Bipolar Disorder

[LabRat]

This is a sensitive subject, but given the mature audience I am hoping for some good discussion. One of our grad students has been diagnosed with bipolar disorder, and had been hospitalized at least twice in the last year and a half. I was just wondering if anyone had any experience with this, as I didn't until now. I know wolf will, but what about those of you who know someone who is personally close to you? Previously I had become good friends with this student, and it seems that she isn't taking care of herself the best she could, therefor is having many episodes and frankly is untrustworthy in the lab. Other labbies are getting disgruntled because she basically has done nothing research-wise for this period, yet has been getting paid fully (and right now $$ is tight, we're paid by grant $, and there ain't much to be had). I am kind of stuck in the middle. I guess I am asking what are her chances of succeeding in life, given that she really hasn't done any improving since her first manic episode? And what can I do to help her???

[wolf]

There is not an easy answer to this question.

First off, having been diagnosed with Bipolar Disorder doesn't mean she HAS bipolar disorder.

Unlike physical medicine where you can perform tests and know a certain result means a certain illness, psychiatry tends to function by diagnosis by exclusion.

There are also diagnoses that placate insurance companies (for example, many insurers will not come across with $$ to treat some drug and alcohol problems, but the cha-ching flows for mental illness ... what do you think happens? Your cocaine user is now "bipolar").

Certain diagnoses are handed out because they are more 'friendly' ... or more in line with the real or perceived socioeconomic status of the individual. Nice girls from rich homes get to have bipolar disorder. People who are living on the street or in poor neighborhoods get Schizophrenia or Schizoaffective diagnoses more often. Also, there is a sense of hope that attaches to bipolar disorder. After all, it what Patty Duke has, and wow, look at what she has attained.

There's not a whole lot you can do, labrat. Much is up to the girl ... she has to go to treatment, stay on medication, and generally not fuck up. She has to stay away from street drugs and alcohol, and carefully watch her patterns to see if she's sliding up or down.

You may be stuck with her as an assistant, because if she can claim that it's her illness that's causing the problems rather than her just generally being stupid, ineffective, or lazy without impact of the disorder, you're looking at an Americans with Disabilities Act Lawsuit ... and fighting it would take a lot more time, money, and energy than you'll lose by keeping her on the schedule and payroll. That's something, though, for the lab manager to consult with the Human Resources and Legal folks about.

[Troubleshooter]

The biggest problem with bipolar is medical compliance.

People want to take the meds when they are depressed and not take them when they are manic. Manics are just as useless as depressives due to the quality of work they produce, not as a person mind you, but as an employee or a workmate.

You can't do that.

Meds will smooth the road.

Also anything she can do to add an element of consistency to her life on a personal level will help.

[Troubleshooter]

Originally posted by wolf
You may be stuck with her as an assistant, because if she can claim that it's her illness that's causing the problems rather than her just generally being stupid, ineffective, or lazy without impact of the disorder, you're looking at an Americans with Disabilities Act Lawsuit ... and fighting it would take a lot more time, money, and energy than you'll lose by keeping her on the schedule and payroll. That's something, though, for the lab manager to consult with the Human Resources and Legal folks about.

This is one of the times when I'm inclined to side with a company that cans someone IF that person is found to be medically non-compliant.

[cowhead]

hmmm, I was diagnosed with the whole 'bipolar' disorder, and what I've found really makes a great difference (a friend of mine is working in a lab @ KU where they are studying it.. and there will be scientific journals on this shortly.. well a year or two.. but!) eating/consuming large amounts of omega3 fatty acids (to the order of about 3-5000 a miligrams a day) a sesnible diet, exercize and some sunlight.. keeps me level.. and the drugs they proscribe for it.. well.... they're awful it's like being one of the living dead..

[99 44/100% pure]

Bi-Polar disorder is a huge contributing factor in the demise of my 16 year marriage. We knew he had it when we tied the knot, but things seemed to be kept steady with a regimen of meds and therapy. Remember L-Tryptophan? That was the first of appx. 12 drugs he's been prescribed over the years. The meds can help, but efficacy and compliance are both serious problems.

I have found that those who don't comply with meds are not doing it to capitalize on a 'manic' high, but because they tend to be bright, organized people (when feeling well) who want to exert some control over their care. Of the 8 B-P folks I know well, 6 are engineers and the other two have very stressful jobs where smarts and quick thinking are required. All have tweaked or completely stopped their medication at some time because they are sure that they can determine their needs better than the MDs can.

My ex is B-P II, and his 'manic' periods are not characterized by energetic periods of creativity and elation, but intense anxiety and energetic activity toward no useful purpose. This, unfortunately, was manifested in very unpleasant behavior toward me.

