Living With a Mood Disorder
MOOD disorders are alarmingly common. It is estimated, for example, that more than 330 million people worldwide suffer from serious depression, a condition characterized by overwhelming sadness and a loss of pleasure in everyday activities. It has been estimated that in 20 years, depression will be outranked only by cardiovascular disease. Little wonder that it has been called “the common cold of mental illness.”
In recent years bipolar disorder has received greater public attention. Traits of this illness include severe mood swings that vacillate between depression and mania. “During the depressed phase,” says a recent book published by the American Medical Association, “you may be haunted by thoughts of suicide. During the manic phase of your illness, your good judgment may evaporate and you may not be able to see the harm of your actions.”
Bipolar disorder may affect 2 percent of the population in the United States, meaning that there are millions of sufferers in that country alone. Sheer numbers, though, cannot describe the tormenting experience of living with a mood disorder.
Most of us know what it is like to experience a wave of sadness. In time—perhaps in just a matter of hours or days—the feeling subsides. Clinical depression, however, is far more serious. In what way? “Those of us who are not depressed know that the rides our emotions take us on eventually end,” explains Dr. Mitch Golant, “but the depressed individual experiences the ups and downs, twists and turns of his feelings as if on a runaway train without a clear sense of how or when—or even if—he can ever get off.”
Clinical depression can take many forms. Some people, for example, have what is called seasonal affective disorder (SAD), which manifests itself during a particular time of year—usually winter. “People with SAD report that their depressions worsen the farther north they live and the more overcast the weather,” says a book published by the People’s Medical Society. “While SAD has been linked mainly to dark winter days, in some cases it’s been associated with dark indoor work spaces, unseasonable cloudy spells and vision difficulties.”
What causes clinical depression? The answer is not clear. While in some cases there seems to be a genetic link, in most instances life experiences appear to play an important role. It has also been noted that it is diagnosed in twice as many women as men. * But this does not mean that men are unaffected. On the contrary, it is estimated that between 5 and 12 percent of men will become clinically depressed at some point in life.
When this type of depression strikes, it is all-pervasive and affects virtually every aspect of one’s life. It “shakes you to the core,” says a sufferer named Sheila, “corroding your confidence, self-esteem, your ability to think straight and make decisions, and then when it reaches deep enough, it gives a few hard squeezes just to see if you can hold on.”
There are times when a sufferer can gain much relief by talking out his or her feelings with an empathetic listener. (Job 10:1) Even so, it must be acknowledged that when biochemical factors are involved, depression cannot simply be willed away with a positive outlook. Really, in such a case, the dark moods of this illness are beyond the sufferer’s control. Furthermore, the sufferer may be as baffled by the condition as family members and friends are.
Consider Paula, * a Christian who endured crippling episodes of intense sadness before her depression was diagnosed. “Sometimes after Christian meetings,” she says, “I would rush out to my car and weep, for no reason at all. I just had this overwhelming sense of loneliness and pain. Although all the evidence showed that I had many friends who cared for me, I was blind to it.”
Something similar happened to Ellen, whose depression required that she be hospitalized. “I have two sons, two lovely daughters-in-law, and a husband—all of whom I know love me very much,” she says. Logic, it seems, would tell Ellen that life is good and that she is precious to her family. But on the battlefield of depression, dark thoughts—no matter how irrational—can overwhelm the sufferer.
Not to be overlooked is the significant impact that one person’s depression can have on the rest of the family. “When someone you love is depressed,” writes Dr. Golant, “you may live with a chronic sense of uncertainty, never really knowing when your loved one will recover from a depressive episode or fall into a new one. You can feel profound loss—even grief and anger—that life has deviated, maybe permanently, from the norm.”
Often, children can detect a parent’s depression. “A depressed mother’s child becomes highly attuned to his mother’s emotional states, carefully observing every nuance and change,” writes Dr. Golant. Dr. Carol Watkins notes that children of a depressed parent are “more likely to have behavioral problems, learning difficulties, and peer problems. They are more likely to become depressed themselves.”
