A Plague Upon Us?

By the year 2020, according to the World Health Organization, unipolar major depression is expected to be the leading cause of disability in terms of life years for women and throughout the developing regions of the world, where four fifths of the world’s population lives.

In its report, "The Global Burden of Disease," WHO states that the toll of mental illness has been seriously underestimated in the past, largely because it doesn’t produce the body counts that make health officials sit up and take notice. Nevertheless, despite being credited for just one percent of deaths, psychiatric conditions account for almost 11 per cent of the total disease burden worldwide. That figure is expected to increase by half to nearly 15 percent in 2020.

Worldwide, unipolar major depression leads all diseases in years lived with disabilities. Bipolar disorder is sixth on the list. In developed countries, depression is second only to ischemic heart disease. In the 15-44 age bracket worldwide, depression tops the list with bipolar at number six.

One of these days, someone will adjust the death figures to account for the silent killer role unipolar and bipolar depression plays in heart disease and other illnesses, and then we’ll see those grim reaper stats go through the roof. Then, perhaps, certain people will sit up and take notice. In the meantime, the NIMH is the poor relation in the NIH family, with a 2001 budget of $1.03 billion, of which AIDS projects unaccountably lopped off a lion’s share of $135 million. By contrast, the National Cancer Institute received $3.5 billion and the National Heart, Lung, and Blood Institute $1.76 billion.

As to why WHO sees no end in sight for depression and bipolar despite all the new medications on the market and scientific advances on the horizon, a simple real-life compare and contrast situation is helpful:

A member of my family very recently had open heart surgery. The operation took five hours as doctors cracked her open like a lobster, took her heart out of the body and grafted four sections of veins from her leg to bypass the four partially blocked arteries in her heart. In addition, they replaced her aorta valve with muscle tissue from a cow. Then they put her back together again.

The next day, she was laughing and joking. A few days later, she was transferred to a care facility for physical rehab. It will still take several weeks before her body fully heals, but soon enough she will be singing and tap dancing, perhaps this time on key. A heart operation may well be one of the most complex procedures known to medical science, but when it’s over there is a sense of completion - of rebirth, even - of one being fully restored to good health.

By contrast, taking a pill or two for depression or bipolar is a deceptively simple exercise, one that utterly belies the intricately subtle chemical processes taking place throughout the brain, all of it off-limits to the surgeon’s scalpel. But having swallowed our pills, who amongst us can claim that same sense of completion? If only getting our brains back in working order were as simple as heart surgery. If only we had that kind of option.

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Discussions

Belinda (Jan 6, 2001): How true. I've had 4 knee surgeries and 1 ankle surgery. I'm back together physically, but I'm a rapid cycling bipolar and taking a pill just doesn't put it back together. Sometimes I feel like the meds don't even work. When will people realize that Bipolar can't really be fixed? We Bipolars are just scientific and medicine guinea pigs hoping to have a series of good days. Which of course seem to be limited by sets of circumstances in our lives. Good day series can last for months, but so can real terrible depressive series. The brain is a funny thing, and so are the people who understand it even less than the ones who are sick. It is pretty sad when I can understand my craziness better than my doctors. I know I can't be fixed, but my psychologist father doesn't. I know that meds and management and support groups and all that crap makes for a better Bipolar. My dad thinks that pills and science should just cure me and that I'm mostly faking and should be able to control these moods and depressive cycles. I'm just supposed to buck up and get over it like a grown up. Boy would I like to let him live in my head for just a day. Thank you for your articles and your belief in we the 'crazies'. I use this term loosely and fondly. I hope that someday people will learn more so that it will be easier on Bipolars. We have it hard enough.

Luke (Feb 21, 2002): Good article, wish people could really understand this. Many good points, Belinda. I don't have bipolar but have been learning a lot about it. I'm unipolar and have anxiety disorder problems....and simply taking pills doesn't quite do it...the brain is so complex and not so fixable especially in bipolar or schizophrenia ...do you have any auditory or visual hallucinations or just mania/depression?

Kudzu2u (June 27, 2003): I think it is indeed a plague. My wife was recently diagnosed bipolar. I began wondering about the frequency at which I find these things happening among people I know. This verse came to mind: And I looked, and there before me was a pale horse! And its rider was named Death.. They were given power over a fourth of the earth to kill by swore, famine and plague...(Rev 6:8). Maybe it is just to much for me, but Sept 11, Iraq, the WTO, and now this. Some things just seem to be falling apart. Thanks for the site, it is really encouraging and helpful.

McMan (June 27): Hi, Kudzu2u. Try to remember Revelation has a happy ending.

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John McManamy

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