Please remember, this column is designed to help the consumer seeking behavioral-health information, and not intended to be any form of psychotherapy or a replacement for professional, individualized services. Opinions expressed in the column are those of the columnist and do not represent the position of other SelfhelpMagazine.com staff.

Question

I am 45, happily married since my youth, and have just been diagnosed as having a "bipolar disorder," which I understand is similar to manic depression. I am in shock. In retrospect, I see a pattern that fits the textbook description, but I need someone "non-professional" to talk to about this. When I went to AA some years ago, this kind of comradeship took away some of the shame, and some of the pain. What is there for people like me?

Answer

As you realize, the labelling of our inner experiential life with a medical term does take some getting used to. It can be a reassuring thing, "I'm not the only one, there is a name for what I'm going through, other people have been here, it's rational." At the same time, your shocked state is understandable; It's true, I have got a problem, if this means I'm sick, am I normal and is it curable?"

Much has been written on whether our psychological types are "pathological," that is, a disease, or merely a distinctive way of being. It's a philosophical, existential and medical debate that will continue to roll. But certainly, when we find we suffer in our mental life, therapy and medication can often make the experience of living more bearable, and bring stability and comfort to the individual. Your age puts you squarely in that category of those of us who are reckoning up their life so far. "What have I made of it? What counts as success, what as failure?"

Middle age is a vague term, but it has been rightly dubbed "the age of mortality." Into this scenario, we bring your diagnosis, bipolar disorder. This, simply put, describes the two poles between which your mood or "affect" swing, mania and depression. Your thinking processes are first in accelerator mode, then brake. Alongside this, your feelings are on a switchback of ups and downs. To a certain extent, this is a universal experience; determining when this tips over into illness is a matter of degree.

The good news is that the mood swings tend to be less jolting as we age. Perhaps it's to do with our gaining wisdom, a better understanding of who we are and how we work. You have read the medical texts, so you'll be aware that bipolar disorder is a diagnosis reached from your observable behavior and from your physician's analysis of how you describe your inward experience. However, I note your positive feelings regarding your experience of AA membership, and it might be helpful to consider a similar interactive group now. Many mental health clinics run helpful groups, but you will realize from your alcohol group experience that each person brings a unique set of life experiences to a group, and bipolarity is found alongside many other personality types and mental health problems.

If normal equates to common, you can be reassured. Bipolars are ubiquitous, and include such worthwhile and creative figures as Winston Churchill, Spike Milligan and John Cleese. Indeed, some observers associate this bipolar tendency with gifts of creativity and other positive and desirable traits.

3/5/98

Trevor Harvey, M.Ed combines lecturing in the School of Health at the University of East Anglia, with writing and counselling, and is based in Norwich, England. After a 12 year naval career, including the Falklands War, he became editorial board member/series advisor with The British Journal of Health Care Management and founder of the men's group AMICUS. He focused on health-related men's issues, particularly the way men negotiate personal transition through relationship crises, and is currently studying the management of information overload. Whenever possible, he combines his passion for photography with hill walking, and piloting his boat on the local lakes and rivers of eastern England.