Stigmatization of People with Mental Disorders

"Stigmatization of people with mental disorders is manifested by bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance. Stigma leads the (public) to avoid people with mental disorders. It reduces access to resources and leads to low self-esteem, isolation, and hopelessness. It deters
the public from seeking, and wanting to pay for care. Stigma results in outright discrimination and abuse. More tragically, it deprives people of their dignity and interferes with their full participation in society."

--U.S. Surgeon General Dr. David Satcher (ret.)

Wednesday, March 16, 2011

Mania-The Morning After

The first arrows of sunlight are cutting their way through the trees outside my window. I sit with my head in my hands on the morning after the culmination of a severe manic episode. Clips of my behavior wash over me in horrifying detail. I am ashamed and bereft.

How many friends did I alienate with my caustic tongue and my grandiose exhibition? How many witnessed or got caught in the path of my mercurial madness?

Apologies and self-flagellation bear no weight against the eviscerating depression that now has sovereignty over my life.

It matters not that my doctor emphatically assures me the extremes of this disorder are out of my control, but it’s still hard for me to understand the physiology of defective nerve cells and brain chemistry. I know I am to blame. I know the signs…I know what steps I can take to keep the manic monster at bay. Instead I recklessly did the opposite: days without sleep, haphazard adherence to my meds, and excessive use of alcohol.

Mania is one of the extremes in the bipolar spectrum. A manic episode is characterized by a distinct period where one’s mood is abnormally and persistently elevated. The initial stages of mania are somewhat deceptive and hard to resist, especially when escalating from a period of deep depression: euphoria, frenetic energy coursing through your veins…The world is full of magnificent possibilities and there is no time or need for sleep. Family and friends who comprise the support network for the bipolar patient should be alerted immediately if their loved one is not sleeping. It’s not too early to step in.

As the manic episode escalates, other symptoms include rapid speech, hyperactivity, and distractibility. Racing thoughts, the inability to focus, irritability, and anxiety are also signs of exacerbating mania.

In full-blown mania, an individual may exhibit rage, self-destructive or suicidal behavior, and a loss of contact with reality. All these symptoms are aggravated by the individual’s inability to see or acknowledge that they are sick.

Ideally, the bipolar patient will sense the first stages of mania and contact their doctor. Sometimes a minor change in medications can head off the deceptive pleasure of mania before behavior is out of control. Often the task of calling the doctor falls upon those closest to the individual. In some severe cases, hospitalization may be required.

In the wake of mania I feel sad, alone, and ashamed. I know I must look at this as a setback, and brand in my mind the lessons that should be known all too well by now…So I call my doctor, take my medications, get some rest, and make amends where amends can be made. I will always be bipolar and it is my responsibility to play my part in managing this disorder.

I will not be defeated by this illness.