August is my birthday month. I will be 67 on the 7th, but as a typical Leo, I think of myself as 17. The illusion is shattered the moment I look in the mirror after I wake up each morning. I splash cold water on my face, see my messed-up grey hair and, if I get close enough to the mirror, I see a couple of wrinkles I did not notice before.
Progressive multiple sclerosis has taken its toll on my body leaving me legally blind and needing to use a cane sometimes. MS is a disease of the central nervous system, but there is something else going on inside my brain. It is bipolar disorder, which ruined relationships and my career until I finally learned how to manage it the year I turned 60. It took nearly 20 years after my diagnosis to get to that point.
My psychiatrist did not tell me what to expect in recovery. I thought that if I just took the medication all would be well. I didn’t know about maintaining a healthy sleep schedule, stress management, nutrition, exercise and psychotherapy to start living as normal a life as possible.
This disorder affects all age groups — and the number of seniors with bipolar disorder is expected to increase as the population ages.
Now that I am an “older adult”, I have challenges each day other than keeping mood swings at bay. According to a study reported in The Journal of Affective Disorders, bipolar disorder often involves disabling and enduring cognitive impairments in older patients. A cognitive impairment is when a person has trouble remembering, learning new skills, concentrating, or making decisions that affect their everyday life. Cognitive impairment ranges from mild to severe. I had to retire and go on disability when I was 60 after giving up trying to hold a job. I could not remember directions necessary for whatever I was supposed to do in my position. I went from being a college professor and Ph.D. candidate in the 1980’s to a technical writer and instructor at the University of California-Berkeley Extension and finally to several unsuccessful telemarketing jobs.
I married an Egyptian woman in 2010 who assured me I would be speaking Arabic in a year. Our dog understands more Arabic than I do. His favorite phrase is “yalla bye bye” which means “let’s go” when it is time for a walk. I can only remember that one and few other words.
In contrast to younger individuals with bipolar disorder, studies have determined that older adults are more likely to be hospitalized for manic symptoms and experience a greater degree of disability related to the depressive symptoms. Older adults are more likely to be “rapid cyclers”, meaning they experience more than four episodes of depression or mania over the course of a single year. That requires psychiatric treatment. Some older adults with BP look forward to the upswings in mood despite the problems they cause. That’s because it is the only time they feel energetic and motivated to pursue something enjoyable. This makes the lows all the worse, however, due to the contrast between the depression and the positive feelings experienced during the manic phase. Mood changes can be complicated because of feelings of agitation, irritability or frustration. The over-expression of these feelings, a common symptom among all ages of people with BP, can complicate intimate relationships with the non-bipolar spouse and children.
Here’s the chilling news: patients with bipolar disorder have a life expectancy that is reduced by about 10 years, relative to the general population, according to Danish researchers. This is due to a higher suicide rate and poor lifestyle choices such as smoking (31% of all cigarettes are smoked by adults with a mental illness because nicotine lifts one’s mood). We are at increased risk for developing dementia, too, a nationwide study in Taiwan confirms.
I now am referred to a “geriatric psychiatrist”. “Geropsychiatry” is a sub-specialty of psychiatry dealing with the study, prevention, and treatment of mental disorders in older people.
All of the news about having bipolar disorder when you are older may be discouraging to all of us Baby Boomers and older. Don’t give in. Our brains are just different from everyone else’s. Bipolar disorder is incurable and this pattern of deterioration occurs in all of us with the disease, whether we are un-medicated, under-medicated, or medicated.
If I give in to the illness, I am finished. Instead, I help someone else. I’ve gone to work on behalf of other people who live with bipolar disorder or other mental illnesses and educate those who do not. My mission is to end stigma, which prevents many people from getting help who need it, and telling people with bipolar disorder how I learned to manage it.
Nineteenth Century American statesman Daniel Webster said “Wisdom begins at the end”. I guess at 66 I am now a “sage”. Well, probably not a “sage” because I have more to learn.
Happy birthday to me. Every day above ground is a good day.
Much attention is given to counter bullying in schools, workplaces and social media. The abuse is not always obvious, however, and many people feel quietly victimized and strategies for workplace injustice don’t give them a voice. Some people call it the “social death penalty”. Recent studies have concluded that the issue is social ostracism and does more damage to people’s mental and physical well-being than bullying. The bottom line for employers? Higher turnover (high rates of turnover lead to higher costs related to recruiting and training new employees), it reduces performance on difficult intellectual tasks, and can also contribute to aggression and poor impulse control, all of which affects the bottom line.
