March 27, 2008

My Life With Bipolar Disorder

I have a confession to make. I live with bipolar disorder, a category of psychological mood disorders. You may recognize it by its former name, manic-depressive disorder. So some recent news that a startup company is now selling a bipolar genetic test ($399) startled me. In my years of dealing (and not dealing) with my disorder I have learned a lot regarding the physiology and progression of the disease and a claim like this scares me.

Dr. John Kelsoe is the designer of the test and after researching for years he identified several gene mutations closely related to the disease. These breakthroughs are no doubt very significant for the identification and treatment of bipolar disorder but they do bring up some very serious questions that the medical profession must answer.

Many public health officials, medical ethicists, and doctors are troubled by the proliferation of such tests. They receive almost no government oversight, and even though many are being sold as tools for making serious medical decisions they are built on thin data. It really is a double edged sword as openness and sharing are very powerful paths down the road to medical discovery, but at the same time a premature test preys on individuals' deepest anxieties.

Kelsoe himself acknowledges that bipolar disorder probably results from a combination of genetic factors and life experiences, and that the presence of these gene variations does not at all mean that someone will, in fact, develop the disease. He admits, too, that his findings about the genetic basis of the illness are far from complete.

But he said his test is a vital starting point toward moving away from the notoriously tricky practice of diagnosing bipolar disorder based purely on a person's behavior.

"The goal of this is to try and help doctors make an accurate diagnosis more quickly so the patient can be treated appropriately," Kelsoe said. "Anything is going to help, even if it just helps a little bit."

This diagnosis help is very useful but should be performed by licensed medical professionals who are capable of making a diagnosis on observation and testing. Making these kits available for home tests only raises fears and self-diagnosis problems. And unfortunately this is a very serious disorder to be putting people at fear of having.

Through my years I've learned the effects of the disease and learned, through medication and diet, how to manage my cycles. Unfortunately this is not the case with many people and realizing you have a problem is very hard. The feelings that you have and urges and emotions that drive them are so ingrained in the being of a person that it is hard to tell if you are outside of the universal consciousness of the population. I didn't realize my own self-destructive behavior until I really sat down with a friend and discussed how we felt and observed things and I began to realize that I process things differently.

As with any psychological disorder, bipolar is a powerful and all encompassing problem. You can never escape your inner thoughts and you must train yourself to see through the eyes of normality and push away a lot of the noise that your brain creates. Racing thoughts and delusions are just a part of my life that I must live with and then learn how to incorporate that into the "real" world. All of my interactions, from friends, girlfriends, parents and strangers have been influenced by my disorder and I have thrown many a good relationship to the curb under the pretenses that I would be better for it, only to find out I was running from having to deal with these problems.

It is a problem that I do not wish on anybody and something I will have to deal with until I squeeze the last breath from my body, but until we learn more about the disease lets keep the diagnosis with the professionals.

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