Bipolar Disorder and Manic Depressive Illness

Depression has been around since the beginning of human history. In biblical times, Saul, who became the first king of Israel, suffered from severe mood swings. His servants hired a harpist, hoping the sweet music would soothe him. The harpist was a young shepherd named David, who became a favorite at the king's house. Later, David became a big hero for killing the giant Goliath. Saul was so jealous of David's popularity that his depression returned. Saul plotted to kill David. His hostility led to a war in which he and his sons were killed, leaving David as the king of Israel.

In the fifth century BC, a Greek doctor named Hippocrates treated patients who had melancholia, a “humor,” or mood disorder, that left people feeling “sleepless, irritable and restless.” Centuries later, in the 1600s, Prince Hamlet, the moody title character in William Shakespeare's play Hamlet, spoke these bleak words:

How weary, stale, flat and unprofitable

Seem to me all the uses of this world.

Although few people are aware of this, U.S. president Abraham Lincoln was so troubled by depression in the mid-nineteenth century that he described himself as “the most miserable man living.”

Today, depression is just as painful and destructive. It affects people of all ages, nationalities, religions, and races. There are various types of depression. One of the most frequent and complex is manic depression, known to professionals as bipolar disorder. The prefix “bi,” which means two, refers to the two moods of bipolar disorder, and the ending “polar” refers to the opposite states or poles that characterize the illness. So bipolar disorder is a condition that causes your mood to swing back and forth between two opposite emotional states.

This means that you experience periods of major depression in which you feel sad, lonely, weak, and helpless. Other times you have manic periods in which you feel energetic and confident. You can experience extreme sensations of anger, irritation, or happiness. Your mood might go from low and despairing (during the depressed phase) to elated—extremely happy—and hypersensitive (during the manic phase), and then back to low and despairing again. Because these phases are so radically different and are often interspersed with seemingly “normal” periods, bipolar disorder can be difficult to diagnose. Take, for example, the case of Lucy.

Lucy first began feeling strange after her thir teenth birthday. At times she heard a buzzing in her head that made her irritable. At home she snapped at her parents, whose comments she thought were stupid and boring. Meanwhile, school was slowly becoming intolerable. Teachers droned on and on and classes seemed never- ending. They were so tiresome that she wanted to scream. Sometimes, Lucy felt as if she were screaming in her head.

By the time she entered high school, Lucy had stopped doing her homework and had begun cut ting classes. For nights at a time, she could not sleep. Her behavior was very irregular.

Once, during a sleepless night, she decided that she did not have any interesting clothes. She pulled all of her clothes out of her closet and threw them on the floor. The next day, she stole her mother's credit card and went on a crazy buy ing spree.

After the second time Lucy stole her mother's credit card, her mother threatened to kick her out of the house. By then, Lucy wasn't getting along with her parents at all. Any discussion led to a massive fight, with Lucy screaming hysterically.

Even Lucy's friends thought she was acting weird. They stopped inviting her out with them. “What's with you?” they asked her. “How come you're acting so strange? You've been really irri table lately.”

Lucy had been feeling increasingly annoyed with everybody. She didn't know what was wrong with her. She felt alone and did not know where to turn. Everybody seemed to be against her.

Lucy thought that she heard whispering behind her back. The whispers joined the buzzing in her head, and at times she felt as if she were going crazy. Nights were the worst. She was so nervous that she sneaked out of the house and went for long walks. If she stayed at home, she would jump out of her skin. On her walks, Lucy discov ered some after-hours bars that would serve minors. She would drink a few beers, hoping that this would help to relax her, but it didn't seem to work. She started drinking harder stuff, such as tequila and gin.

Lucy was barely showing up at school. The school principal finally had a talk with her parents about how difficult she had become. The principal wondered if there was something wrong at home. Afterward, Lucy's parents were furious. “Why are you acting like this?” her mother demanded. Her dad yelled at her, “You're ruining your life!”

Lucy tried to turn over a new leaf. For a while, things seemed OK. She went back to school and tried to pay attention. At night, with her parents watching over her, she tried to do homework. Her friends still ignored her. Nobody understood. Everything was becoming too much of an effort. She was still drinking, only now it was not to relax but because she needed a pick-me-up.

Then Lucy crashed. One day, shortly after she started walking to school, Lucy turned around and went home. All she wanted to do was to stay in bed and cry. She had never felt so useless and miserable in all her life. When her parents saw her in this state, they realized that Lucy was not just a rebellious teenager acting up. They realized that she had a problem and that she needed help.

Lucy's mother talked with the counselor at Lucy's school and with the family doctor. Both said it sounded as if Lucy was suffering from some kind of depression. They recommended that Lucy and her parents see a psychiatrist. Lucy did not want to see anybody. She had never felt so low. It seemed impossible that anyone would be able to help her or that she would ever feel better. Her parents pleaded with her. They finally got angry and yelled at her. Lucy didn't care. She felt as if she had plunged into the bottom of a well and couldn't climb out.