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Q:  Hi David,

Recently my father committed suicide due to bipolar disease. I am not understanding this disease. I am 22 and my dad was 44 when he died. I didn't know that he had it until after he died, I am scared that I have bipolar disease. One minute I am happy and then the next I could be in tears. I have battled depression my whole life, so I am not to sure if it is upset over loosing my dad or if there is something really  wrong with me. Is there anything that you can tell me.

Dear J.,
I am so sorry to hear about your father's illness and recent death.  Despite your despair, you have the strength and courage to write for advice. It is this ability to reach out to others that may well carry you through your most difficult times of depression. Bipolar disorder differs significantly from clinical depression, although the symptoms for the depressive phase of the illness are similar. Most people who have bipolar disorder talk about experiencing "highs" and "lows" the highs are periods of mania, the lows periods of depression. These swings can be severe, ranging from extreme energy to deep despair. The severity of the mood swings and the way they disrupt normal life activities distinguish bipolar mood episodes from ordinary mood changes.

Symptoms of mania - the "highs" of bipolar disorder:

* Increased physical and mental activity and energy

* Heightened mood, exaggerated optimism and self-confidence

* Excessive irritability, aggressive behavior

* Decreased need for sleep without experiencing fatigue

* Grandiose delusions, inflated sense of self-importance

* Racing speech, racing thoughts, flight of ideas

* Impulsiveness, poor judgment, distractibility

* Reckless behavior

* In the most severe cases, delusions and hallucinations

Since you have "battled depression" your "whole life", I am assuming you have been under the care of a psychiatrist with whom you can communicate openly about all of your behaviors and symptoms, who is persistent in getting as much accurate information from you as possible. If this is not the case, this is a critical time in your life to select a psychiatrist who is knowledgeable about depression and bipolar disease and be relentless in getting the correct diagnosis, making it your top priority so that your life can achieve stability. Appropriate medical treatment is a big part of treating the disorder first. Don't be 'scared that you have bipolar disease'. Talk first hand to an expert who can answer your questions by taking a full history. Also, consider talking to an adult you trust or other family member who is either familiar with this situation or can just provide a good listening ear. In other words, rather than remain scared, take the proper steps to get the answers.

If you do not have regular access to a licensed psychologist or counselor for therapy for your ongoing depression, this would be an extremely important time to find one. The questions you have asked honestly are excellent questions but require much more attention than a single email can provide. You deserve to learn more about yourself, your father and his disease/life sitting face to face with someone with whom you have built a trusting relationship. This may be a bit uncomfortable at first but I have seen the courage of your convictions in your writing and trust me, you are not alone in your fear. There is help waiting for you out there IF you choose to pursue it.

It would not be accurate or professional of me to attempt to diagnose based on the limited information in this email but being happy one minute and being in tears the next following so closely after the death of a loved one may indicate a normal grief reaction to the loved one's death or the recurrence of a major depression, not necessarily the start of bipolar disorder although this too should be ruled out since it is in your family background but IN PERSON by a psychiatrist during a comprehensive evaluation.

The key right now is not to isolate yourself....stay on your quest to confirm a diagnosis and following through on your treatment and therapy. Just because your father had bipolar disorder does not guarantee that you will have it too, in fact statistics suggest that among children there is only approximately a 30% chance. Additional "comorbid" disorders include ADHD (Attention Deficit Hyperactivity Disorder) and Major Depression, which you already feel you have.

American Psychological Association 

National Alliance for the Mentally Ill 

Depression and Bipolar Support Alliance http://www.dbsalliance.org/info/bipolar.html

National Institute Of Mental Health http://www.nimh.nih.gov/Publicat/bipolar.cfm

David Schafer, M.Ed.
Staff Psychologist

Published May, 2006

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