Suffering in Silence

Depression and bipolar disorder bring various dangers to the individual, including personal problems such as unemployment, financial struggles, homelessness, and broken relationships. Those with bipolar disorder may also struggle with substance abuse and tend to engage in risky behaviors, including angry outbursts, reckless driving, promiscuity, and gambling. By far, however, the most severe danger they face is suicide. Let’s take a moment to examine each of these dangers.

Personal Problems
Those with depression and bipolar disorder are at a higher risk of pervasive personal problems. Both illnesses can lead to issues such as loss of employment, financial trouble, homelessness, and broken relationships. Due to the unpredictable nature of depression and bipolar disorder, many experience difficulty gaining and keeping a job. Economic challenges brought on by lack of employment or reckless spending may lead to defaulting on mortgage or rent payments. As a result, many are forced to move from one place to another and may have difficulty finding a place to live. The help of family and friends may become exhausted by the cyclical and recurrent nature of the disease. These problems compound if the individual has committed a felony. In this case, they will be unable to lease an apartment or house for at least ten years. This pushes many of those with bipolar disorder into homelessness or living on the streets. Between one-third and one-half of those who are homeless are severely mentally ill.

Marriages and relationships with friends and family can be, and often are, ruined due to either manic or depressive episodes. A typical personal problem encountered with bipolar disorder is broken relationships. Rebuilding trust after a severe manic or depressive episode may take months or years. Family and friends may feel trapped in crisis-and-response mode or feel they must restart life again. As a result, marriages fail, friendships fracture, and family relationships may be permanently damaged. In this way, social support for the individual may dry up or vanish overnight.

Risky Behavior
Those with bipolar disorder may engage in risky behaviors, including outbursts of violence, reckless driving, promiscuity, and gambling. While bipolar disorder is not typically physically violent, any violence that does occur is more likely to be perpetrated upon self rather than others. Outbursts often include self-injury or mutilation, such as scratching or clawing at one’s arms or face or pulling out one’s hair.

Another risky behavior often displayed by those with bipolar disorder is reckless driving. This typically occurs due to one or more of three causes:

1. The individual is in the throes of a manic episode and is driving wildly.
2. The individual is experiencing an outburst of anger and is displaying road rage.
3. The individual has been self-medicating with either drugs or alcohol and is driving while impaired.

It is dangerous for those experiencing mania to get behind the wheel of an automobile. Innocent people may be injured or killed, and the individual may suffer lifelong consequences.

Those in a manic state often exhibit gambling and promiscuity. Gambling may take different forms, from playing the stock market or online gaming with one’s life savings to illogical behavior such as spending entire paychecks on lottery tickets. Gambling frequently results in considerable financial hardship or bankruptcy.

Twenty to twenty-five percent of individuals with
depression or bipolar disorder will die from suicide.


Increased sensuality is another common characteristic of mania. There is an overwhelming desire to seduce and be seduced. The temporary euphoria of sexual release may become an addictive form of self-medication. Sexual activity may provide a sense of love or validation or replace a lost or broken relationship, which can lead to promiscuous relationships or other unsafe sexual practices. These behaviors can damage or destroy personal relationships.

Substance Abuse
People with depression and bipolar disorder are also at a higher risk of substance abuse. Those with bipolar disorder tend to abuse alcohol and drugs more than the general public. Approximately 13 percent of Americans struggle with alcohol addiction, while 10 percent struggle with drug addiction. However, 60 percent of those with depression or bipolar disorder struggle with some form of substance abuse. When someone with a mental illness struggles with substance abuse, this is called a dual diagnosis. If your church has five individuals with bipolar disorder, three of those people struggle with alcohol or drug addiction. We do not like to consider this when we look around our churches on Sunday morning and see our fellow believers. Abuse of alcohol or drugs is frequently a form of self-medication but can lead to other risky or illegal behavior with concurrent personal, social, health, and legal consequences.


Suicide
Those with depression and bipolar disorder have a higher rate of suicide than the general population and are more likely to commit suicide than individuals in any other psychiatric or medical risk group. Twenty to twenty-five percent of those diagnosed and treated for bipolar disorder will die by suicide. The suicide rate is even higher for those who remain untreated. Seventy percent of all suicides can be traced to depression. According to Dr. Frederick Goodwin and Dr. Kay Jamison, the presence of depression and bipolar disorder is the most critical risk factor for completed suicide. I cannot overemphasize the lethal nature of this illness. Bipolar disorder is the deadliest form of mental illness. Says Dr. Jamison, “Suicide, for many who suffer from untreated manic-depressive illness, is as much “wired” into the disease as myocardial infarction is for those who have occluded coronary arteries.”