May is Mental Health Awareness Month . . . . .
Trigger warning – this post talks about suicide and suicide rates. For some merely talking about the topic can be triggering.
A couple of weeks ago, I came across this video of an interview with Stephen Fry (a British actor, if you are unfamiliar; and if you are unfamiliar look up Fry & Laurie, a comedy sketch show where he teamed up with Hugh Laurie of House long ago). He has been diagnosed with cyclothymia. Cyclothymia is technically a separate diagnosis from bipolar; the Mayo Clinic describes it as, “Cyclothymia causes emotional ups and down, but they’re not as extreme as in bipolar type 1 or 2”. Stephen himself calls it the most mild form of bipolar. They are certainly closely related mood disorders.
In the video, he calls Bipolar a “morbid” disease and then qualifies it as “morbid in the medical sense – it kills people.” (He has a lot of other good things to say, too, like the part about it being like the weather and the story of the guy who stood in front of a lorry (truck)).
And it does, in the sense that the suicide rate among those with bipolar is higher than in the general population.
A 2000 study indicates that 25-50% of those diagnosed with some form of bipolar attempt the act – up to HALF of people with some form of bipolar attempt suicide. About 10-15% of people diagnosed Bipolar I commit suicide (others suggest as high as 20%). A 2007 study indicates that the rate in patients with bipolar II may be even higher.
“. . . the rate of prior suicide attempt is higher in biplar II patients, and bipoloar II disorder is overrepresented in depressed suicide victims. Among patients with different clinical manifestations of major mood disorders (unipolar major depression, bipolar and bipolar II disorder), bipolar patients in general and bipolar II subjects in particular carry the highest risk of suicide.”
People with bipolar II tend to spend more time in a depressed state. Some researchers even suggest that major depressive disorder and episodes are really on a spectrum of bipolar II.
And there is data that the clear majority of people who attempt suicide are in the grips of a depressive episode (78-89%), about 11-20% attempt during a “dysphoric manic” state, that is a mixed state. A mixed state can be either “dysphoric mania” or “agitated depression”.
I know, for me, when deeply depressed, I may think about it, but I don’t have the energy to actually DO anything. For me, a mixed state is much more dangerous. Having the energy and agitation of mania and the thought patterns of depression? Very dangerous.
So, what can you do to help someone? I guess I often assume that everyone has been exposed to information on avoiding suicide and/or other mental health issues, so it feels repetitive to me to post it yet again. But maybe someone reading this might need the info so. . . .
- Talking about it. When someone is talking about suicide, they aren’t just being melodramatic, they are asking for help. When someone jokes about it, too. I used to make statements such as, “Maybe I should take myself out of everyone else’s misery.” (It was apparently a little subtle for most people to pick up on – but at the time, I was pretty serious.)
- Gathering stuff that will help them do it, the examples given by the Mayo Clinic include stockpiling pills or buying a weapon.
- Withdrawing from social contact.
- Mood swings (which, you know, for a rapidly cycling bipolar would be ALL THE TIME)
- Preoccupation with death
- Feeling trapped and hopeless
- Increasing use of alcohol and/or drugs (also known as self-medicated)
- Changing eating and/or sleeping patterns.
- Risky and self-destructive behavior.
- Giving away treasured belongings and/or “setting affairs in order”.
- Personality changes and/or being severely agitated or anxious.