A Primer on Depression and Bipolar Disorder

A. Why This Pamphlet?

Perhaps the most common reaction people have to mental illness in general, or to depression/bipolar disorder in particular, is to ask ``Why in the world would anyone want to discuss such an unpleasant subject?'' This perhaps along with an (unspoken) intimation that the subject is also in rather bad taste. The answer to this question is long and complicated; indeed it is the subject of the entire essay. Yet there are a few basic points that need to be made from the outset. First, mental illness of varying degrees of severity affects many people. The estimates differ a good good deal from one source to another, partly because the criteria used in different surveys differ from another. But it is clear that something like 3% of the population of the United States (i.e. roughly 7.5 million people) suffer from chronic depression or bipolar disorder. A similar number suffer from chronic schizophrenia. And another 1% or so suffer from various other mental disorders (e.g. obsessive-compulsive disorder, dementia, ...). These are the people who have chronic mental illness (CMI), the ones who must (and whose families must) struggle with the illness day-by-day, year-by-year, perhaps for a lifetime. Isolated episodes of serious depression are far more common. It is conservatively estimated that something like 25% of the U.S. population will have at least one bout of depression serious enough to merit medical attention during their lifetime.

Second, depression and bipolar disorder can be extremely unpleasant. It can blight a person's existence for years. In its more severe forms it can incapacitate a person as completely as any serious physical disability; often employment becomes impossible, which implies severe economic and social hardships for both the individual and his/her family. In its most extreme form, depression can lead to suicide, destroying one's life as surely as cancer.

Third, all mental illness strikes at the very ``part'' of us which makes us human: the mind. Depression and bipolar disorder are mood disorders; they affect how we feel about ourselves, our surroundings, our lives. In their most severe forms they can make life a living hell. Schizophrenia is a thought disorder; typically it causes major distortions in the victim's perception of reality, producing delusions and hallucinations. All of these illnesses tend to dehumanize the victim, leaving him/her more vulnerable to loss of self esteem, loss of will to live. It is one of our most sacred obligations as humans to reach out to our fellows who suffer, through no fault of their own, the extreme misery of these illnesses.

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Beyond all of this, I want to offer a message of hope. I want to say from first-hand knowledge that depression and bipolar disorder are treatable, often with truly remarkable results. In fact, among other people who have CMI, I sometimes joke that depression and bipolar disorder are the ``Mercedes of mental illness'' just because they are so treatable. Next, I want to say first-hand that there is life after treatment; often a very rich and rewarding life. There are no guarantees, of course, but I can truthfully say that since successful treatment of my illness, I have enjoyed the very best period of my life.

Finally, I want to do what little I can to help break down the stigma associated with mental illness. It is bad enough to have to suffer the horrors of an illness, but it is insufferable to be cast out of society just because one has the bad luck of being ill. The time has come to end this practice. Society has to change its views. I offer myself as an example of a someone who has CMI and who, thanks to treatment, can continue to function at a valuable level of creativity and productivity in a highly technical and demanding profession, and as a counterexample to the common picture of a mentally ill person as violent, disordered, and/or ``crazy''.

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