{"id":15397,"date":"2018-04-19T08:24:48","date_gmt":"2018-04-19T14:24:48","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=15397"},"modified":"2023-07-27T09:59:04","modified_gmt":"2023-07-27T15:59:04","slug":"bipolar-disorder-the-torture-and-beauty-of-an-unquiet-mind","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/bipolar-disorder-the-torture-and-beauty-of-an-unquiet-mind\/","title":{"rendered":"Bipolar disorder: The torture and beauty of ‘An Unquiet Mind’"},"content":{"rendered":"
<\/div>
\"Kay
Kay Redfield Jamison was 17 when she had her first breakdown and was a 27-year-old psychiatry professor at the University of California Los Angeles when she saw a psychatrist for the first time for her own bipolar disorder. Photo by Tom Traill.<\/figcaption><\/figure>\n

The allure of mania can be utterly spellbinding, like the solo voyage to Saturn that Kay Redfield Jamison vividly recalls taking in her mind many years ago.<\/p>\n

\u201cPeople go mad in idiosyncratic ways,\u201d the Johns Hopkins psychiatry professor<\/a> said during a recent visit to the Anschutz Medical Campus. \u201cPerhaps it was not surprising that, as a meteorologist’s daughter, I found myself, in that glorious illusion of high summer days, gliding, flying, now and again lurching through cloud banks and ethers, past stars and across fields of ice crystals.\u201d<\/p>\n

Jamison said she still remembers the \u201cravishing colors laid out across miles of circling rings.\u201d<\/p>\n

She knows she was experiencing a psychotic episode. Nonetheless, it was beautiful, and the memory is real.<\/p>\n

Jamison revolutionized her field when she stepped forward to publicly share her personal struggles with bipolar disorder in her book, An Unquiet Mind.<\/em><\/p>\n

During her Colorado visit, Jamison shared passages from her book and highlighted the need for medical providers to understand why their patients might refuse to take medication. Some love feeling manic until their insanity spins out of control and they sink, as Jamison did, into devastating, suicidal depressions.<\/p>\n

Painfully common<\/strong><\/h2>\n

The need for diagnosis and treatment is urgent, Jamison said. Bipolar disorder and other mood illnesses are treatable and common.<\/p>\n

\u201cDepression is the common cold of psychiatry. It\u2019s very, very common,\u201d Jamison said. \u201cWe tell our medical students, \u2018A lot of you are going to get depressed. It\u2019s in the cards. What we can\u2019t tolerate is not getting treated. We can\u2019t have impaired doctors.\u2019\u201d<\/p>\n

\"Kay
Kay Redfield Jamison spoke at the Anschutz Medical Campus about the difficulty of getting patients with mood disorders to take medications. She said doing so has saved her life. Photo by UCHealth.<\/figcaption><\/figure>\n

About one in 100 people will get the severe form of bipolar disorder that Jamison has suffered, which includes severe mania and depression.<\/p>\n

Another two or three people out of every 100 will get a milder version and one in five people will cope with clinical depression.<\/p>\n

\u201cWe all will have a friend or a colleague who gets depression,\u201d Jamison said.<\/p>\n

Unlike illnesses such as heart disease that typically strike older people, mood disorders often hit the young, emerging most often in late adolescence and early adulthood.<\/p>\n

Jamison was 17 when she suffered her first breakdown. And she didn\u2019t see a psychiatrist until she was 27 and working, herself, as a psychiatry professor at the University of California Los Angeles. Now 71, she said lithium has saved her life and she knows both personally and professionally that mood disorders can be deadly or debilitating for decades.<\/p>\n

Making behavioral health a cornerstone of primary care<\/strong><\/h2>\n

Jamison saluted primary care leaders at the University of Colorado\u2019s Department of Family Medicine<\/a> and UCHealth for their ongoing efforts to integrate behavioral health providers into primary care clinics. She said people suffering from mood disorders often don\u2019t get diagnosed. Having trained experts in primary care clinics can be critical to getting patients help.<\/p>\n

Within the next month, full-time behavioral health providers will be joining Denver-area primary care clinics to work hand-in-hand with medical staffers. For years, some clinics have experimented with having part-time behavioral experts. Now, patients will have access to help from full-time staffers.<\/p>\n

