March 30, 2025 • 30 mins
03/30/25
The Healthy Matters Podcast
S04_E12 - Bipolar Disorder: The Ups, Downs, and In-Betweens...
Bipolar disorder affects millions of people worldwide - and actually, a higher percentage of people in developed countries. It can bring euphoric highs and depressive lows at any time, with no rhyme or reason, and understandably, can have a real impact on those living with the condition, as well as their loved ones. But what is bipolar disorder, exactly? What's the lived experience like? And what are things to be aware of for those with the condition and the people in their lives?
This is a condition that's often misunderstood and might not be what you think, so on Episode 12 we'll be joined by psychiatrist Dr. Vanessa Stumpf, MD, to help get our brains around what's going on in the brain. Whether you’ve been diagnosed, know someone who has, or just want to understand more, this episode aims to shed light on the emotional rollercoaster that is bipolar disorder—with empathy, insight, and a few moments of humor along the way. We hope you'll join us!
We're open to your comments or ideas for future shows!
Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
Helpful mental health resources:
National Alliance on Mental Illness (nami.org)
If you or a loved are seeking mental health care, help is available, simply dial 988 from anywhere in the U.S.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health healthcare and
what matters to you. And nowhere's our host, Dr. David Den.
Speaker 2 (00:19):
Hey everybody and welcome to episode 12 of the
podcast. I am your host, Dr.
David Hilden , and I want tothank my colleague Megan McCoy
for being a guest host on thelast episode on topics around
our children. Today we aregonna talk about bipolar
disorder with psychiatrist Dr.
Vanessa Stump. She treats thiscondition here at Hennepin
Healthcare in downtownMinneapolis. With me, we're
(00:41):
gonna dive into this topicthat's kind of misunderstood,
but it affects millions ofpeople worldwide. Vanessa,
welcome to the show.
Speaker 3 (00:48):
Thank you. Happy to be here.
Speaker 2 (00:50):
So break it down for us. Start with the basics. What
is bipolar disorder?
Speaker 3 (00:55):
Absolutely. Well, I agree with your introduction
that I do think this disordertends to be misunderstood for
various reasons. I thinkunfortunately in the media
there's still a lot of stigmaaround this and I also think it
doesn't get represented veryaccurately. So I think it's
really good for us to sit downand talk about what this really
(01:17):
looks like. So bipolar disorderis classified as a mood
disorder. People do havecontrasting mood episodes. So
people for two weeks to monthsat a time can feel very
depressed. Have an episode ofwhat we call major depressive
disorders. So they might notwanna get outta bed, they don't
enjoy things like they usuallydo. They might feel really
(01:39):
tired, not be eating as much,and then they can have periods
of time for weeks to months onend where their , their mood is
okay, they feel fine, they'rekind of living their day-to-day
life. And then they can haveperiods of time for usually at
least a week or longer wheretheir mood can get really
elevated. And this can lookdifferent. So sometimes people
(02:02):
can be really happy, reallyover the top , or they can even
get kind of irritable andthey're not sleeping. Sometimes
people start talking reallyfast, they're just on the go
doing all sorts of things theywouldn't normally do. And so
people can have thesefluctuations in their mood.
It's not necessarily day to day. I think that's how some
people think of it. It'sgenerally sort of weeks to
(02:24):
months on end and blocks.
Exactly, exactly. So
Speaker 2 (02:28):
Is is the elevated move , is that sort of the
opposite of depression? It
Speaker 3 (02:32):
Is, yeah .
Speaker 2 (02:32):
And that's why bipolar to polls .
Speaker 3 (02:34):
Exactly.
Speaker 2 (02:35):
So I do sort of know the answer to this, but I want
you to help our listeners evena little bit more about why is
that bad? Mm-hmm. To be exceptionally happy.
Mm-hmm . Or havewhat they might think of as the
opposite of depression. Mm-hmm . Why isn't that
a good thing? Well, it
Speaker 3 (02:48):
Can feel good. So certainly sometimes for a
period of time people feel goodwhen they're, we call it manic
or, or hypomanic is kind of theless severe version of that.
