Mental Health

Bipolar Disorder and Personality

By Rabbi Azriel Hauptman

Bipolar disorder, which used to be called manic depression, is a mental health disorder that is defined by periods of depressed mood and mania. When one is in a manic phase, it is common to experience high energy, decreased need for sleep, feelings of grandiosity, increased talkativeness, racing thoughts, increased risk taking, and a loss of touch with reality. There is another form of mania called hypomania (which literally means less than mania), where a person is in a high-energy state but does not experience a break with reality.

Sometimes, individuals with a natural talent for creativity feel their creative juices flowing intensely when they are in a hypomanic or manic state. This can lead individuals with bipolar disorder to resist taking their medications, as they do not want to lose the extra boost they receive from their mania. Another common fear of taking medication for bipolar disorder is that the medication will flatten their personality.

This dangerous misconception is partially the result of the grandiose feelings that are common during manic phases. This euphoria makes the person truly believe that he functions at his best in that state. This is analogous to saying that automobiles function the best when the accelerator is pushed to the floor and the brakes are not working. True, the car will go very fast, but it will likely crash. Similarly, during a manic phase the energy level feels great, but being that it is uncontrolled it will most likely be more detrimental than beneficial.

Moreover, the medications most commonly taken for bipolar disorder are the mood stabilizers (such as lithium, Lamictal, and Depakote). These medications operate on your mood and not on your personality or talents. If you are naturally talented, your talents will not be lost when you take your medication. Just the opposite is true, as it will provide you the stability that you need to carry out your goals.

Actually, there are times when medication will make you feel not like yourself. However, this is usually not due to the medication per se, but rather due to a wrong dosage or incorrect type of medication. One of the hardest parts of psychiatry is finding the right medication and the right dosage for each individual person. It can take a lot of trial and error until the right medication and dosage is discovered. Once you have reached that point, the medication will make you feel like your true self.

This is not only the case with bipolar disorder; it is true by all mental health disorders. Every class of psychiatric medication has many medicines that do the same thing. The reason is that every psychiatric medication carries with it the risk of negative side effects. Some people will experience these side effects with one medication in that class, and others will feel it from another. Indeed, there are ongoing studies trying to determine if a DNA profile can determine the right dosage and medication for each individual person.

An additional mistake with bipolar disorder is to identify the grandiosity of the manic phase as a true representation of yourself. When one is in a manic phase, he feels on top of the world and super-human. It can feel like a letdown when you can no longer have that experience, but that is actually a positive development since those feelings of grandiosity can be very dangerous.

Life is not always easy, and the journey to find the right medication for each individual with bipolar disorder can be arduous. That journey is not simply a pathway to symptom relief; it is also an endeavor to be able to live your life with access to the full range of your talents and personality.

This is a service of Relief Resources. Relief is an organization that provides mental health referrals, education, and support to the frum community. Rabbi Yisrael Slansky is director of the Baltimore branch of Relief. He can be con-

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