\u201cWe are committed to operating all of our primary care clinics on a team basis, with one of the core members being a behavioral health clinician,\u201d said Dr. Frank deGruy, Chair of Family Medicine at the University of Colorado.<\/p>\n

The new behavioral health staffers will start by early summer at multiple clinics including the UCHealth Family Medicine Clinic \u2013Boulder<\/a>, UCHealth Family Medicine Clinic \u2013 Westminster<\/a>, the UCHealth Primary Care Clinic \u2013 Lone Tree<\/a>, the A.F. Williams Family Medicine Clinic \u2013 Stapleton<\/a> and the UCHealth Women\u2019s Integrated Services in Health (WISH) Clinic at Anschutz<\/a>.<\/p>\n

\u201cWe are going for complete penetration, so it becomes a normal primary care experience to have access on every visit to behavioral health care,\u201d deGruy said.<\/p>\n

Depression grips one in five<\/strong><\/h2>\n

The need for more help is clear.<\/p>\n

\u201cAbout two-thirds of patients who come to see us have psychological symptoms or psychosocial distress,\u201d deGruy said.<\/p>\n

Of those patients, about half already have a mental health diagnosis such as depression, post-traumatic stress or anxiety. Others are experiencing substance abuse, suicidal feelings or physical symptoms that could be signs of mental health challenges, like insomnia and fatigue.<\/p>\n

Untreated substance use and mental health challenges can exacerbate physical problems like diabetes. That\u2019s why it\u2019s so critical to integrate physical and behavioral health care, deGruy said.<\/p>\n

Cost traditionally has been a big obstacle to integrated care since insurance reimbursements in the past have not covered behavioral health. To pay for the new staffers, deGruy said UCHealth and the Family Medicine Department are teaming up to subsidize costs.<\/p>\n

Not all behavioral health woes can be treated in a primary care setting. About 10 percent of patients experiencing mental health challenges have what deGruy describes as \u201cdeep end,\u201d severe challenges. For those patients, the primary care clinics are building better partnerships with psychiatrists or psychiatric nurse practitioners.<\/p>\n

Once the new experts are in place, deGruy said providers plan to screen every patient at some point during their care for a range of mental disorders and symptoms.<\/p>\n

\u201cWhen we get a positive screen, our behavioral health clinicians will meet with them,\u201d he said.<\/p>\n

From a regular childhood to crushing depression<\/strong><\/h2>\n

Jamison said the Colorado model of anchoring behavioral health providers within primary care is exceptional and could be extremely beneficial.<\/p>\n

\"Kay
Kay Redfield Jamison said during a Colorado visit that depression is the “common cold of psychiatry.” She called for more access to treatment.<\/figcaption><\/figure>\n

Stigma and silence continue to prevent many people from ever getting diagnosed or seeking treatment.<\/p>\n

Jamison said that when she was young, no one discussed mental health issues.<\/p>\n

\u201cIt wasn\u2019t done,\u201d she said.<\/p>\n

Jamison had had a perfectly normal childhood when she suffered her first breakdown at age 17.<\/p>\n

\u201cI was involved with sports. I loved school. There was no reason to expect that anything would go wrong,\u201d she said.<\/p>\n

She\u2019s grateful to her friends and family for helping her survive.<\/p>\n

\u201cWhen you are 17 and there\u2019s not much public education, it\u2019s terrifyingly beyond belief. I got suicidally depressed. Then I got well. By the time I graduated, I was perfectly fine to go to college. I joined the faculty at UCLA. Then I went manic and had hallucinations and delusions.\u201d<\/p>\n

Life-changing advice: \u2018Learn from it. Teach from it. Write from it.\u2019<\/strong><\/h2>\n

Before writing a medical textbook on mood disorders and penning An Unquiet Mind<\/em>, Jamison anonymously shared insights with colleagues and students on what it feels like to have bipolar disorder.<\/p>\n

\"Book
Kay Redfield Jamison shared her personal journey with bipolar disorder in her book, An Unquiet Mind.<\/figcaption><\/figure>\n

\u201cWhen you\u2019re high, it\u2019s tremendous. Ideas are fast and frequent, like shooting stars. You have the ability to captivate others. Interests are found in uninteresting people,\u201d she said.<\/p>\n

