After running a Google Search on ‘bipolar disorder’ with the date, as I often do to catch up with the latest on the topic, I came to the conclusion that all bipolar disorder (BD) research and findings have taken a holiday, and it is all Jesse Jackson, Jr., all the time.
The Wall Street Journal let, “Rep. Jesse Jackson Jr. has been diagnosed with bipolar disorder. . .,” USA Today added, “Rep. Jesse Jackson Jr. is being treated for bipolar disorder and responding well to treatment,” NBC News phrased the same idea somewhat differently, asserting that, “Rep. Jesse Jackson Jr. is “regaining his strength,” following his admittance to the Mayo Clinic for bipolar disorder earlier this summer,” and the list of publications just goes on and on.
As earth-shattering as the news seems to be, it’s important to remember that Rep. Jackson is far, far from alone, both in his illness, and in how it has played out.
The National Institute of Mental Health’s page Statistics page on Bipolar Disorder Among Adults informs us of the 12-month prevalence of the disorder, or those interviewed in their research study who had been diagnosed with BD or had an episode within the past year–and it’s fairly high:
Then we discover how many of those with the disorder have received healthcare treatment within the past year. Although I actually find the number fairly low, given that preventative treatment can go far in preventing hospitalizations, still nearly 50% of those with BD receive some form of healthcare services within a year.
[The upsetting following statistic is that only 18.8% of BD people are receiving minimally adequate treatment, but that's a soap box for a different day.]
And that doesn’t cover hospitalizations.
Although coverage of Jackson’s hospitalization implies a rare occurrence, inpatient treatment for bipolar disorder is anything but.
The National Institute of Health’s “HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2008 [Internet]” found that, in 2008, BD accounted for 20% of all mental health inpatient hospital stays.
But the Center for Disease Control and Prevention’s Burden of Mental Illness page found that
- “the inpatient hospitalization rate of bipolar patients (39.1%) was greater than the 4.5% characterizing all other patients with behavioral health care diagnoses”
and
- “for every dollar allocated to outpatient care for persons with bipolar disorder, $1.80 is spent on inpatient care. . .”
And once in the hospital, the battle is far from over.
First, there’s length of stay, which is not by any means the longest for a disorder, but is greater than the average length for a mental illness, as another figure from the NIH’s HCUP study illustrates.
Average Length of Stay by Principal Reason for MHSA Stay, 2008
[Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 2008.]
The Millman Behavioral Health Advisor notes that:
1. The three largest mental health conditions for inpatient hospitalizations are: Major Depressive Disorder, Bipolar Disorder, and Substance Abuse Disorder.
2. Major Depressive Disorder has relatively few readmissions (6.9%), while Bipolar Disorder and Substance Abuse together are almost half of all behavioral admissions, and both have double-digit readmission rates.
3. The readmission rate for Bipolar is 10.6%.
In fact, at the American Psychiatric Association’s annual meeting in San Francisco, researchers reported their findings that three-fourths of the hospitalizations for BD are repeat admissions.
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With good a good biopsychosocial treatment plan, and ongoing compliance, there is always hope that the life of the one suffering from BD will be radically improved–although the illness itself never goes away.
I am sorry that Jesse Jackson, Jr, and his family are suffering right now, and I hope he can come out of his acute suffering soon.
But I also note that each time someone famous struggles with the disorder, and speaks about it in public, it removes one of the layers of shame that films the illness.
And as for comfort for the Representative himself–he should know that he is far, far from alone, and many have fought the fight, and are here to tell their stories, not in graphs, not in statistics, but in inspiring personal narratives, unique, painful, riveting–and hopeful.
billgncs
August 14, 2012
with high profile people, one always wonders if it is real or posturing to cover drugs/alcohol issues. Either way, let us hope he faces and slays his demons.
DeeDee
August 24, 2012
Does that 39.1% hospitalization rate refer to lifetime hospitalization (yes/no) for bipolars? I’m just curious how many of us manage to do without hospitalization at any point. I’d also assume it’s less likely for bipolar II than bipolar I, but I have no info to base that on and wouldn’t be surprised if I’m wrong.
candidaabrahamson
August 24, 2012
Yes–that’s a lifetime (fortunately not a 12-month or 30-day prevalence) statistic, and –unfortunately–was not broken down into BD I vs. BDII, although I’m not convinced at all that BD II don’t have high rates of hospitalization as well. In fact I have a few minutes to check it out–I’ll get back to you if I find something of note.
candidaabrahamson
August 24, 2012
Wanted to share a few interesting notes about BDI vs BDII, esp since I think there’s a general sense that one is more ‘serious’ than the other.
–>”Patients with bipolar disorder do not experience manic or mixed episodes, and most return to fully functional levels between episodes. However, bipolar II patients have a more chronic course, significantly more depressive episodes, and shorter periods of being well between episodes than patients with type I. Bipolar II disorder is highly associated with the risk for suicide.” (http://health.nytimes.com/health/guides/disease/bipolar-disorder/print.html)
–>The second point is as you suspected. It’s from Mayo Clinic, which is highly reliable, but unfortunately doesn’t have the breakdown of the stats: “Because bipolar I is generally more severe than bipolar II, the need for urgent outpatient treatment or hospitalization is more common with bipolar I.”
–>That’s confirmed by Roggero’s 2007 “Psychosocial Impairment Associated With Bipolar II Disorder”: “Bipolar II disorder had fewer hospitalization than bipolar I disorder which may have led to slightly less severe work impairment. Both conditions had similar rates of serious suicide attempts.”
I still was unable to find an absolute breakdown of the statistics, but I can keep at it. Does confirm what you sensed, though.
DeeDee
August 24, 2012
Very interesting – thanks for checking! I’ve definitely seen the discussions of neither being “worse” than the other. It seems that full mania in bipolar I (which also gets people diagnosed quicker) would be much more likely to result in hospitalization than hypomania, and for depression, perhaps equally likely overall despite the higher number of depressive episodes in bipolar II.
I’ve spent plenty of time depressed, and even suicidal, without the thought of hospitalization ever crossing my mind! My therapist says I’d be a poor candidate for it anyway since I’d be very distressed by the confinement and relatively few options for occupying the mind.