Claire Festa bought two cars in one day. "I couldn't afford it. I just did it," says the administrative
assistant, who had been experiencing one of her impulsive manic moods -- a symptom of bipolar disorder. The other side of the disease can put people in a spiral of depression.
"But in my depressive moods, it feels like I am at the bottom of a funnel, and I'm trying to climb out but I can't," she says. "All you want to do is die."
Impulsivity and suicidal thoughts are two of the symptoms that make bipolar disorder a tough illness to manage and for loved ones to understand. It also has a societal stigma, where many think those with it must be crazy or out of control.
But Festa, who attends a support group in Westport through the Depression Bipolar Support Alliance, considers herself a success even after two suicide attempts. "I am extremely happy with who I am and where I'm going. I want people to see that this disease can be one that you can live with, just like other diseases such as diabetes," she says. "It gets a bad rap. The word `bipolar' signifies violence and all sorts of negatives. People think a bipolar person is going to flip out on them. They don't want to associate with them."
More than 2.5 million Americans are diagnosed as bipolar, defined as recurrent episodes of changes in mood, thinking, energy and actions, according to the DBSA. The illness is also known as manic-depressive disorder because someone's mood varies between symptoms of mania and depression.
Dr. Joseph Goldberg, a Norwalk psychiatrist who has worked with many bipolar patients, says that with the right medications, therapies, support and diet, it's hard to tell who has it. "Many people wouldn't dispute that depression is the most noxious part of the disorder. Its unpredictability becomes a problem. It is the great hole in their lives, and it can affect marriages, families, work and quality of life," he says. "But the people that tend to do well have insight and accept treatment, and they avoid things that make things worse, such as alcohol."
What is Bipolar?
The disorder is a treatable medical illness that can come in many forms. The mania side can make someone act like the Energizer bunny. He talks fast, moves fast, buys things impulsively without much thought and acts as if he's on cloud nine.
"I knew a guy who was driving along and bought a house on the spot without telling his wife," Goldberg says. "Their behaviors are influenced by their thoughts. That's when they end up buying things they don't really need, and making social or professional decisions without forethought."
But once they come off of that episode, they can experience depression -- deep depression that sometimes lands them in the hospital.
Bipolar disorder doesn't go by a set pattern -- depression doesn't always follow mania. Someone might stay in the same mood for a week, a month or sometimes years at a time before suddenly moving to the complete opposite. Each patient is different, says Goldberg.
Hypomania is a less severe form of mania and a state some wouldn't consider a problem. The person feels euphoric, creative and energetic. But for someone with bipolar disorder, hypomania can evolve into mania -- or it can switch into serious depression.
Goldberg says several types of bipolar disorder exist but all involve episodes of mania and depression, just to varying degrees. Bipolar I involves severe mood swings. The bipolar II person has milder versions of the illness.
Up to 90 percent of bipolar disorders start before age 20, although the illness can start in early childhood or as late as the 40s and 50s. The disease has a genetic component. More than two-thirds of people who are bipolar come from at least one close relative with the illness or with major depression, according to the National Institute of Mental Health.
What the illness looks like
Alan Rosenthal didn't experience the high manic episodes. His bipolar disorder took on the aura of a very irritable, angry man. His mother was bipolar, and his father suffered from depression. "I never got euphoric or had racing thoughts. I was just agitated," he says.
For years, he was treated for anxiety, but finally was diagnosed in the 1990s as bipolar. He had a busy physical therapy business in Madison, but sold it and went on private disability because of his illness. He now helps others as a facilitator of three DBSA support groups -- one in Westport, which Festa attends, and two in Branford.
Most who attend the meetings are in the 35-50 age range. But the group has included people in their early 20s and 70s. During each session, participants take turns talking about their lives. Then the discussion focuses on a central topic, such as anger management, family issues or work issues.
"We don't talk about medications or physicians," Rosenthal says. "We have to avoid those dialogues because everyone has different side effects to medicines and different feelings about their doctors."