But then, the ideas flow too fast and there are far too many, she said.<\/p>\n

\u201cConfusion replaces clarity,\u201d she said.<\/p>\n

Then comes great despair.<\/p>\n

Jamison recounts her own suicide attempt.<\/p>\n

\u201cI took a lethal dose of pills, was in and out of a coma and nearly died,\u201d she said. \u201cThen I started taking lithium.\u201d<\/p>\n

Throughout her ordeal, Jamison feared she would lose her job. She credits a remarkable leader.<\/p>\n

\u201cMy chairman stuck by me. He said, \u2018I understand you have a problem with your moods. Keep seeing your doctor. Keep taking your medication. Learn from it. Teach from it. Write from it.\u2019\u201d<\/p>\n

Thanks to that advice, Jamison opened up, wrote about her life and her mind and students and patients continue to learn from her.<\/p>\n

At the Anschutz Medical Campus, leaders decided to have all students from all schools read and discuss a single book. For their \u201cOne Book, One Campus\u201d program, they selected An Unquiet Mind<\/em> and brought Jamison to campus through the Levitt Distinguished Speaker Series.<\/p>\n

During her visit, she talked about the genetic links with mood disorders. After writing her book, she showed it to her family and her father said, \u201cI think I might have this illness.\u201d Jamison agreed with him.<\/p>\n

Stigma still prevents some from being open about mood disorders<\/strong><\/h2>\n

She urged families to be open about relatives who have struggled.<\/p>\n

\u201cI spend a lot of time on college campuses and I\u2019m amazed how many kids found out about their family history only after they were in the hospital,\u201d she said.<\/p>\n

She urges parents to tell their children about mood disorders, just like they would discuss other illnesses that run in the family.<\/p>\n

\u201cTalk about it very frankly. This is how it looks early on. Say that you are unlikely to get it, but if you do, what you don\u2019t want to do is ignore it,\u201d Jamison said.<\/p>\n

She also said it\u2019s vital to speak to people when they are healthy.<\/p>\n

Jamison, herself, has given her husband the power through a living will and advanced directives to make care decisions for her.<\/p>\n

\u201cIt gives them the authority to know what my wishes are,\u201d she said. \u201cIf you have to commit someone against their will, it\u2019s really hard to do it. It breaks families apart.\u201d<\/p>\n

By granting her husband permission in writing to make decisions on her behalf, she has made his life much easier.<\/p>\n

\u201cIf I get manic or suicidally depressed again, my husband can do what he sees fit. If he thinks I need to be hospitalized or taken in by the police, fair enough.\u201d<\/p>\n

Medication and therapy are critical<\/strong><\/h2>\n

And, as difficult as it is, she pressed medical providers to keep urging their patients to stay on medications.<\/p>\n

\u201cIt\u2019s very hard, particularly in young people,\u201d she said, noting that about 50 percent of mentally ill people don\u2019t take their medications.<\/p>\n

\u201cSometimes education helps. That\u2019s one of the goals of psychotherapy. Say, \u2018Look, we\u2019re in this together,\u2019\u201d she said.<\/p>\n

Having patients track their own moods to discover patterns can also be effective.<\/p>\n

\u201cPatients can feel cornered,\u201d she said.<\/p>\n

Jamison urged people who think they might have a mood disorder to get help.<\/p>\n

\u201cDepression and bipolar disorder are very treatable with medication and psychotherapy,\u201d she said. \u201cIt\u2019s very important to get treated early on. If you feel like you have any symptoms and you aren\u2019t sure, get help.\u201d<\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

The allure of mania can be utterly spellbinding, like the solo voyage to Saturn that Kay Redfield Jamison vividly recalls taking in her mind many years ago. \u201cPeople go mad in idiosyncratic ways,\u201d the Johns Hopkins psychiatry professor said during a recent visit to the Anschutz Medical Campus. \u201cPerhaps it was not surprising that, as […]<\/p>\n","protected":false},"author":2123,"featured_media":15399,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[606,113,112,351,1792],"class_list":["post-15397","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-a-f-williams-family-medicine-clinic","tag-behavioral-health","tag-mental-health","tag-primary-care","tag-uchealth-family-medicine-center"],"acf":[],"yoast_head":"\nBipolar disorder: The torture and beauty of 'An Unquiet Mind' - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Dr. Kay Redfield Jamison revolutionized the field of psychiatry when she wrote about her own struggle with bipolar disorder. 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