As a mental health advocate, my attention is drawn to mental illness stigma as one of the reasons why someone may be ostracized. I’m concerned, too, with overall mental health because social rejection increases anger, anxiety, depression, jealousy and sadness. On one of my last jobs before retirement word got among fellow employees out that I had bipolar disorder. Several of my co-workers started treating me with a slight smirk and limited or avoided interaction with me. Ignorance, which is the basis for mental illness stigma, conditioned them to ostracize me and, to them, it was socially acceptable. I needed a friend or two on the job. People I liked and who liked me helped me look forward to going to work each day and doing my best instead of overwhelming feelings of paranoia.
Ostracism is among the most devastating experiences we can endure whether on the playground or in the workplace. Not only can ostracism damage the brain; it is also more commonly directed at those who have cognitive and psychiatric challenges. I faced both with multiple sclerosis which affected my short-term memory and bipolar disorder where occasional mood swings became obvious.
Professor Sandra Robinson of the University of British Columbia concluded in her study of the issue:
“We’ve been taught that ignoring someone is socially preferable — if you don’t have something nice to say, don’t say anything at all. But ostracism leads people to feel more helpless, like they’re not worthy of any attention at all.”
British film director Derek Jarman best summarizes why every workplace should be reminded social exclusion is unacceptable: “Pain can be alleviated by morphine but the pain of social ostracism cannot be taken away.”
Nineteenth century author and poet Charlotte Bronte wrote in her classic novel Jane Eyre that “remorse is the poison of life”. In other words, you can't fix the past and worrying about it will make your life miserable. I thought I moved beyond my remorse over the major manic episode that destroyed my marriage 29 years ago, I was confronted recently, however, with something I never wrote or spoke about regarding my 50-year journey before and after diagnosis with bipolar disorder. It is the collateral damage I left behind. The damage was burned into the minds of my then 10-year-old son and six-year-old daughter. Their unfortunate mother moved forward eventually with a new husband and I hope she sought appropriate therapy.
My son is now 38 and my 34-year-old daughter is a wife and mother of two, soon-to-be three. Out of respect for their privacy, I will not disclose their individual emotional challenges as they grew up. Now that I am closer to the grave that to the cradle as I approach my 67th birthday, it is time to leave with what I hope are words of healing for my children and for the more than five million American children of severely mentally ill parents.
The scope of the problem is larger than most people assume. These children have a parent with a serious mental illness (SMI) such as schizophrenia, bipolar disorder, or major depression. “Adults with a serious mental illness are likely to be parents. In fact, 68% of women with an SMI are mothers and 57% of men with an SMI are fathers; further, 73% of women with PTSD and 68% of men with PTSD are parents,” Michelle D. Sherman, PhD wrote in her Social Work, Today article “Reaching Out to Children of Parents with Mental Illness”.
While sociologists continue working on ways to help these young people, there are specific ways we as parents with a major mental illness in recovery can help. For example, I want all adult children of a mentally ill parent today, including mine, to know:
First, it wasn’t their responsibility to fix or save the parent with the mental illness. They were just a child trying to learn their own way. Their only job today is to accept their parent as-is and develop their own lives.
Second, most people whose parents have a mental health condition don’t develop one themselves. These negative stereotypes only feed mental illness stigma and blocks each child on his or her journey into adulthood.
Third, it’s like putting one's own oxygen mask on first while on an airliner before assisting others — taking care of one's own emotional, physical and spiritual health first is critical.
Finally, your mom’s or dad’s past doesn't dictate your future.
I recognize now that my adult children mourn several losses. They lost a carefree childhood, a stable family structure and in my case my children had to cope with bizarre behavior such as their 38-year-old father running off to Hollywood to be an actor instead of teaching at the university where he was employed and providing for his family. They endured financial stresses because of reduced income or spending sprees. They were aware of strained marital and extended family relationships.
One successful and resilient daughter of a narcissistic, bipolar mother, sums it up nicely: "Ultimately, I have to love myself more than I hate her”.
I often read and re-read essays by American philosopher and psychologist Williams James as I struggled through the ups and downs of recovery from BP. One of his statements is one I share with all adult children of the severely mentally ill: “Acceptance of what has happened is the first step to overcoming the consequences of any misfortune”.
Fulton Oursler, author of The Greatest Story Ever Told, wrote "Many of us crucify ourselves between two thieves - regret for the past and fear of the future." That is what I want to avoid on my journey through recovery from bipolar disorder to more fully enjoy my children and grandchildren.
My friend Stanley Victor Paskavich lives with PTSD from his military service and bipolar disorder. He turned his pain into poetry to help others on similar journeys. Stan wrote a poem for me as it relates to this essay about the collateral damage I left behind in the war with myself. He called it “Cage the Rage”.
“We all know how the past can become an endless page, and know how it can trigger us to feel anger, hurt and rage. Search deep within to find your one, true self, and trap your demons in your diary so high upon your shelf.”