But sadness and depression aren't the only group topics. They also socialize and have parties together, go on hikes or hold other events.
"I have 60 people in my three groups. Their bipolar symptoms all look different," Rosenthal says. "Some are shoppers. Some might have unsafe sex. Some make impulsive decisions. I still make some pretty stupid mistakes. But we all help each other."
Someone who goes through life with untreated bipolar disorder can live a short life, says Dr. Bruce Shapiro, a psychiatrist practicing in Stamford. "Bipolar can wreak havoc in relationships and wreak havoc in other areas of your life," he says. "The incidence of suicide in untreated bipolar is 20 percent. If people don't get treated, one in five will die by suicide. It's a very serious disorder that can be lethal."
It's also tough to diagnose someone with bipolar that is younger than their late teens. "We now know that symptoms can occur in early childhood. But trying to tell the difference in a 10-year-old kid with hyperactivity or bipolar disorder is tough," Shapiro says.
Sometimes doctors put people on antidepressants when they actually are bipolar and not just depressed. Doing this is like putting gasoline on a fire, since the antidepressant accelerates the bipolar symptoms. "Sometimes that antidepressant will push them into hypomania," Shapiro says. "It's not extremely common, but can happen."
The stigma, family strain and help/treatment
Telling others that you suffer from bipolar disorder can be a challenge. People don't know what to say and most don't understand mental illness.
"Bipolar disorder can change families entirely," says Shapiro. "It can change relationships between family members. Parents go through tremendous heartache when one of their children is bipolar. Alternatively, if you are a teen and one of your parents is bipolar, it is tough to live with. The mother might be extremely depressed and can't function."
One in four families are affected by mental illness. Another organization to which they can turn is The National Alliance on Mental Illness, which provides education, outreach and support programs.
"I had a family member diagnosed with bipolar. I didn't know what I was supposed to do. What does all this mean? I needed skills," says Judy Gardner of Fairfield. "The press always shows bipolar people who are untreated and do crazy things. But the truth is that those with mental illnesses have a greater chance of being victims than being violent."
When she needed answers, Gardner turned to NAMI and now is president of the Fairfield chapter. NAMI has 13 affiliates across the state of Connecticut and hundreds more in the United States. One of the organization's signature programs is Family-to-Family, a support group for family members of those with a mental illness.
"Family-to-Family is one of the best things we do. It is a 12-week program. You learn about the different illnesses and how to take care of your loved ones and yourself," Gardner says. "Mental illness strikes the whole family, not just the one who is ill. Unfortunately, we have a very damaged mental health care system. So the family is often the main support."
Facts about Bipolar Disorder
- Although bipolar disorder is equally common in women and men, research indicates that approximately three times as many women as men experience rapid cycling.
- Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is 15 to 30 percent. When both parents have bipolar disorder, the risk increases to 50 to 75 percent.
- Some 20 percent of adolescents with major depression develop bipolar disorder within five years of the onset of depression.
- Up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder.
- Bipolar disorder results in 9.2 years' reduction in expected life span, and as many as one in five patients with bipolar disorder commits suicide.
- Those with bipolar disorder face up to 10 years of coping with symptoms before getting an accurate diagnosis, with only one in four receiving an accurate diagnosis in less than three years.
- Up to 90 percent of bipolar disorders start before age 20, although the illness can start in early childhood or as late as the 40s and 50s.
Source: Depression and Bipolar Support Alliance
Look to these organizations:
Depression and Bipolar Support Alliance
Westport: Support group meets 6-8 p.m. Thursdays, St. Vincent's Behavior Center, Westport Campus. Call Alan Rosenthal at (203) 779-5253.
National Alliance for Mental Health
Several programs for those suffering with mental
illness and bipolar disorder and for their families.
Fairfield: Namifairfield.com or call Judy Gardner
(203) 259-8396, Ext. 30 or e-mail her at
Stamford & Greenwich: Call Rob Fry, (203) 381-6981
The Balanced Mind Foundation
For families raising children with mood disorders with resources, webinars, forums, chats.