The problem is, is it canbecome very disruptive for
people's lives because for onething, it can be hard for
people to understand whatthey're saying 'cause they can
be talking so fast, have allthese ideas that some of it
(03:11):
just starts to not even makesense. Sometimes people start
to do really impulsivebehaviors that they wouldn't
normally do. So I have peoplewho have spent their life
savings in, you know, a shortamount of time they think that
they're gonna start a newbusiness. So they might quit
the job that they're working.
Sometimes people do thingstotally outta character, like
they use drugs or they have sexwith people that they normally
(03:33):
wouldn't. And when it getsreally severe, sometimes people
can even get what we callpsychotic. And that means that
they aren't really connectedwith reality anymore. So
sometimes they might believethat they're a superhero or the
president and you know,sometimes people do dangerous
things because of that. So it ,it can feel good but it can
(03:55):
become incredibly disruptive totheir life.
Speaker 2 (03:57):
Why do you think it's important that we are even
talking about this? Why, youknow, why should the public
know about bipolar disorder?
Speaker 3 (04:04):
Well, it doesn't impact a small number of
people. So the prevalence isanywhere between about one to
3%, which in the United States,they think is about 6 million
people. 6 million people. Yeah.
And so that's a lot of people.
Mm-hmm . Andindividuals with bipolar
disorder are higher risk forcertain, like cardiac illnesses
(04:28):
for being a victim of crime.
There's sometimes higher riskfor being incarcerated. Their
lifespan can be shorter. So wehave a lot of room, both as a
society and in healthcare tokind of make interventions and
try to improve these people'slives.
Speaker 2 (04:43):
When, when they're in the various swings of mood,
you say they kind of come inblocks, is the depression part
more common or is the maniapart more common? Mm-hmm
Speaker 3 (04:53):
Most people spend more time of their life in the
depression part, which that canactually be the more
challenging part of the illnessto treat. And that also can be
part of why it doesn't alwaysget identified right away.
Because sometimes when peopleare having that elevated mood,
that mania, well they don'treally seek out help at that
(05:13):
time 'cause they're feelinggreat. They're like, I don't
need to go to the doctor. Whenthey come and seek out help,
it's when they're feelingdepressed. And then it can be
hard to kind of parse outwhat's really going on.
Speaker 2 (05:23):
Do we know what causes it?
Speaker 3 (05:25):
Like most things in psychiatry, it's a mixture in
comparison to some of the otherdisorders we treat. It is
thought to have more hereditarycomponents. And unfortunately
we haven't really been able tonail that down to, oh, here's
one gene. But if somebody has afirst degree relative with
(05:46):
bipolar disorder, so that wouldbe a parent sibling, they're
actually about five times morelikely to develop bipolar
disorder than someone in thegeneral population. So the risk
is still, you know, it's about5%. So it's not a guarantee,
but still much higher risk.
People who have what we calllike adverse childhood
(06:08):
experiences seem to be higherrisk for developing this. So if
people unfortunately experiencetrauma, they experience abuse.
There also does seem to be somecorrelation to that. If people
are using substances,especially cannabis, that that
might kind of exacerbate theillness or they might develop
the illness earlier than theymight normally have. So it's
(06:32):
kind of a mixture. There's notreally kinda one thing that we
can pin it down on.
Speaker 2 (06:36):
I like what you said, like a lot of things in
psychiatry.
Speaker 3 (06:39):
Yes. We, we
Speaker 2 (06:39):
Live in the , the human brain is complicated.
Speaker 3 (06:42):
We live in the gray area. There's not a lot of
things that are black and whitein psychiatry. .
Speaker 2 (06:47):
What are the first signs of it? In other words,
how, what are the symptoms thatpeople should look for or that
you look for? Especially early,
Speaker 3 (06:54):
Most people at first they'll present with
depression. And so that's whyit's hard because when you meet
with a patient, we'll alwaysask them if they've had a
history of kind of a manic orhypomanic episode. And usually
what I do with that is I kindof describe what that might
look like. It can be helpfultoo, to talk to people's family
(07:15):
or friends. 'cause sometimesthey might have observed a
change in someone's behaviorthat maybe they don't remember
or didn't notice.
