Treatment For Manic Depression in Chicago

“I am a male in my upper 20’s. About four months ago I was briefly hospitalized with a manic episode. I am usually fine but just messed up on my meds that time. Ever since I came out of the hospital my friends and family seem different toward me. They seem to be afraid of me; they don’t want to be around me or talk to me. I have never been violent. I can’t understand what is going on or what I can do about it?”

You mention that you “messed up on your meds that time” and you were “briefly hospitalized with a manic episode.” My questions would be 1) How many times have you “messed up on your meds?” 2) What specifically was the manic episode? 3) Was it an isolated episode or had it happened before? 4) How long were you in the hospital? 5) How many times have you been hospitalized? 6) Have you informed your friends and family of your illness and its effects on you and your behavior?

I ask these questions because the answers have definite implications for how others treat you, especially if you have shared your situation, and family and friends are aware of the answers. While it is usually difficult to share this information with family and friends, it is imperative to your relationships that these people close to you are aware of what you are going through. It is only through this communication that they will better understand and be able to continue to maintain positive relationships with you.

In their book, New Hope for People with bipolar Disorder  Fawcett, Golden and Rosenfeld state that it is understandable that friends and family would be fearful about how to deal with you, your recent manic episode and hospitalization, especially since our society places a high value on self-control, free will and individual responsibility. Due to your illness, you have been less able to manage normally. There is also the factor of possible ignorance on their part regarding causes and treatment, which also contributes to a sense of stigma about mental illness. Shame and stigma may well be at the core of both their feelings and reactions and your own.

In Surviving Manic Depression, Torrey and Knable speak of loss, anger and resentment in relationships with persons suffering from manic depression. Family and friends may feel the person with illness is “lost” to them or that the person demands too much time and is like an emotional sponge. When you demand too much understanding and patience from others, the continuation of the relationship is much more difficult and often becomes of less and less importance. Torrey and Knable quote a number of persons—including Mary Ellen Copeland, Patty Duke, Linda Sexton, and Kathy Cronkite—all commenting on the reactions to them and their illnesses on the part of children and other family members. In all these recollections, fear, loss, anger, frustration, and feelings of helplessness are all too apparent.

So, to share or not to share? While there is disagreement on telling coworkers, new acquaintances and the “occasional” friend, there is general agreement that family members and close friends will be better informed and better able to deal with you if they are aware of your illness and your attempts at maintaining a sense of equilibrium. In the meantime, you will have to be extremely aware of your own symptoms so as to better control them, especially in your contacts with family and friends. Convincing them, by your words and actions, that you are approaching stability is a slow and laborious but extremely worthwhile process.

Dr. Manuel S. Silverman, PhD