Bipolar Disorder—Consistently Inconsistent
Clinical depression is indeed challenging. But when mania is added to the equation, the result is called bipolar disorder. * “The only consistent thing about bipolar disorder is that it is inconsistent,” says a sufferer named Lucia. During mania, notes The Harvard Mental Health Letter, bipolar patients “can be unbearably intrusive and domineering, and their reckless and restless euphoria may suddenly change into irritability or rage.”
Lenore recalls her experience with the exhilaration of mania. “I was absolutely brimming over with energy,” she says. “Many called me a superwoman. People would say, ‘I wish I could be more like you.’ I often felt a great sense of power, as though I could accomplish anything. I exercised furiously. I functioned on very little sleep—two or three hours a night. Yet, I woke up with that same high energy level.”
In time, however, a dark cloud began to hover over Lenore. “At the height of my euphoria,” she says, “I would feel an agitation from somewhere deep inside, a motor running that could not be shut off. In a flash, my agreeable mood would become aggressive and destructive. I would verbally pounce on a family member for no apparent reason. I was furious, hateful, and completely out of control. After this frightening display, I would suddenly become exhausted, tearful, and extremely depressed. I felt worthless and wicked. On the other hand, I might switch back to my amazingly cheerful self, as if nothing had ever happened.”
The erratic behavior of bipolar disorder is a source of confusion to family members. Mary, whose husband suffers from bipolar disorder, states: “It can be confusing to see my husband happy and talkative and then suddenly become despondent and withdrawn. It’s a real struggle for us to accept the fact that he has little control over this.”
Ironically, bipolar disorder is often just as distressful—if not more so—to the sufferer. “I envy people who have balance and stability in their lives,” says a bipolar patient named Gloria. “Stability is a place that bipolar people visit. None of us actually live there.”
What causes bipolar disorder? There is a genetic component—one that is stronger than that of depression. “According to some scientific studies,” says the American Medical Association, “immediate family members—parents, siblings, or children—of people with bipolar depression are 8 to 18 times more likely than the close relatives of healthy people to develop the illness. In addition, having a close family member with bipolar depression may make you more vulnerable to major depression.”
In contrast with depression, bipolar disorder seems to afflict men and women equally. Most often, it begins in young adulthood, but cases of bipolar disorder have been diagnosed in teenagers and even children. Nevertheless, analyzing the symptoms and arriving at the proper conclusion can be highly challenging even for a medical expert. “Bipolar disorder is the chameleon of psychiatric disorders, changing its symptom presentation from one patient to the next, and from one episode to the next even in the same patient,” writes Dr. Francis Mark Mondimore of the Johns Hopkins University School of Medicine. “It is a phantom that can sneak up on its victim cloaked in the darkness of melancholy but then disappear for years at a time—only to return in the resplendent but fiery robes of mania.”
Clearly, mood disorders are difficult to diagnose and can be even more difficult to live with. But there is hope for sufferers.
^ par. 8 In part, this may be due to their susceptibility to postpartum depression as well as hormonal changes at menopause. Then, too, women are usually more inclined to seek medical attention and, hence, receive a diagnosis.
^ par. 11 Some names appearing in this series have been changed.
^ par. 16 Doctors report that often, each mood persists for many months. However, they note, some “rapid cyclers” vacillate between depression and mania several times per year. In rare cases, sufferers switch from one extreme to the other within a 24-hour period.
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“Stability is a place that bipolar people visit. None of us actually live there.”—GLORIA
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Symptoms of Major Depression *
● A depressed mood, most of the day, nearly every day, for at least two weeks
● Loss of interest in once pleasurable activities
● Significant weight loss or gain
● Excessive sleep or the opposite, insomnia
● An abnormal speeding or slowing of motor skills
● Excessive fatigue, with no discernible cause
● Feelings of worthlessness and/or inappropriate guilt
● Diminished ability to concentrate
● Recurring thoughts of ending it all
Some of these symptoms may also indicate dysthymia—a mild but more chronic form of depression
^ par. 31 This list is presented to serve as an overview and not to provide a basis for making a self-diagnosis. Also, some of the symptoms by themselves may be symptoms of other problems besides depression.