Speaker 2 (07:22):
And you said they're not usually seeing you for the
first time during a manic
Speaker 3 (07:25):
Episode? Not usually, although
unfortunately, especially ifthe mania becomes severe,
sometimes the firstpresentation people have is
actually in the hospital.
'cause they might be doingsomething kind of disruptive in
the community. They, you know,maybe were trying to jump over
the airport security orsomething that totally kind of
out of their character. And sothen their first encounter with
(07:48):
us is actually in the hospitalsetting.
Speaker 2 (07:50):
Is it possible that someone could have this for a
long time and not know it?
Speaker 3 (07:54):
You could. I mean there's definitely patients
who, especially individuals iftheir symptoms are more mild
and if they're still able tomaintain their work or their
relationships, there's probablyindividuals who can go a
lifetime without reallyinteracting with a healthcare
provider. Probably that's theminority of people though,
Speaker 2 (08:14):
Right? Right. Most people come to the attention
of, of the healthcare system ortheir family. Mm-hmm
or psychiatrists.
Mm-hmm in , inthe mental health
professionals, are theredifferent types or is it all
bipolar? You have depression,you have mania, that's the
type,
Speaker 3 (08:27):
There are different types. So bipolar one disorder
is kind of what we think of asclassic bipolar disorder. So
that's where people haveepisodes of depression and
those episodes of mania that wetalked about. And the episodes
of mania are quite pronouncedfor those individuals. So it is
a noticeable difference.
(08:49):
They're behaving in a way thatis noticeable to other people.
They're talking really fast.
They might be psychotic, theymight get hospitalized. There's
also a disorder called bipolartwo disorder. The main
difference with that is that,so they also experience
episodes of depression. Theyhave what we call hypomania,
which is really just a fancyterm for, they have periods
(09:12):
when their mood gets elevated.
They might be a little moreirritable, they might not sleep
as well, but it's not asdisruptive or as noticeable.
And they don't generally losetouch with reality like someone
can during a full blown manicepisode. There is kind of this
subset, there's this disorderif people really dig or read
(09:33):
into things, there's somethingcalled psychia , which is sort
of this interesting disorderwhere people don't really quite
meet criteria for manicepisodes and maybe they don't
even have full-blowndepression. But they sort of
have this, I guess, moodlability or some changes in
their mood. But it's kind ofmore of a rare disorder and
(09:54):
it's not something that wenecessarily see as often.
Speaker 2 (09:57):
Yeah . A lot of our listeners like to learn new
medical terms. Cyclo, thia .
Yes . Cyclo sounds likecyclical. Yes. What's thia ?
Speaker 3 (10:04):
Thia So is essentially someone's like
temperament or mood. So in theold days and sometimes still
we'll say someone can bedysthymic and that is kind of
another in a bad mood. Yeah,yeah. They're kind of depressed
or they're in a bad mood.
Speaker 2 (10:19):
Okay. Um, you already told us that maybe one
to 3% or 6 million people haveit in the United States alone.
Is it more common in certainsubgroups of the population or
is it equal across the country?
Across age, across men, women,
Speaker 3 (10:34):
It's equal amongst men and women. Um, so we don't
really see any differencesthere. It does seem more common
in higher income countries,which is interesting. I did
some digging into this. I don'thave a good answer for you why
that is. It could be that wejust detect it more. It could
be something to do with lifeexperiences, genetic factors.
(10:57):
Typically the onset of theillness is in early adulthood,
so 18 to 20, 20 to 30 kind ofdepending on the source you
look at. And this is consideredwhat we call a a chronic mental
illness. So it is classified ina group that we call serious
and persistent mentalillnesses. So once somebody is
(11:17):
diagnosed with this, it issomething that they generally
are coping with lifelong.
