50 Years of Bi-Polar Illness: 1956-2006

RonPrice

MY BI-POLAR DISORDER: A 50 YEAR STORY--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.

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 some here in this account. Those whose names I mention are not troubled by my 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 disorder. My mood swings, now in 2006, take place, for the most part, at night 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 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, perhaps, of 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 care for the last five years.

It seemed appropriate to provide some detailed statement 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 serve in any employment position and 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 experience on a daily basis now in which I cross from normal behaviour to an abnormal extreme. The extreme position has varied from year to year. 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 and the part of the process which occurs in varying degrees of a more accentuated form, it has 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 it has no longer been difficult to know where I am in this process. 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."1 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 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. The 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. 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. It was not until I was 19 in 1963 that any characteristics of this illness became more clearly apparent in my day-to-day life.

My episodes seemed to be quite separate tendencies; hypomania often lead to depression and vice versa. In the 1978 episode, elation and depression followed each other 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: mental hallucinations, specific fears and paranoias, electroconvulsive therapy, psychiatric analysis and diagnosis, the many years of dealing with a death wish, experiences in and out of half a dozen hospitals, unnumbered doctors’ clinics and advice from more people than I care to think of. The situations, looking back, were often humorous and the contexts absurd. And they were much else but I hesitate to go into more detail.

There are a variety of manic-depressive profiles, different typicalities. It is bipolar because both ends of the spectrum, the mood swings, 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 for me to fully accept the lithium treatment. From time to time 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 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 experienced at night, from late in the evening to early morning. The death-wish has always been associated with these blacknesses. With the fluvoxamine, gradually the blacknesses, the depressions, disappeared. The death wish remained as did sleeping problems, but in a much milder form. Like so many things in life, the death wish has varying degrees of intensity.

Frequent urination, periodic nausea and memory problems related, in part, 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—in the last four years--to have been treated.

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. Many 100s of thousands of people have died from this illness in the last several decades. My form of COPD was not a serious one. I also suffered from RSI which I 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 and do not trouble me significantly.

In the last decade or so there has developed in psychiatry what has been 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 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 to the NT in 1982, nearly 25 years ago. The doctors do not know what the cause of her physical problems is, 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. 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.

Perhaps the one advantage my wife’s ill-health has is that it allows me to focus on her problems, to talk about her problems, when the subject comes up in community life and thus take 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. But such a situation has the disadvantage that people have little idea of the battles I face in my personal life.

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. 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.

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 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.

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 seniors school 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.

In three years I will be 65 and will go on the Australian Pension. I have not worked in full time employment for seven years for reasons associated with this illness. I have been on a Disability Services Pension(DSP) for four 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. 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 behaviour associated with my memory loss for several years now. All of this adds to my present incapacity.

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
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