This article is a good example of how the Catholic Church understands many psychiatric issues. I almost didn’t post it because imo a few points are simplistic. Mental health and illness is a complicated topic, and I think the power of the scientific ethos can have a deleterious effect on some individuals when it is uncritically (or incompetently) applied. Having said that, we must begin the discussion somewhere. And Brother Christopher makes a good stab at it, given the reservations just mentioned. — MC
Once called manic-depressive illness, Bipolar Disorder it affects around 5.7 million American adults or about 2.6% of the population in the United States. According to the literature most people will start to see symptoms of bipolar when they are around 25 years of age or older. Race, creed, culture, gender, social class, and age do not seem to have any bearing on the diagnosis.
According to the study done by the National Institute of Mental Health, more than two thirds of people living with Bipolar Disorder will have a history of bipolar disorder within their family, which typically includes at least one close relative who has the diagnosis or unipolar major depression.
Statistically there are three times as many women over men who experience rapid cycling bipolar. Other studies show that women tend to have more depressive episodes and more mixed episodes than men do.
When it comes to children with bipolar and the teens who present with it, they usually have one parent who has the disorder. Children who have parents with this illness will have a risk of 15% to 30% to be diagnosed with Bipolar. If both of the parents have it then the risk will be increased to 50% to 75%.
So, what are the symptoms of Bipolar? Bipolar Disorder causes serious shifts in mood, energy, thinking, and behavior—from the highs of mania on one extreme, to the lows of severe depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder will last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with the ability to function in life’s day to day challenges. The initial symptoms can be subtle and confusing and many people with Bipolar Disorder are often overlooked or misdiagnosed—resulting in unnecessary suffering for all involved. But with proper treatment and support, everyone can lead an abundant and satisfying life.
During a manic episode (the high), a person might impulsively quit their job, charge up huge amounts on credit cards, or feel rested after sleeping only two hours sleep, if that. While during a depressive episode (the low), the same person might be too exhausted to get out of bed, and be full of a self-loathing and hopelessness temperament over being unemployed and in debt or just disgusted with life in general. These cycles of up and then down wreak havoc on not only the individual but the family and friends in his or her circle. And those friends and family, often stressed themselves by the actions of the individual’s disorder, often separate themselves from the afflicted over time. The causes of Bipolar Disorder aren’t completely understood, but it often it appears to be hereditary. A 2000 study in the American Journal of Psychiatry it was reported ‘in those with bipolar disorder, two major areas of the brain contain 30 percent more cells that send signals to other brain cells.’ This report theorizes that ‘the extra signal-sending cells may lead to a kind of overstimulation, which makes sense considering the symptoms of bipolar disorder.’ Other studies suggest that a low or high level of a specific neurotransmitter such as serotonin, norepinephrine or dopamine is the cause of the illness; while other studies suggest that an imbalance of these substances is the real problem, i.e., that a specific level of a neurotransmitter is not as important as its amount in relation to the other neurotransmitters. And still other studies propose that they have identified evidence that a change in the sensitivity of the receptors on nerve cells may be the causing issue. In summation, researchers are quite certain that the neurotransmitter system is at least part of the cause of Bipolar Disorder, but further research is still required to verify the exact underlying cause. What we have determined is that research has found that stressful life events can lead to the onset of symptoms in bipolar disorder. These can range from a death in the family to the loss of a job; from the birth of a child to a move (stress affects each of us differently). The stressful event can be just about anything. Once the disorder is triggered and progresses it takes on a life of its own. Once the cycle begins both the psychological and biological processes take over and keep the illness active.
So to provide an exact cause of the illness the best explanation, according to the current research available, is what is termed the ‘Diathesis-Stress Model.’ (Diathesis meaning’ a physical condition that predisposes a person more than usually susceptible to certain diseases.) The Diathesis-Stress Model states that each person inherits certain physical vulnerabilities to problems that may or may not appear depending on what stresses occur in his or her life. The bottom line in the causality of Bipolar Disorder is something you were born with that lays dormant until something in your life sets it off; at least this is the working model until research finds something new.
There are different faces of bipolar disorder in which the medical community classifies the illness.
Bipolar I Disorder (mania or a mixed episode) – This is the classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode.
