Tarnow Articles

The Young Adult with Bipolar Disorder: Treacherous Terrain by Sophia K. Havasy, Ph.D.

Learning to manage a chronic illness is difficult at any age. For young adults with a recent diagnosis of bipolar disorder, it can be particularly challenging. Suddenly they are no longer like their peers who can party, stay up all night, and generally, take regular ventures to the edge. The edge is where, without careful management, the bipolar young person can get stuck. With cycling in charge, labile moods and impaired reasoning are the norms. Concerned family and friends watch as jobs are lost, courses are failed, relationships are jeopardized, and the young adult's life spins out of control.

He will have to come to terms with having the illness, as well as making decisions as to what he wants his life to look like. Responsibility has to be taken to be on a stable sleep schedule, to stay off of alcohol and other drugs, to take medicines as prescribed, to work collaboratively with doctors and therapists, and to maintain a support system that promotes growth.

The young person also must learn patience, not always a strong point for those with bipolar. The diagnostic process can be extensive, often taking years before a diagnosis of bipolar is made. Once the diagnosis is made, however, there is some relief as a life in turmoil begins to make sense. Medicines are initially seen with hope and as an answer to the chaos. This is when the hard work begins.

The young adult begins a process of grieving. She grieves for lost years, lost opportunities, and an uncertain future. As she grieves, the young adult is also feeling bombarded with new information. Cognitive impairments from the cycling, especially when combined with drug abuse, interfere with processing new information and decision-making. There is also anger at the unfairness of it all. This can be a dangerous time for the patient and his or her family to lose their footing. There is not yet sufficient understanding of the illness and this particular young person's version of bipolar to provide road maps for staying out of danger.

Collaboration and communication with the treatment team is vital during these early stages of treatment. What the young adult and family may not realize is that "early stages of treatment" can be one to three years, depending upon all of the factors listed above including: responses to medicines, managing a good sleep schedule, not using alcohol and other drugs, maintaining communication, and having a good support system.

Managing a chronic illness takes a lifetime-just ask any diabetic. It is sad. It is unfair. It is also a learning process. When the young adult becomes an active collaborator in the treatment process, progress is made and future cycles are more easily offset. That is when a new sense of future can begin to unfold with plans that allow for managing the illness, as well as, one's life.