Swing Time

College Can Complicate Bipolar Disorder

Jennifer was first hospitalized for her bipolar disorder near the end of her freshman year. Along with the natural stress that stemmed from being away from home for the first time in her life, there was the erratic sleep schedule. Because the disorder, which is marked by mood swings from the highs of mania to the lows of depression, often manifests itself alongside other complications (such as a change in eating habits) misdiagnosis as depression is often a problem. Jennifer's symptoms mirrored those of depression, so she was prescribed Wellbutrin, an antidepressant, and she tried to resume her class schedule.

"I started sleeping 20 out of 24 hours a day," she says. "It wasn't very long that I was on the antidepressants—it was probably a month—and I came home and was hospitalized a short time after." Jennifer (who requested anonymity) describes herself then as "passively suicidal"—she had thoughts of killing herself, but lacked the motivation to carry it out. She didn't fantasize about slit wrists or sleeping pills, but a momentary jerk of the wheel at the right time, and . . . "If I got into a terrible accident, no one could get mad at me," she says. "Nobody could feel that bad because it was just an accident."

Half of all people with untreated bipolar disorder attempt suicide at least once in their lives, and 20 percent are successful. It can be an incredibly destructive disease, wreaking havoc with families, finances, jobs, and ambitions. Approximately 2.3 million Americans have bipolar disorder but because it is particularly hard to diagnose, the average sufferer goes 10 years before a proper diagnosis. For Jennifer, it would take four years between her first hospitalization and her second, during law school, for doctors to accurately diagnose her bipolar disorder.

College is notorious for the topsy-turvy schedule, for nights spent studying or partying deep into the next day. "Lifestyle can interrupt or cause more frequent episodes and challenge appropriate management of the disorder," says Dr. John Guthman, director of counseling services at Hofstra University.

Then there's the tendency to get help when feeling bad, not euphoric, which is the case during the manic phase of bipolar disorder. "If you're feeling OK, it's unlikely that you're going to seek out assistance," Guthman says.

For college students, treatment options vary depending on the quality of care and staffing levels at campus clinics. Jennifer claims that the administration at her law school was understanding, assisting her with her particular needs. But some schools don't know the first thing about helping students with bipolar and other illnesses, and a few have months-long waiting lists to see a mental health professional, says Renata Ponichtera, of the National Alliance on Mental Illness, which describes itself as the nation's largest grassroots mental health organization. "When a student experiences various problems and comes to the decision that they are going to seek help today, they need the help immediately because it took them a while to come to that conclusion," she says.

To help remedy the shortage of mental health services on some campuses and to raise awareness of the challenges of mental illnesses like depression and bipolar disorder, NAMI has sponsored a series of campus chapters at 29 universities around the country, with 15 more in the works. They function as meeting places, information centers, and support networks.

And while college-age people are among the most familiar with bipolar disorder, they're still in the minority: Only 35 percent report any knowledge of the disease, according to a 2003 survey released by NAMI. The disorder is still a mystery to most of us.

Though there is no cure, the symptoms and frequency of cycles can be managed for most people with the right combination of medicine and lifestyle choices.

Jennifer credits her parents for their support, who because of a family history of bipolar diagnoses (there is a strong genetic component—the risk of having the disease increases to 20 percent if a family member has it) are familiar with the disease and have been sensitized to its signs and how to handle it. Studies have shown that bipolar therapy that incorporates family members and loved ones leads to fewer relapses and longer periods of wellness.

Jennifer also thanks her boyfriend, who she says plays the most important role in maintaining her symptoms—that of the patient listener, the supportive shoulder. "He is just unbelievably amazing," she says. "I would not be alive today without him." He was there for her again at her recent law school graduation, right alongside her family, all gathered at a ceremony Jennifer often doubted she'd ever enjoy.

 
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