Someone You Know Is Mentally Ill

One out of three people is mentally ill. Ask two friends how they’re doing. If they say they’re OK, then you’re it.

Mental illness is common in the entire world’s population. However many people are unaware of the mentally ill who live among them because the stigma against mental illness forces those who suffer to keep it hidden. Many people who ought to be aware of it prefer to pretend it doesn’t exist.

The most common mental illness is depression. It is so common that many are surprised to find out that it is considered a mental illness at all. About 25% of women and 12% of men experience depression at some time in their lives, and at any given moment about 5% are experiencing major depression. (The statistics I find vary depending on the source. Typical figures are given by Understanding Depression Statistics.)

Roughly 1.2% of the population is manic depressive. You probably know more than a hundred people – the chances are great that you know someone who is manic depressive. Or to look at it another way, according to K5’s advertising demographics, our community has 27,000 registered users and is visited by 200,000 unique visitors each month. Thus we can expect that K5 has roughly 270 manic depressive members and the site is viewed by about 2,000 manic depressive readers each month.

A slightly smaller number of people have schizophrenia.

About one in two hundred people get schizoaffective disorder during their lives.

More statistics can be found in The Numbers Count.

While homelessness is a significant problem for the mentally ill, most of us are not out sleeping on the streets or locked up in hospitals. Instead we live and work in society just as you do. You will find the mentally ill among your friends, neighbors, coworkers, classmates, even your family. At a company where I was once employed, when I confided that I was manic depressive to a coworker in our small workgroup, she replied that she was manic depressive too.

Life on a Roller Coaster

Nullum magnum ingenium sine mixtura dementiae fuit. (There is no great genius without madness.)
— Seneca

When I don’t feel like going to the trouble to explain what schizoaffective disorder means, I commonly say that I’m manic depressive rather than schizophrenic because the manic depressive (or bipolar) symptoms are more prevalent for me. But I experience schizoid symptoms as well.

Manic depressives experience alternating moods of depression and euphoria. There can (blessedly) be periods of relative normalcy in between. There is a somewhat regular time period to each person’s cycle, but this varies dramatically from person to person, ranging from cycling every day for the “rapid cyclers” to alternating moods about every year for me.

The symptoms tend to come and go; it is possible to live in peace without any treatment sometimes, even for years. But the symptoms have a way of striking again with an overwhelming suddenness. If left untreated a phenomenon known as “kindling” occurs, in which the cycles happen more rapidly and more severely, with the damage eventually becoming permanent.

(I had lived successfully without medication for quite some time through my late 20’s, but a devastating manic episode that struck during graduate school at UCSC, followed by a profound depression, made me decide to go back on medication and stay with it even when I was feeling well. I realized that even though I might feel fine for a long time, staying on medication was the only way to avoid being caught by surprise.)

You may find it odd that euphoria would be referred to as a symptom of mental illness, but it is unmistakably so. Mania is not the same as simple happiness. It can have a pleasant feel to it, but the person who is experiencing mania is not experiencing reality.

Mild mania is known as hypomania and usually does feel quite pleasant and can be fairly easy to live with. One has boundless energy, feels little need to sleep, is creatively inspired, talkative and is often taken to be an unusually attractive person.

Manic depressives are usually intelligent and very creative people. Many manic depressives actually lead very successful lives, if they are able to overcome or avoid the illness’ devastating effects – a nurse in Santa Cruz’ Dominican Hospital described it to me as “a class illness”.

In “Touched with Fire” Kay Redfield Jamison explores the relationship between creativity and manic depression, and gives biographies of many manic depressive poets and artists throughout history. Jamison is a noted authority on manic depression not just because of her academic studies and clinical practice – as she explains in her autobiography “An Unquiet Mind” she is manic depressive herself.

I have a bachelor’s degree in Physics, and have been an avid amateur telescope maker for much of my life; this led to my Astronomy studies at Caltech. I taught myself to play piano, enjoy photography, and am quite good at drawing and even do a little painting. I have worked as a programmer for fifteen years (also mostly self-taught), own my own software consulting business, own a nice home in the Maine woods, and am happily married to a wonderful woman who is very well aware of my condition.

I like to write too. Other K5 articles I have written include Is This the America I Love?, ARM Assembly Code Optimization? and (under my previous username) Musings on Good C++ Style.

You wouldn’t think that I have spent so many years living in such misery, or that it is something I still have to deal with.

Full-blown mania is frightening and most unpleasant. It is a psychotic state. My experience of it is that I can’t hold any particular train of thought for more than a few seconds. I can’t speak in complete sentences.

My schizoid symptoms get a lot worse when I am manic. Most notably I get profoundly paranoid. Sometimes I hallucinate.

(At the time I was diagnosed, it was not thought that manic depressives ever hallucinated, so my diagnosis of schizoaffective disorder was based on the fact that I was hearing voices while I was manic. Since then it has become accepted that mania can cause hallucinations. However I believe my diagnosis to be correct based on the current Diagnostic and Statistical Manual criterion that schizoaffectives experience schizoid symptoms even during times they are not experiencing bipolar symptoms. I can still hallucinate or get paranoid when my mood is otherwise normal.)

Mania is not always accompanied by euphoria. There can also be dysphoria, in which one feels irritable, angry and suspicious. My last major manic episode (in the Spring of 1994) was a dysphoric one.

I go for days without sleeping when I am manic. At first I feel that I don’t need to sleep so I just stay up and enjoy the extra time in my day. Eventually I feel desperate to sleep but I cannot. The human brain cannot function for any extended period of time without sleep, and sleep deprivation tends to be stimulating to manic depressives, so going without sleep creates a vicious cycle that might only be broken by a stay in a psychiatric hospital.

Going a long time without sleeping can cause some odd mental states. For example there have been times when I lay down to try to rest and started dreaming, but did not fall asleep. I could see and hear everything around me, but there was, well, extra stuff going on. One time I got up to take a shower while dreaming, hoping that it might relax me enough that I could fall asleep.

In general I’ve had the fortune to have a lot of really odd experiences. Another thing that can happen to me is that I might be unable to distinguish between being awake and asleep, or to be unable to distinguish memories of dreams from memories of things that really happened. There are several periods of my life for which my memories are a confusing jumble.

Fortunately I have only been manic a few times, I think five or six times. I have always found the experiences devastating.

I get hypomanic about once a year. It usually lasts for a couple of weeks. Usually it subsides, but on rare occasions escalates into mania. (However I have never become manic when I was taking my medication regularly. The treatment is not so effective for everyone, but at least that much works well for me.)