Millennials and Bipolar Disorder – Why so High and so Low?

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There has been a startling rise in the incidence of what is known as “Bipolar Disorder” (formerly known as manic/depression) in Millennials. The search is on for the probable causes and best ways to prevent and effectively treat this crushing and debilitating condition. The question arises whether unbearably elevated levels of emotional and financial stress and social conditions beyond their control could be causing this condition characterized by wildly fluctuating emotions that many sufferers describe as “being on an emotional rollercoaster.”

According to a new study through Bank of America/Merrill Lynch Workplace Benefits discussed in an article in Time Magazine (amp.timeinc.net June 1, 2017) 67% of millennials report being under financial stress which is twice the rate of 32% reported for “Baby Boomers” (“Boomers” are those born between 1946 and 1964). In addition, 68% of millennials in this study indicated that financial stress had a negative impact on their physical health as compared with similar reports by 51% of Boomers. It is certainly probable that this unbearable stress which is leading to physical illness is also causing mental instability and thus leading to the increased levels of Bipolar Disease.

Another study which backs up the Bank of America findings was conducted in 2016 by the New York City Controller’s Office (controller.nyc.gov April 16, 2016). This study found that millennials living in New York City earned an average of 20% less than previous generations and entered the work force facing the toughest economy since the Great Depression. Many with bachelor degrees were found to be underemployed and underpaid with young people in the 5 Boroughs of New York City tragically found to owe 14 billion dollars in student debt. Could the way millennials use their lack of earning power, their frustration at working in jobs they are over qualified for and their insurmountable debt and unaffordable housing costs to have a lack of hope and a rise in fear and anger be creating a mental disequilibrium that is causing a rise in mental health conditions of all types including Bipolar Disease? Could they be using what they see wrong in society to give themselves the right to separate themselves from the workforce and to feel alienated and disenfranchised?

Instead of simply castigating all those in the Millennial age group as “lazy,” “self-involved,” and “selfish,” it appears that a far more sensible approach would be to understand how difficult their lives are in the current economic environment and try to help ease their tensions and anxieties. This can be done by changing economic policies and increasing economic fairness while encouraging them to see all the deficiencies in society in a way that is for their integration, strength and mental health.

Bipolar Disease is widespread affecting approximately 5.7 million Americans and 29 million people worldwide. According to the National Institute of Mental Health there are four basic types of Bipolar Disease. In “Bipolar 1” the manic episodes last for at least 7 days with depressive symptoms lasting for 2 weeks. “Bipolar 2” is characterized by a pattern of depressive episodes and “hypomanic” but not “full blown” manic/depressive episodes. Type 3 is called “Cyclothymic Disorder” and is associated with numerous episodes of hypomanic symptoms and depressive symptoms lasting at least 2 years. Type 4 is more general and encompasses “Other Specified and Unspecified Bipolar and Related Disorders.”

Symptoms of a patient’s manic phase include: a feeling of elation, having lots of energy, increased activity, feeling “jumpy” or “wired”, insomnia, talking fast, drifting of thought, agitation, irritability, racing thoughts, feeling “invincible” and high-risk behavior such as spending a lot of money frivolously and engaging in “reckless” sexual behavior.

Symptoms of a depressive phase includes: feeling sad, “down” or empty, low energy, decreased activity, insomnia or sleeping too much, inability to enjoy anything, worry, problems concentrating, forgetfulness, eating too much or too little, fatigue and thoughts about death or suicide.

Demi Lovato Diagnosed with Bipolar Disorder

How you see is how you feel. For example, it is useful to associate a well-known millennial who has had success in her life and who still experienced this increasing mental health problem. Could the cause be in how you see what is not yourself and what you do about it?

Popular American actress and singer Demi Lovato wound up in rehab in 2011 where she was diagnosed with Bipolar Disease. She described in an article in Women’s Health Magazine how she felt during one of her manic phases. She said she would stay up all night until five o’clock in the morning and write seven songs in one night. She described how she felt “invincible” and that her mind “would go all over the place.”

Demi’s descriptions of how she felt during her episodes turn out to be quite typical of other patients with her condition.

Another Type of Patient

As a third- year medical student at the Albert Einstein College of Medicine in the Bronx, New York, one of my most interesting rotations was in Psychiatry at the Bronx State Mental Hospital.

One unforgettable patient unlike the successful or stressed out millennial was an African American male who we will call “Aubrey.” Aubrey had been admitted as an inpatient in a locked ward because his behavior had become outrageous and he was totally “out of control.”

Aubrey’s mood would wildly fluctuate from being extremely depressed to being wildly manic. In his depressed state, he had repeatedly tried to commit suicide and was a “danger to himself.” In his manic state, Aubrey would go on spending sprees that could last for weeks.

During one episode, Aubrey stole his sister’s credit cards and decided to go on a “spending spree.” When his sister returned home after several days away, she was astounded by what she found in the house. Aubrey had purchased six or seven washing machines, nine TVs, five or six refrigerators and several dish washers. In addition, he had bought a new car and had taken an expensive trip to Las Vegas to go gambling. He had piled up thousands of dollars in bills and expenses and felt horrible about doing this to his sister once his mood stabilized. This, of course, is an extreme case but represents the poor judgement of someone in a manic phase.

According to a new psychosomatic approach to mania as expressed by Eli Siegel in his major work “Self and World” we have two generalized impulses in us: one towards the broad and comprehensive; another towards the narrow and concentrated.” He goes on to define mania as “imagination fiercely narrowed is equivalent to mania.” It is certainly possible that if millennials were better able to like the way they see the world and people that they could better achieve a state of balance in their lives and “mental homeostasis.”

Treatments for Bipolar Disease traditionally include psychotherapy and drugs such as lithium and atypical anti-psychotics which help stabilize wild mood swings. It is also certain that achieving more fairness in employment, wages, student debt and housing could only help millennials be more balanced and less frantic about their futures. More research is needed to help understand how we can better balance the drives towards expansiveness and the drive toward a “diseased concentration” on ourselves which we all battle.

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James D. Okun, M.D.

James D. Okun, M.D.

Contributor

James D. Okun, MD is a Phi Beta Kappa graduate of Duke University and a graduate of the prestigious Albert Einstein College of Medicine in the Bronx, New York. He is the co-author of Erasing Scars: Herpes and Healing and of The History of New Innovations in Modern Medicine.

All posts by James D. Okun, M.D.

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