Speaker 2 (11:23):
You talked about it as being a mood disorder, the
other big one being majordepression. How is that
different from uh ,schizophrenia? Mm-hmm
and the , themore psychotic disorders,
because you did say thatsometimes people with bipolar
disorder can also have somepsychosis. Mm-hmm
. Are theydifferent? They
Speaker 3 (11:40):
Are different. So individuals with bipolar
disorder will only have apsychotic episode if they're
also in like a mood episode. Soduring times when their mood is
good, life is going well,they're feeling good, they will
not have an episode ofpsychosis. The other difference
is that individuals with theillness that you mentioned,
(12:02):
schizophrenia, even outside ofpsychosis, they tend to
struggle more kind of withtheir thinking. Sometimes they
become kind of less motivated ,uh, less interested in things
they used to. They can havekind of what we call like a
flatter affect . So they'rejust not really as responsive
to the world. Whereas that'snot really seen as commonly
(12:23):
with bipolar disorder.
Speaker 2 (12:25):
It's more about the mood. It is,
Speaker 3 (12:27):
It
Speaker 2 (12:27):
Is breast mood, elevated mood and the things
that are associated with your
Speaker 3 (12:30):
Mood. Exactly.
Speaker 2 (12:31):
How do you diagnose it?
Speaker 3 (12:33):
So unfortunately we don't have any magical tests
yet. So sometimes I havepatients who say, can you just
scan my brain? Right , right.
Can't you just look at it andtell me what's going
Speaker 2 (12:45):
On ? Is there a blood test? Isn't there an
x-ray? Isn't there an MRI scan?
Not
Speaker 3 (12:48):
Yet. But basically we just do what we call a
really good clinical interview.
So when we have initial visitswith patients, they're
generally at least an hour longand we're sitting down with
them and we are going over allof their symptoms. We're asking
a lot of questions like Imentioned, if we can, we often
(13:08):
will try to talk with family ora friend or someone who can
kind of give us theirobservations. There are some
psychological tests or somekind of questionnaires that we
can use to help us narrowthings down. But ultimately
it's just sitting down, talkingwith someone, getting their
story and then trying to put itall together.
Speaker 2 (13:27):
We're talking with Dr. Vanessa Stump. We're
talking about bipolar disorderand we're gonna take a short
break, but when we come backI'm gonna ask you Vanessa, to
talk about how bipolar affectsreal people. We've talked a
lot, some about the data, theprevalence, what might cause
it. We're gonna talk about whatit's like to live with bipolar
and I'm gonna ask you to sortof reflect on what you've seen
in your patients and listeners.
(13:49):
We're gonna talk about how youcan support either yourself or
a loved one who might havebipolar disorder. Stick around,
we'll be right back
Speaker 3 (13:58):
When
Speaker 4 (13:59):
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(14:21):
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Speaker 2 (14:36):
Hey everybody, we are back talking with Dr.
Vanessa Stump about bipolardisorder. Vanessa, let's talk
about treatments. We've talkedabout what it is, how common is
it? What do you do about it?
Yeah,
Speaker 3 (14:46):
So fortunately we have a lot of treatment options
now and in psychiatry I alwaystell people we kind of have
three buckets of things thatwe're working on. So there's
the biological stuff, so that'sthings like medications,
interventional treatments,there's the psychological
stuff. So that's things liketherapy changing kind of how
(15:08):
you think about yourself, howyou think about the world. And
then there's the social kind ofbucket and that's things like,
can we help you get back intoemployment? Can we support you
with school? Can we help youform healthy friendships? All
of those things. So bipolardisorder is best managed if
people are on some kind ofmedication. And usually this
(15:31):
looks like a class of medicinesthat we call mood stabilizers.
