Bipolar has a new modifier and it really works for patients of all ages - ABILIFY

The best teacher on any subject, is life itself. That is especially true when teaching students suffering from bipolar disorder and schizotypal personality disorder. I found there was a high percentage of mental illness in the homeless that attended some of my classes and a high degree of mentally ill that wound up homeless. I often wondered if they had been sick and undiagnosed before they lost their homes or if their homelessness encouraged the manifestation of their symptoms.

In the seventies, about 22% of the public thought that a bipolar patient could just "snap out of it." In 2006, about 11% of the public still thought that way. Surprisingly, in 2009, that percentage has dropped, but not by much, and the very word bipolar still raises the hair on the necks of the uninformed.

For those still asking, "What is bipolar disorder?" it is the medically accepted term for a set of physical differences of the brain. That’s right - bipolar disorder is a physical condition not a mental one and increasingly, evidence now exists proving that bipolar traits are based in the genes. MRI (magnetic resonance imaging) studies have proven that the bipolar brain is significantly different from the non-bipolar brain. Interestingly, the bipolar brain has 25 to 30% more "message sending" cells than has the regular brain (which may explain the unexpected, if not spectacular mood deviations).

It begs the question, "Is the bipolar brain, with its increased message sending ability, possibly just a stepping-stone toward the evolution of the future human brain?" After all, the human body physically evolves and adapts to its geographic and environmental circumstances. Why would not the brain also evolve being subject to similar stimuli? Which brings us to the matter of bipolar geniuses? Edgar Allan Poe and Henry David Thoreau, offered the following on the subject of genius:

"Men have called me mad but the question is not yet settled, whether madness is or is not the loftiest intelligence -- whether much that is glorious -- whether all that is profound -- does not spring from disease of thought -- from modes of mind exalted at the expense of the general intellect." - Edgar Allan Poe.

"If a man cannot keep pace with his companions, perhaps it is because he hears a different drummer. Let him step to the music he hears however measured or faraway." - Henry David Thoreau.

In forbidding times, a genius might not fare as well as a genius and or a bipolar might today. In the past, geniuses were termed heretics. The established church often referred to them as "the possessed." Today, science and medicine recognize the condition of bipolar disorder as being little more than a genetic, physical, brain difference (albeit that it affects every aspect of a bipolar and their family’s life), but none-the-less, the public has not yet caught up with the medical definition. Most people still overreact at the mention of "bipolar" just as they recoil when they hear the words "mental illness."

In some families, when there is a "diagnosed" bipolar sufferer; there are usually more lurking in the shadows. Sometimes the lesser afflicted, wait until the "leader" comes of age and leaves home. The most pronounced of the siblings living in the same home, usually plays "the lead." The siblings and other successive relatives, begin to assume (or are assigned) their respective "supporting roles." I call it "the dance of the marionettes."

This group dynamic can be seen even amongst the bipolar sufferer’s friends. I have also seen this group dynamic in my classroom when teaching students afflicted with a variety of similar conditions (e.g., bipolar disorder, schizophrenia and schizotypal personality disorder). I refer to the victims of these diseases as the "afflicted" because these conditions are no picnic. They usually last a lifetime, can be treated but not cured or eradicated.

MedPageToday.com, reports that Stockholm, Sweden researchers conducting a comparison study of bipolar disorder and schizophrenia found that close relatives (such as direct siblings and offspring) of schizophrenics are also more likely to suffer from bipolar disorder. This discovery affects the ongoing argument between psychiatrists about the relationship of bipolar disorder and schizophrenia.

Siblings and offspring of schizophrenics have relative risks of 5.2 (95% CI 4.4 to 6.2) and 3.7 (95% CI 3.2 to 4.2), respectively, for having bipolar disorder themselves, reported Paul Lichtenstein, Ph.D., of the Karolinska Institute, ET. al, in The Lancet’s Jan. 17, 2009 issue.

Through the years, I have found that most of my schizophrenic students, also had bipolar traits and adult siblings of adult students suffering from bipolar disorder had bipolar traits and behaviors themselves. Albeit, at a lesser or more downplayed rate but the behavior was almost always present. Once an adult sibling has been diagnosed with bipolar disorder, the family focuses most of their attentions on that one sibling.

The bipolar disorder sufferer’s other siblings tend to avoid close examination by psychologists or psychiatrists because they secretly live with the knowledge that they are manifesting the same or similar symptoms. They are aware that they too suffer from some form of mental illness. Submitting to a psychiatric examination, would reveal that they harbor the same symptoms so they usually live in the shadows of the diagnosed sibling. Yet while the other siblings’ may go undiagnosed for years, and they keep their traits under wraps, their tell-tale arrogant and intrusive behaviors usually give them away.

Several years ago while trying to teach a student with a bipolar brain, software application usage, her siblings insisted on guiding me towards the best practices for teaching their bipolar sister. I explained that I had taught students suffering from bipolar disorder in the past but they would not hear of it. An older female sibling claimed that "only she" understood her young sister. One of the younger male siblings claimed there was nothing wrong with the bipolar sibling to begin with. His solution to bipolar symptoms was to take his sick sister by her shoulders and shake her firmly. He suggested I try his method on his sister in class. I had to explain that shaking someone by the shoulders was considered battery in the state we lived in at the time.

Except for referring the siblings to the latest publications on bipolar and similar disorders, I had to manage my student’s symptoms. There was nothing on earth I could possibly say to convince my student’s siblings and other close relatives that they were slowing down the learning process. I went along with the family’s requests and ideas for some time and their bipolar sister got further and further behind in her studies. Once the siblings calmed themselves enough to be taught how to communicate properly without trying to leverage my student, her learning hastened. She grasped in a day, what it usually took me a week to teach a student with a non-bipolar brain.

