The devastating peaks and valleys of Bipolar disorder
http://www.dailytidings.com/2005/0317/031705n1.shtml

The devastating peaks and valleys of Bipolar disorder

By Jennifer Squires
Ashland Daily Tidings

Two months ago the body of local comedian and activist Joanie McGowan was
found on the Bear Creek Greenway. She committed suicide after leaving a
treatment program. After her death, her struggle with bipolar disorder
became public knowledge.

"The tragedy with Joanie was she had just started on the journey,"
said Michael Dawkins, an Ashland resident who has also been diagnosed with
bipolar disorder. "Little things got her down. The bigger issues, she was
ready to tackle."

McGowan's death incited conversations about mental health, suicide,
treatment options and how the community can prevent such losses in the
future.

"Bipolar disorder is one of those mental health issues right now,"
said Jane Reeder, triage manager at Jackson County Health Services. "A lot
of it may just be because it's in the news."

The disorder is characterized by a rise and fall between mania and
depression. During a mania period people with bipolar disorder may feel
euphoric and not recognize what is happening to them. They may play loud
music, not sleep, go on a spending spree, abuse drugs or deny anything is
wrong. A depressive episode is characterized by insomnia or excessive
sleeping, a lack of interest in once-enjoyable activities, fatigue, change
in appetite and suicidal thoughts or attempts.

The symptoms of bipolar disorder differ from the normal ups and downs
everyone goes through and can result in damaged relationships, poor
performance at work or school and even suicide. An individual cannot
self-report the illness; the symptoms of bipolar disorder must be observed
by someone else. Mania must last at least a week and depression two weeks to
be considered severe enough to indicate bipolar disorder.

"A lot of times people will describe what they experience as mood swings,"
said Becky Martin, the division manager for mental health at Jackson County
Health Services. "Bipolar disorder can be quite debilitating. People can't
control it."

Hits home

Michael Dawkins had been doing really well for the past year. The 58-
year-old landscape artist, Ashland planning commissioner and avid Nordic
skier has dealt with bipolar disorder since he was in the seventh grade at
Ashland Junior High.

Medication, aerobic exercise and cognitive behavioral therapy - which
teaches people to reframe negative thoughts into constructive ideas - have
helped Dawkins. He facilitates Moody Blues Stress Club, a twice-monthly
support group for people with depression, anxiety or bipolar disorder at
Ashland Community Hospital and has stepped forward as "another voice" trying
to increase public awareness of mental health issues.

But on March 4, none of it mattered.

"You start to go off the edge and it starts spinning around. The negative
thoughts start feeding off of one another," Dawkins said. "It's a constant
battle inside."

Dawkins had run out of medication and a mix-up at the pharmacy had left him
without the mood-stabilizing drug for more than a week. He e-mailed a
suicide note to several friends and disappeared. Dawkins had left under
similar circumstances twice in the past and survived the suicide attempts,
though he says he should have died.

"I can't even explain how absolutely hopeless it feels when you're down
there," Dawkins said. "This time, probably within 12 hours, I knew that
(suicide) wasn't what I was going to do."

But bipolar disorder affects people differently.

When McGowan committed suicide in January, people who had known her for
years were shocked to hear she suffered from bipolar disorder, which she had
dealt with by self-medicating.

"Everybody knew the manic Joanie," Dawkins said. "No one here really knew
the depressed Joanie. I did, because I'm there."

The manic side of bipolar disorder can make people seem like the "life of
the party," full of energy and accepted by others, according to Dawkins. The
depression tends to be hidden because friends and family don't understand
the despair involved.

Dawkins used what he'd learned through cognitive therapy to rethink the
situation. For example, he stopped referring to what he'd done as "stupid,"
instead telling himself he'd "made a bad decision."

"I've often made the analogy between cancer and bipolar disorder,"
Dawkins said. "A cancer cell will eat up all the healthy cells.
Mental illness is distorted thinking that eats up healthy thoughts."

Two and a half days later, Dawkins returned home on his own. He learned "a
big lesson" that he needs to remain on his medication, even though he
opposes the way pharmaceutical companies distribute prescription drugs.
Eventually, he would rather find an organic or holistic solution that keeps
his moods level.


Some help

The dramatic mood swings caused by bipolar disorder can often be managed by
a combination of medication, therapy, diet and exercise.
Because bipolar disorder is a recurrent illness, long-term preventive
treatment is strongly recommended and almost always indicated. A strategy
that combines medication and psychosocial treatment is optimal for managing
the disorder over time, according to the National Institute of Mental
Health.

"Bipolar disorder, at this time, is controllable," Reeder said. "But, like a
lot of things, we're not totally sure what causes it."

There is no cure for bipolar disorder. Much like his cancer analogy, Dawkins
hopes for "remission" from the illness. In recent months he has also worked
to educate the public about bipolar disorder, which has drawn more attention
lately as public figures such as Mike Wallace and Jane Pauly have been frank
about their struggle with the illness.

"I really am on a mission to bring mental health awareness to the public,"
Dawkins said, explaining he didn't have a name to attach to his problems
until about 10 years ago. He had always been very creative - he performed at
the Oregon Shakespeare Festival when he was six years old - and figured his
depressive states were part of an artistic, emotional personality.

He was relieved when doctors at a clinic in Aspen diagnosed him as bipolar,
even though the subsequent treatment aimed to level out the depressive mood
swings often associated with artistic creativity.

"I try to tell people that's just a red herring," Dawkins said. "The
artistic side is still there."


Staff writer Jennifer Squires can be reached at 482-3456 x 3019 or
jsquires@dailytidings.com

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Posted by az/maroc at 9:20 AM MST
Updated: Saturday, 26 March 2005 4:33 PM MST
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