And then there's also a lot ofmedicines called
antipsychotics, which I thinkis kind of a misnomer 'cause we
honestly use them for a lot ofdifferent things. And a lot of
those medicines can be reallyhelpful for individuals with
bipolar disorder as well. Sotypically they're gonna be
working with a psychiatricprovider who's gonna be helping
(15:51):
to manage these medicines. Andwe do know that for individuals
who are on medication, that itdoes reduce the number of
episodes they have of bothmania and depression. It can
reduce the severity of theepisodes if they do happen. And
it also seems to prolongpeople's lifespan. So it , some
of the other things that peoplewith bipolar disorder can
(16:15):
struggle with, like theirphysical health, heart disease,
these other things. It actuallyseems to be better when people
are taking medication. What
Speaker 2 (16:22):
Do you say to people who are maybe understandably
nervous about takingmedications for something they
can't see And you know there's,you know, it's not like an
antibiotic. I got this bug,you're treating it , the bug
goes away. Mm-hmmuh , it's even been in our
national discourse a little bitin the country. You know,
sometimes people say, yeah ,I'll use psychiatrists. You
just want to give a pill toeverything. How do you respond
(16:43):
to that?
Speaker 3 (16:44):
Well I always frame medications as you know, it's
kind of one tool in yourtoolbox. So I certainly don't
sell to people that medicinesare the be all end all for
treatment. There are otherthings that are important to
do, but the way that I look atit is it's , it's kind of like
if someone has diabetes and ifyou ask someone with diabetes
(17:05):
who needs insulin not to useinsulin, well that's just not
gonna work. Or sometimes Ithink of it as, I'll tell
people it's like running amarathon and you break your leg
but you don't get to have acast so everybody else gets a
cast but you don't, so your legis just gonna heal at all these
weird angles,
Speaker 2 (17:21):
You know ? I like that. Yeah, I like that. Yeah.
Both the diabetes and therunning thing, you know, there
are some basic things that arepart of the treatment that you
need.
Speaker 3 (17:28):
Absolutely. And you know, I tell people that you
know, these medicines areworking on biological things in
our brain that we might not beable to see. But we know from
science that they do work. AndI also normalize for people
that, you know, I understandthat taking medication might
not be what you were hoping foror envisioning for your life.
(17:50):
And I say, let's find somethingthat's a good fit for you.
Let's work together to find amedicine that agrees with your
body that you feel okay takingand then we can just have it
there. We won't have to worryabout it anymore. And then
let's focus on your goals andthe things that you wanna do
and how being on that medicineand feeling well can help you
with the goals that you wannaaccomplish.
Speaker 2 (18:11):
Makes complete sense. That's a great, that's a
great response I think. Okay,so it's not just medications,
there's two other buckets yousaid?
Speaker 3 (18:17):
Yeah, so the psychology bucket is, and this
can be a variety of things, butthis kind of goes with what we
call therapy or psychotherapy.
And this is how people canlearn stress management skills.
'cause we know that if someonegets really stressed, that can
be, you know, it can impactyour sleep, it can impact your
mood. And that's when kind of amood episode can start to
(18:40):
unravel. So learning stressmanagement and also just
learning about the illness,getting education about it and
kind of learning how peoplethink about themselves. 'cause
there can be a lot of shamethat comes from bipolar
disorder when people are in themidst of these mood episodes.
And so it can be helpful to sitdown with someone
professionally who can reallyhelp kind of tease that apart
(19:03):
and really look at it and kindof change how we think about
it. And then the social pieceis , well I mean some of this
can kind of go in the otherbuckets too, but especially for
bipolar disorder, exercise,sleep, eating, well obviously
those are important foreveryone. But for bipolar
disorder it's like medicine.
It's very important to helpeducate individuals on how to
(19:26):
kind of live a healthylifestyle and get good sleep.
And then also just learning,yeah. How to go back out into
the world. You know, how do youform friendships now? How do
you have relationships? What doyou want that to look like? You
know, maybe when you were inthe midst of a mood episode,
that was something that youwere struggling with. So how
can we work on maybe evolvingor repairing some of that? Um,
(19:48):
or maybe you lost your job whenyou had a manic episode. Well
let's help you get back in,let's help you find a job. So
it
Speaker 2 (19:53):
Sounds like a holistic approach. There's
medications, there's therapy,there's social supports. Does
it always get worse? Doessometimes it get better? Um,
uh, and, and this is a hardquestion, but is it life
threatening?
