollyannaish, affectionate guy,
then a guy who couldn't function" when the depression phase took over.
Armetta, who says he once lived in a desert for eight months just for
the experience, said that though he has been diagnosed as bipolar,
"that is not who I am. It's only when bad behavior becomes too bad that is classified as
morbid/pathological and is termed an illness. The honest answer is that
first you became stupid (or were always stupid) and gradually your thoughts
got worse and worse to the point where it had to be classified as an illness
so that someone could treat it and help correct our incorrect thought
patterns. I loved a few weeks ago on desperate housewives when the therapist of the
crazy guy said "well, I don't believe in evil, we just take the bad behavior
and treat it like it's an illness". Fortunately, the crazy guy attempted
suicide and they let him die in his misery.
There's a big difference between stupid and crazy. Stupid is slow and
unimaginitive and more free of suffering - like the saying, "Ignorance
is bliss." Crazy-manic is like being in love, full of violent passions
and intensities; crazy-depressive is like dying, or watching a loved
one die. And mania isn't always "bad" - look at what Beethoven created, what
Abraham Lincoln accomplished, what Mark Twain wrote. Yet does their
lack of "badness" mean they weren't ill, or that they were stupid, or
that this illness didn't effect their lives in substantial ways?
Look at Elizabeth Sidall (married to the Pre-Raphaelite Dante Gabriel
Rossetti) - she was more uni-polar depressive than bipolar but very
creative. She painted some beautiful pieces and died by an overdose of
laudanum. Her illness killed her, the same way cancer kills, and she
never did anything "bad".
Crazy is not bad or stupid, it is genetic, inevitable, and too often
ends in tragedy. Sometimes logic and reality may slip our grasp in the
throws of our illness - but these are the antitheses of creativity and
imagination. Without seeing the things we've seen, experienced our
experiences, would we still be the creative strong people we are today?