When loving siblings and friends assume codependent roles in the lives of bipolar sufferers, they are almost always well convinced that "they" know what’s best for the bipolar disorder victim. They have usually loved the person for years or even a lifetime (especially in the case of siblings and parents). Codependents are often so accustomed to holding onto their supporting role that when the bipolar patient’s health improves, or the bipolar relative shows signs of making a sound decision, codependents have difficulty making room for the possibility of improvement and tend to sabotage it.

Quite often, the reason behind this resistance is because the improved health of the bipolar relative, whom has emotionally led the pack (sometimes for years), also means an end to the codependents’ long-lived roles. I have actually seen relatives begin to "act out" when their bipolar sibling graduates from college, marries or moves to a new location for a better paying job. Codependents feel comfortable in the status quo. The idea of change frightens the relatives more than it does the person suffering from bipolar disorder and the relatives almost always justify their poor behavior by claiming they are doing so "out of love" for their sibling.

Perhaps a bipolar sufferers’ ability to retain vast amounts of information is a result of their chronic bipolar condition and not in spite of it. Perhaps they were already highly intelligent prior to being diagnosed. Whatever the case, victims of bipolar disorder tend to have extraordinarily interesting minds (even if disordered).

One of the most mysterious aspects of bipolar disorder is the many ways they "script out" what they expect of those around them. Sadly, since their condition is brain based, and ever-changing, bipolar sufferers sometimes forget the roles they have assigned their codependents and are upset by even the slightest change. They often misinterpret what people say or mean and even what they hear. They tend to hear "a whisper as a roar."

Current medications prescribed to bipolar patients were designed for all sorts of other maladies but were not designed for bipolar disorder in the first place. Pharmaceutical firms do not engineer bipolar medicines because there is no profit margin in making medicine for so few. That’s why even the best and latest "mood balancer" commonly known as aripiprazole is almost always prescribed as a medication "to be taken in combination" with something else. A highly respected psychiatrist, Dr. Reid working as a Psychiatrist assigned to the Veterans Administration facility informed me that Aripiprazole is now being prescribed for children and is showing remarkable success. When discussing the matter further with a social worker at the same facility, I learned that aripiprazole, known by the name of Abilify, is now being administered to patients by itself without another accompanying drug.

Perhaps as science advances in years to come, pharmaceutical firms will start manufacturing medication specifically engineered for bipolar treatment. Unfortunately, that won’t happen while pharmaceutical firms see the bipolar condition as "an orphan" illness, meaning that there are not enough people suffering from bipolar disorder to justify investing in the manufacture of bipolar medicine specifically.

I do know one thing that works wonders for bipolar disorder sufferers the world over (and costs absolutely nothing), an orderly, predictable day-to-day life. Meals should be served in as attractive a manner as possible. That is a good suggestion for serving any meal to anyone but it is most especially appreciated by the bipolar sufferer.

In my experience living with bipolar students and young people that were "court ordered" to live in my home by Family Court Judges, scheduling meals with precision helped the bipolar sufferers tremendously because they would look forward to specific meal times on-the-clock. Knowing meals would be served at specific times helped ease their anxiety overall.

Additionally, and most important, is that their entire environment must be kept clean and orderly (not just when it is convenient) but on a 24 hour basis. While they are unable to keep things orderly for themselves, they absolutely enjoy living in "cleaner than clean" conditions. Their concern and fear of germs, bacteria and microbes is eased tremendously when all dishes, pots and pans are cleared immediately after meals and the eating areas are returned to a pristine condition.

It is also important to discourage the "collection of useless" items, otherwise the home will become cluttered with collections of things whether they have value or not. What may start as a minor collecting behavior, most often grows into extreme hoarding, more commonly referred to as Diogenes Syndrome.

You cannot affect or cure a bipolar sufferer’s behavior but you can be instrumental in modifying his or her tendencies so that he or she may enjoy the highest quality of life possible. In the case of people assigned to live in my home by Family Court Judges, regardless of gender, I found they all responded to consistent affection, caring and kindness.

It has been my experience that there are more than enough people willing to join the emotional "dance of the marionettes." Do not let your love and affection for the bipolar sufferer "cloud your judgment." Your bipolar sufferer, does not need you to be emotional, overly involved with the significance or importance of behaviors and you must always, refrain from drama.

While you can love and care for a bipolar parent, spouse, sibling or offspring, you must not become one of their codependents. Monitoring and managing your own emotions is most important to the sufferer’s health and well-being. Always remember that you cannot help him or her if you cannot take charge of yourself. Love them with “your head” first and “your heart” second.

Listen politely, but do not react to well meaning, highly emotionally charged codependents’ remarks. Maintain an open discourse with the bipolar sufferer’s psychiatrist because that medical professional is your best defense and advice provider. Personally, since I have seen Abilify not only positively modify a patient's behavior but stabilize it, I wish they would prescribe it earlier on rather than prescribing it as a last resort.

Remember - the responsibility of your bipolar sufferer’s well being falls to you. Do everything in your power to make your bipolar sufferer feel loved and cared for but be legally prudent and always take measures to provide for his or her safety.

I do not work for, nor am I in any way associated with the pharmaceutical firm that manufactures Abilify, nor am I a paid spokesperson for them or their agencies nor do I benefit in any way from having posted this blog. The opinion I am offering in this blog is completely my own, based on personally having witnessed the improvement in the day-to-day lives of patients that are now taking Abilify and living productively.