Speaker 3 (20:06):
So your first question, you know, does it,
does it get worse? Does it getbetter if people do not treat
it? People can start to havemore episodes or more severe
episodes over time. Sotypically we expect it to be
sort of chronic or even kind ofget better with time. But if
someone's not treating it, wecan kind of see an increase in
(20:28):
that frequency or the severityof episodes. It can be life
threatening. And so this issomething where when we're
working with patients, therecan be a lot of joy in the work
we do together. And you know,we can have a lot of humorous
moments. And also kind of likeI mentioned earlier, this is
classified as something that wecall a serious and persistent
(20:49):
mental illness. When people arediagnosed with this,
unfortunately we don't have acure. We have ways of managing
it, but we don't have a cure.
And there are a subset ofpatients, I mean up to a fifth
of patients with bipolardisorder may attempt suicide in
their lifetime. Which is,that's a serious statistic.
That's something we really haveto take seriously.
Speaker 2 (21:09):
That is a serious statistic. It is . You are so
right.
Speaker 3 (21:12):
Yeah . Yeah . So there can be complications and
you know, like any seriousillness, when we're sitting
down with people we say, youknow, these could be
complications and at the sametime, look at all these
strategies we have for managingthis . Let's focus on kind of
the pieces that we can controland taking charge over it and
taking control of the disorder.
Speaker 2 (21:33):
Let's talk in our last segment about impact on
people's lives. Can people livelike a normal life or what are
your reflections from your ownpractice about of the impact of
bipolar disorder on realpeople? Mm-hmm.
Speaker 3 (21:46):
Individuals with bipolar disorder absolutely can
live a, a quote unquote normallife. I don't really know
exactly what a normal lifemeans. Yeah , it
Speaker 2 (21:54):
Was a normal life.
I'm not exactly sure what that, I dunno what a normal life is
. You live a normal life. Idon't think either one .
Speaker 3 (21:57):
I'm sure I do, but certainly they can. I always
say if you've met oneindividual with bipolar
disorder, you've met one personwith bipolar disorder, the
illness is incredibly differentin different people and comes
in varying degrees of severity.
So yes, for some people, youknow, it can become hard for
them to return to school or itcan be hard for them to work or
(22:20):
they might work part-time or doa different job because they
just do have challenges withfunctioning at the same level
as they used to. But I have alot of individuals that
essentially resume theirregular life. And the only
difference is that now theytake some medicine once a day
or twice a day and maybe theycheck in with a therapist once
(22:41):
a week or every other week.
Definitely it can be helpful ifpeople have supportive family
or supportive friends who arewilling to kind of go on their
journey with 'em and learnabout the illness. We know that
people who have supportivefamily and friends really have
a much better outcome with thisillness. So that's something
(23:02):
early on. If we can getpeople's family or friends kind
of engaged and educated, thatcan be really helpful.
Speaker 2 (23:08):
Talk to us if you could, about your own practice.
Yeah.
Speaker 3 (23:11):
So I treat many, many patients with bipolar
disorder. Like I said, varietyof kind of severity that I see.
But , um, many of them, like Isaid, really have been able to
kind of resume their quoteunquote normal life. Um, and
some of them actually have kindof shared with me some sort of
(23:31):
pieces of advice or kind ofexperiences that have been
helpful for them. Are
Speaker 2 (23:36):
You able to share those with us?
Speaker 3 (23:37):
Absolutely. Yep . So this is, this is straight from
the experts. 'cause I alwayssay the the true experts on
bipolar disorder are the peoplewho are living with it. Some of
the biggest things, so one islike education, education,
education. So podcasts likethis are fantastic. Like I was
saying earlier, it's somisunderstood and so much of
(23:58):
the information that people seereally doesn't explain what
this illness is. And unlikesomething like high blood
pressure or a heart attack, nota lot of people really know
what bipolar disorder is. Yeah.
