All posts by Jennifer Price

A Journey with Bipolar Disorder

By Jennifer Price “Just because you don’t understand it doesn’t mean it isn’t so.” ― Lemony Snicket, The Blank Book. Much has been written and said recently regarding Robin Williams and factors that led to his suicide. It is not my place to discuss the “whys” and “what ifs” of statistics, seeking help, and treatment protocols. I simply wanted to share a little about what I have learned (and am still learning) over the past 18 years as I’ve watched my husband John struggle with a pain that I cannot even begin to fathom. I met John when I was 23 years old and was drawn to his dry sense of humor and it didn’t hurt that he had “a real job”, a house, and matching living room furniture that didn’t include a beat-up card table and lawn chairs. Although he has always been very quiet (friends say that’s a good thing; I can talk enough for both of us!), even from the beginning, I sensed something a bit sad in his eyes. I wondered if maybe I was reading too much into it because I had dated guys who were the life of the party and never seemed to have a bad day; because John was 10 years older than me, perhaps he was just more reserved. That wasn’t it…. John was diagnosed with bipolar II disorder with rapid cycling when he was 17 years old, before depression was discussed more openly on television and in magazines. For more than 30 years he has dealt with a chemical imbalance that has led to stretches of not sleeping for days to not being able to get out of bed. John has also dealt with numerous changes in medication and dosages, trying to find combinations that will level off the hypomanic highs and the crushing troughs. He has experienced times when medications no longer worked and when the side effects were more detrimental than the chemical imbalance itself. Even though I grew up in a family of physicians and therapists and intellectually I knew how depression could affect a person, when John and I were first married I took it very personally that he would “choose” solitude or seek solace in hours of online chess when depression sank in. If I’m being completely honest, I sometimes still do. I mean, someone just can’t NOT get out of bed, right? He or she must be doing it on purpose. Wrong. I have learned, even after all of these years, that bipolar disorder is not a choice; John isn’t choosing to shut down and withdraw. He is choosing to cope and survive. It has taken me a long time to recognize that just because he isn’t coping in ways that I might, John knows better than anyone how he can withstand, in his words, “a nightmarish downswing.” Having never faced anything like that, who am I to judge his coping mechanisms; to discount his experiences as just being a little down? Yet, I have judged; I have discounted; and while I have been told that those are common reactions family members can often experience, that doesn’t mean they are right and they certainly aren’t helpful. I’ve learned the hard way those things can make an already tenuous situation much worse — you can’t slam a door or yell someone out of a chemical imbalance. But, you can realize that even though he or she may not be able to show it at the time, he needs you and that you are helping him by being there and letting him know he’s not alone in this struggle. Although I may not fully understand why John copes the way he does or how a chemical imbalance can bring a smart, funny, and hardworking man to his knees, as a loved one, I try to do my best to support, yet not enable. I try to give space when it’s needed, but not abandon. I continue to learn more about bipolar disorder; knowledge goes a long way in diminishing fear and fostering understanding. And understanding is all John has ever asked for. Disclaimer: The views expressed here are solely those of the author in her private capacity and do not in any way represent the views of the Southern Medical Association, the Southern Medical Journal, or any of its Council members, officers, partners, vendors, or subsidiaries. Furthermore, neither the Southern Medical Association nor any of its subsidiaries have approved, endorsed, or embraced anything associated with this post.

June’s Free SMJ Article: “Do Physicians Underrecognize Obesity?”

Beginning with the June 2014 issue, a special series on obesity will be featured in the Southern Medical Journal over the coming months. This public health issue has been popularly termed an “epidemic” in the United States, and that can be understood in the context of motivating public health and healthcare professionals, as well as patients, to evaluate seriously the implications of this disorder. In strict medical terminology, however, “epidemic” is not an appropriate descriptor. My own assessment is that the incidence rate and prevalence of obesity in the US population are increasing, and this remains alarming, no matter what terminology is used. In the June issue, Rothberg and colleagues, through a study at three academic ambulatory clinics, explore whether physicians underrecognize obesity and I commend to you not only this article which has been made free for the “SMA Pulse”, but also the complete series of articles appearing throughout the next several issues of the Southern Medical Journal as fine examples of the dedicated efforts under way to learn more about obesity, to prevent and manage excessive and morbid weight gain, and to apply evidence-based protocols to care for the clinical needs of these patients.

G. Richard Holt, MD, MSE, MPH, MABE, D BE
Southern Medical Journal

Click here to view the article.