Bipolar II Disorder (hypomania and depression) – In Bipolar II disorder, the person doesn’t experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
Cyclothymia (hypomania and mild depression) – Cyclothymia is a milder form of bipolar disorder that consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.
The most effective treatment for Bipolar Disorder is a combination of medications and counseling. Physicians often treat the mania symptoms associated with bipolar disorder with one set of medications, and use another set of medications drugs to treat the depression. Specific medications are also used for ‘maintenance care’ to maintain a stable mood over time. And although chemic al (medication) treatment is primary, ongoing counseling is important to help patients, and their families better cope with the disorder.
Today, the recommended treatments for Bipolar Disorder may include medications like lithium, anticonvulsant medications, antipsychotic medications, mood stabilizers, or a combination of any these medications they are prescribed with the goal of tempering moods without igniting the manic episode. It is important to take the medications exactly as prescribed and not to stop them. Should the patient feel the need to stop the medication both the patient and the family together should consult the doctor. Many of these medications have harmful effects if discontinued suddenly and should be tapered under the care of the prescribing physician.
As a pastoral counselor our role is to be involved with the counseling aspect of the treatment. ‘Talk’ therapy is an important part of the treatment for Bipolar Disorder. During therapy those involved, both patient and family can talk over their feelings, thoughts, and behaviors that are causing problems within their lives. It’s easy to feel alone and abandoned by God. But God has not abandoned his faithful. It is the person who abandoned God because of the way their disease performs. It is here that a program which includes not only mind and body approach, but an approach to strengthen the spiritual relationship with God; a renewal of faith must be part of the healing process.
Such a Christian approach to treatment is based on the belief that:
God who created us and loves us (Genesis 1:26)
-Then God said, ‘Let us make mankind in our image, in our likeness, so that they may rule over the fish in the sea and the birds in the sky, over the livestock and all the wild animals,[a] and over all the creatures that move along the ground.’
Jesus the Christ who redeems us (Isaiah 53:5)
-But he was pierced for our transgressions, he was crushed for our iniquities; the punishment that brought us peace was on him, and by his wounds we are healed.
The Holy Spirit who guides us (Acts 1:8)
-But you will receive power when the Holy Spirit comes on you; and you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth.’
Within this approach the goal is to minimize symptoms, help individuals address life problems that they have in developing their lives, and to provide the tools to live a more fulfilling life. While God certainly has the ability to work miracles and cure any malady, He often allows us continue our journey with a ‘thorn in the flesh’ to remind us that He is sufficient (2 Corinthians 12:7–9).
2 Corinthians 12:7–9
7 or because of these surpassingly great revelations. Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me. 8 Three times I pleaded with the Lord to take it away from me. 9 But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me.
If a Christian had diabetes or cancer, he would seek medical advice from trained doctors, take prescribed medications and treatments, and seek righteous counsel on how to deal with both his physical and emotional symptoms. The same must hold true for a believer with Bipolar Disorder. Because Bipolar Disorder affects the way a person thinks, finding spiritual counsel and spending time in God’s word are essential to reconnect to God. In order to do what is right, we must identify what is True. Bipolar Disorder alters a person’s perceptions of reality, so a strong and consistent foundation in truth is a necessity when dealing with its symptoms. Followers of the Christ should treat the afflicted with Bipolar Disorder with the same Jesus-like compassion they would show toward everyone else.
About the Author
Brother Christopher Bashaw OFD, RN, M.Div. is a professed Brother in the Franciscans of Divine Mercy, an Old Catholic Tradition within the Independent Catholic Church of the Americas. He is also enrolled in the Independent Catholic Church of the Americas Seminary studying for the permanent deaconate. Brother Christopher has worked as a RN since graduating nursing school in 1984, with nursing experience including drug and alcohol recovery/detox, psychiatric nursing, physical rehabilitation, pain care, military nursing, occupational health, nursing home care, and pediatric/camp nursing. He has brought these skills into the developing his ministry the Mother Mary Society and Franciscan Pastoral Counseling. In addition to holding a M.Div., he holds certificates in Biblical Counseling, Marriage and Family Counseling, and Alcohol & Drug Addiction Recovery (Level 3) with a Christian approach.