Speaker 2 (24:09):
I think most people don't really know.
Speaker 3 (24:10):
No, they don't really know. So I think finding
whether it's podcasts like thisfrom medical professionals ,
uh, if you can even attend avisit with a loved one and
getting education straight fromtheir psychiatric provider. One
of the organizations that isfantastic is the National
Alliance for Mental Illness orNAMI Minnesota has an
(24:33):
incredibly strong active NAMIorganization in our state. They
have support groups, they haveeducation groups for both
family and individuals livingwith a disorder. They have
really good information onlinethat you can read. They are
just like a gold mine ofsources
Speaker 2 (24:51):
Listeners. I would concur with that and we'll put
a link to that in the shownotes.
Speaker 3 (24:54):
The other thing that people have shared is that it
can be helpful if their friendsor family are kind of educated
on warning signs of whenthey're not doing well. One of
the unique things about bipolardisorder is that there is this
phenomenon that someindividuals really don't have
(25:14):
insight into when they aresick. And it's not that they're
in denial, it's, it's differentthan that. It's truly part of
the disorder that they do notrealize when they are sick. And
that can be challenging becauseof course when they get really
sick, that's when they mightneed treatment or need medicine
and they'll say, I , I don'tneed medicine. There's nothing
wrong with me. I don't have anillness. But if somebody that
(25:36):
they trust who knows them cansay, I know that you don't
think you're sick right now,but you're not the person I
recognize, you know, you're notthe loved one that I know. I
think something's going on.
Maybe can we get some help thatcan be incredibly valuable.
Other things that they'veshared with me, patients have
shared is , uh, it's helpful iffamily members don't kind of
(25:57):
think everything is part of theillness. So they're like, it's
okay. Chalk every single,they're like, I'm allowed to
have a bad day. I'mallowed to be in a bad mood.
And I, I think some of thatjust comes with time and , and
living with an illness andlearning things. And it's
understandable that family canfeel anxious when they've, when
they're seeing these changeshappen in their loved one. But
(26:18):
just understanding that theycan have bad days. And then the
other thing I think isimportant to note is that
people are not their illness.
And as I mentioned earlier,sometimes in the bouts of
severe depressive episodes orsevere manic episodes, people
will do things that are way outof their character that really
(26:39):
aren't reflective of who theyare as a person. And I think
it's important to be able todifferentiate that and really
respect that. 'cause that'swhere a lot of the shame can
come with living with thisdisorder is kind of having to
live with the, the consequencesof some of the bad things that
can happen in the midst of amood episode.
Speaker 2 (26:55):
Yeah, I think what the , some of the
misunderstanding around the disthe disorder that it leads to
that stigmatization of peoplemm-hmm . Who are
not, they're not acting as theperson that you know them to
be.
Speaker 3 (27:06):
Exactly.
Speaker 2 (27:07):
Are there emergency resources available?
Speaker 3 (27:09):
There are. So most counties in Minnesota have some
kind of crisis team or crisisline. Uh, in Hennepin County.
We're lucky to have what wecall Hennepin County cope,
which is a fabulousorganization. If you call 9 8
8, they will directly connectyou to your county's local
crisis intervention service.
(27:31):
And that doesn't automaticallymean that you're gonna go to
the hospital. Sometimes that'sjust talking with someone.
Sometimes they can get youconnected with more resources.
Sometimes they can meet withpeople kind of doing a little
bit of like therapy or someinterventions for a few weeks
to help them through a toughtime. And
Speaker 2 (27:48):
Then , then that's important. If you're living in
the United States, call 9 8 8,yes. Three digits. Yes. That's,
Speaker 3 (27:52):
That's national.
That's not just in Minnesota.