I think the diagnosis of B-P is a catch all for a range of ailments which we do not yet have the ability to discern from one another. The meds are becoming more targeted and effective with each generation developed (about avery 7-8 years), but scientific advances have been too little, too late for us.

Talk therapy, IMHO, is sorely underutilized in many cases. My guy spent his entire life creating beliefs and behaviors to help explain (to himself and the world) his aberrent feelings and reactions. Simply taking a pill to reduce the occurrence of symptoms will not help the patient learn new, appropriate ways of coping with stress. Near the eventual denoument, when I urged my husband's psychiatrist to try to pursuade him to enter marriage counseling with me, his response was "you are expecting too much -- he's maintained a job, he's still married and he hasn't killed himself -- he's a success!"

On the plus side, he's been a much better parent, and very pleasant to be around now that he lives one mile away and sees the kids in two very small doses totalling 8 hours per week.

Couldn't possibly begin to speculate on the questions you ask about your colleague, as each case is so different from the others. Glad you're interested in helping her, but it may be a long, vexing journey.

[Crimson Ghost]

As has already been stated, just because someone is diagnosed with something, doesn't mean they have it, or will display symptoms of it.

When I was 16, I was diagnosed as "Paranoid Schitzophrenic with Homocidal Tendencies." (Imagine that on a business card.)
So, what did I do fresh out of High School? Join the Marines. (If you got it, flaunt it.)

Back to the subject at hand...

My wife has been diagnosed and is currently being treated for Bi-Polar Disorder. When she goes into one of her "phases" (for lack of a better term), she believes herself to be Jesus Christ. It got so bad one time, she attempted to crucify herself.

As long as she takes her meds, she's OK. When she goes off them, it's a fun time trying to convince her she's not Christ and to put the hammer down. This is not me trying to be funny. I literally had to pry a hammer out of her hand before she drove a 12" spike thru her wrist. A chokehold into a sleeperhold later, into the car, and off to the hospital. I had to get a private room for her so that I could be there the whole time. (Normally, hospitals don't let you do that, but a little intimidation goes a long way sometimes.)

Of course, explaining to her why I choked her ass out was worth the price of admission.

But I love her, so I will put up with a whole lot of shit from her.

As long as someone with this disorder gets help and takes care of themself, there should not be a problem.

As per your student, someone needs to nip this in the bud now. If she won't take care of herself and is untrustworthy in the lab, she should be released from this lab exercise.
I'm sorry, my heart goes out to her, but the needs of everyone must be weighed.
If she takes care of herself and regains the trust she lost, by all means, bring her back.

Kirk: "The needs of the many outweigh the needs of the few."
Spock: "Or the one."

Good luck in this very sensitive time.

[LabRat]

how fast can an 'episode' come on? with or without meds? 2 thurs ago i was talking to said student, and she seemed better than she had in quite awhile. no drugged out look to her expression, shakieness in her voice etc from the meds. then the next day she called in that she was having an episode and was trying to get into the doc. she wasn't in the following week, and prob won't be in much of this one either. she is adament about not being hospitalized this time, they are tweaking her meds while she stays home. i wonder (due to the normalness of her right before) if she was taking all of her meds. the zyprexa has made her gain a fair amount of weight, and she is VERY sensitive about it. because of her neuroscience background, and her nature, i am sure she is one of those playing with her dosages on her own. she admitted to me not long after she came back from the first hospitalization that she was doing so, so i can only assume she is still ocassionally doing it. This is frustrating to me because she is SO intellegent, and i really want her to succeed in her PhD career, she could really do some neat stuff. but on the other hand if she can't get it together, she needs to be moving on...so as not to be impeding other students chances at doing neat stuff. ugh. at least i'm not my boss right now...

[Clodfobble]

My stepmother was manic depressive, and she used to have episodes that would come on with only maybe a half hour of warning. When you got to know the signs, there was sometimes a little more warning than that, but they were really subtle, usually you had no idea what was about to hit you.

[Crimson Ghost]

"how fast can an 'episode' come on?"

Depends on each person.
Some people could take a few days, some might take a few hours.
Every case is different, taking into account the persons bio-chemical make-up. It also depends on how much medication is required.
If she played with her doses before, she's playing with them now.

Like Clodfobble said, you might get only a half-hour warning. With my wife, she usually gets "manicy" (her phrase) and cleans the house, washes the floor, ect., basically running at full speed for hours. That's my warning. The depressive stage is interesting too. Crying nonstop, everything pisses her off, ect. Every warning is different.

I hope she levels out and gets her PhD. Good luck.

[LabRat]

thanks for all of your input, i appreciate it!