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Bipolar
Disorder in the News
Carlos Santos, Times-Dispatch, December 12, 2005
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Cynthia Power
has been bipolar since she was 18. Peter Armetta has had the
disorder most of his life, too. Both say that it's a cruel,
complicated mental illness, but also that it can be controlled
and life can be good.
"You probably know people with bipolar disorder and don't even
know it," said Power, who is 58. "I'm not exactly like someone
who doesn't have the disorder. Life is more difficult like
breast cancer makes life more difficult. But it makes you
stronger, too."
"I've wrecked my life," said Armetta, 41, who was only recently
diagnosed as being bipolar. "I've lived in 22 places in 22
years. Never been married. I ran away from women, though I
always make a great first impression. . . . But now I'm doing
well, and I'm hoping to stay that way."
Power and Armetta are two of about 2.3 million Americans who
have been diagnosed with bipolar disorder, which is also known
as manic depression. It's a mood disorder that's different from
the ordinary ups and downs, instead characterized by periods of
extreme elation or irritability countered by periods of severe
depression.
The manic symptoms include overly inflated self-esteem,
increased physical agitation and increased talkativeness. Stress
can trigger the manic phase.
"It's not just moods," said Gary S. Sachs, the director of the
bipolar mood-disorder program at Massachusetts General Hospital
and one of the foremost authorities in the country. "Their
thoughts and perceptions color their entire life experience. . .
. It's highly treatable. It's just not curable."
"It affects men and women equally," said Anita Clayton,
professor of psychiatric medicine at the University of Virginia.
The mood changes are cyclical and "not driven by anything in
particular," she said. "It is biologically based."
The disorder has been mentioned in both state and national news
stories recently, raising questions about the treatment of the
disorder and, perhaps, unfairly stigmatizing those who carry its
burden.
On Wednesday, Rigoberto Alpizar was killed at Miami
International Airport after bolting from a jetliner and claiming
to have a bomb in his backpack. He was shot by federal agents
after ignoring requests to cooperate. His wife said her husband
was bipolar and had not taken his medicine.
In Henrico County, Joe Casuccio fatally shot his girlfriend and
then killed himself, writing a note to his mother that "having
bipolar took away the freedom to live. I've been tortured since
99."
Benjamin Fawley, a suspect in the death of Virginia Commonwealth
University freshman Taylor Marie Behl, has been described by his
lawyer, Chris Collins, as suffering from bipolar disorder. He is
being held without bond on unrelated firearms and
child-pornography charges.
There are other recent cases, in the state and across the
country, in which men and women with bipolar disorder have been
charged with crimes, but the incidents appear to be more a
coincidental series of events than a reflection on those with
the illness, experts say.
Are people with bipolar disorder more dangerous than anyone
else?
"In 23 years of treating thousands of patients, there's been no
[physical] incidents," Sachs said. "Not a patient of ours has
been arrested for anything like attempted murder or murder."
Bipolar people have more workplace accidents because of their
impulsiveness during the manic phase, Sachs said, and they are
"over-represented in prison." In part, that is because during
the manic phase "your perception of risk and the downside of
things is greatly reduced," he said. "You take a quick read on
something and sometimes react inappropriately to the situation.
"There is an elevated risk of violence," Sachs said. "But the
odds ratio is only very slightly different" from those without
the disorder.
Clayton, who has treated many patients with bipolar disorder,
said they "are no more dangerous than anybody else. Almost no
one with psychiatric illness is dangerous."
Power said she believes that "people with mental disorders are
more likely to be victimized than to do the victimizing. I can't
say with a clear conscience that bipolar doesn't contribute to
violence. Having been there, it's a scary place. I never
inflicted harm. It may have been by the grace of God."
"That guy on the plane [in Miami] seemed to have that anger that
some folks with bipolar disorder have," Armetta said. "I had the
peace and love aspect. . . . The problem with all mental illness
is getting the right treatment. People should be no more afraid
of people bipolar than anybody else. That bipolar people are
violent has no credence with me."
Carol G. Cutler, a clinical assistant professor at Virginia
Commonwealth University who has studied bipolar disorder, said
the "stigma is out there, but it shouldn't be. It used to be
schizophrenia was the particular illness that got targeted out
of proportion" as leading to violence. "Most people who commit
crimes aren't bipolar."
The irony is that bipolar disorder, which can make life so
difficult, often is borne by unusually creative and talented
people.
"They're very talented and exceptional people on the whole,"
Sachs said. "They are over-represented at the highest level of
corporate America for example," though often no one knows they
have the disorder. "They are creative and industrious. A
controlled bipolar illness makes a terrific citizen.
"They have great facility with language, music and math," he
said, noting that a number of historical figures are believed to
have had bipolar disorder, including President Abraham Lincoln
and writer Mark Twain.
"Despite the stigma attached to the illness, they're really a
remarkable group," Sachs said. "But that doesn't take away from
the extraordinary cruelty of this condition."
Armetta understands that characterization. In the throes of his
disorder, he would commit to doing more work than anyone else.
"I would run until I dropped," he said.
He now works helping foster children in Charlottesville. "I do a
lot of writing. . . . I am creative. . . . I knew I was not a
conventional person."
The treatment for the disorder, which includes psychotherapy,
has improved over the years with lithium, anti-convulsants and
what are known as atypical anti-psychotic drugs used separately
or sometimes in conjunction, Sachs said.
"We've had effective treatments for decades, but in the last 10
years, especially the last five, we've had treatments that
patients perceive as less burdensome" because of lessened side
effects, he said. "It's been a terrific boon. . . . Patients
still get off their medicine, but not like they used to."
Power and Armetta take medication. "I'm doing well on meds, but
it's just a piece of the treatment," said Power, who believes
family and a passion for work and other interests make up the
framework that stabilizes her. She works in Charlottesville as a
volunteer in the mental-health field.
"I look over my life and it hasn't been so bad," she said. "In
fact, my life has been pretty good.
"I know a lot of people with bipolar. Some are well-hidden.
There is a community of us. There is a sense of camaraderie,"
she said. "We live under a stigma and I see our movement as
being a civil-rights type of movement. You can't characterize
us. We're just people like anybody else."
She doesn't like the condescending attitude that some people
have with those struggling with mental illness. "The assumption
is I got sick and I got stupid the same day. . . . We are never
going to erase the stigma of this disorder if we don't stand
tall and say it's OK."
Armetta said his high moods would last over a year "without let
up. . . . I was too happy, too gleeful. My hyper-focus could be
a bad thing. . . . I looked like two people -- this
Pollyannaish, affectionate guy, then a guy who couldn't
function" when the depression phase took over.
Armetta, who says he once lived in a desert for eight months
just for the experience, said that though he has been diagnosed
as bipolar, "that is not who I am.
"People are scared of what they don't understand. If you don't
understand it, learn about it."
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