Here at Hennepin Healthcarewe're lucky enough to actually
have a psychiatric emergencydepartment. It's called acute
psychiatric services. You know,certainly any emergency
department, whatever's closestto you is good, but you know,
if needed, that's also aservice we have available as
well. So
Speaker 2 (28:12):
We're just about out of time. Vanessa, if you could
leave our listeners with anyparting thoughts, what would
they
Speaker 3 (28:17):
Be? Like I said earlier, get educated, find
good resources, ask yourhealthcare provider. Ask your
psychiatric provider. Findpodcasts or, you know, reliable
resources. You know, Reddit isgreat for getting tips on how
to fix your sink, but notnecessarily the best place to
get information about yourhealth. I glad
Speaker 2 (28:37):
You said that. Yeah.
Yeah.
Speaker 3 (28:38):
I think be curious.
I think anytime that you thinkthat you might have this
disorder or a loved one orsomeone you care about has this
disorder seek out help. Um, Ialways tell people, you know,
primary care is kind of ourfirst line , so if you aren't
able to get into a psychiatricprovider immediately, primary
(28:59):
care providers are a greatplace to start and get
connected to someone who canhelp you with care. You know,
even though we talked aboutthat this can be a serious
illness and can havecomplications, I don't want
people to be scared of it.
People with bipolar disorderare not scary. This illness is
treatable. You know, this issomething that every day it's
part of my day-to-day life thatI'm treating people with this
(29:21):
and it can be very routine. Um,so I just don't want people to
be afraid of it.
Speaker 2 (29:24):
Great words to end on. Dr. Vanessa Stump . Thank
you so much.
Speaker 3 (29:28):
Thank you for having me.
Speaker 2 (29:29):
Listeners, just a friendly reminder to please
seek care from your primarycare clinic, seek emergency
care if you need it, 9 8 8 isavailable as well. And thank
you for listening to thisepisode and I hope you'll join
us in two weeks time foranother show. And in the
meantime, be healthy and bewell.
Speaker 1 (29:48):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy matters@hcme.orgor call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. The Healthy Matters
(30:10):
Podcast is made possible byHennepin Healthcare in
Minneapolis, Minnesota, andengineered and produced by John
Lucas At Highball Executiveproducers are Jonathan , CTO
and Christine Hill . Pleaseremember, we can only give
general medical advice duringthis program, and every case is
unique. We urge you to consultwith your physician if you have
a more serious or pressinghealth concern. Until next
(30:31):
time, be healthy and be well.
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health healthcare and
what matters to you. And nowhere's our host, Dr. David Den.
Speaker 2 (00:19):
Hey everybody and welcome to episode 12 of the
podcast. I am your host, Dr.
David Hilden , and I want tothank my colleague Megan McCoy
for being a guest host on thelast episode on topics around
our children. Today we aregonna talk about bipolar
disorder with psychiatrist Dr.
Vanessa Stump. She treats thiscondition here at Hennepin
Healthcare in downtownMinneapolis. With me, we're
(00:41):
gonna dive into this topicthat's kind of misunderstood,
but it affects millions ofpeople worldwide. Vanessa,
welcome to the show.
Speaker 3 (00:48):
Thank you. Happy to be here.
Speaker 2 (00:50):
So break it down for us. Start with the basics. What
is bipolar disorder?
Speaker 3 (00:55):
Absolutely. Well, I agree with your introduction
that I do think this disordertends to be misunderstood for
various reasons. I thinkunfortunately in the media
there's still a lot of stigmaaround this and I also think it
doesn't get represented veryaccurately. So I think it's
really good for us to sit downand talk about what this really
(01:17):
looks like. So bipolar disorderis classified as a mood
disorder. People do havecontrasting mood episodes. So
people for two weeks to monthsat a time can feel very
depressed. Have an episode ofwhat we call major depressive
disorders. So they might notwanna get outta bed, they don't
enjoy things like they usuallydo. They might feel really
(01:39):
tired, not be eating as much,and then they can have periods
of time for weeks to months onend where their , their mood is
okay, they feel fine, they'rekind of living their day-to-day
life. And then they can haveperiods of time for usually at
least a week or longer wheretheir mood can get really
elevated. And this can lookdifferent. So sometimes people
(02:02):
can be really happy, reallyover the top , or they can even
get kind of irritable andthey're not sleeping. Sometimes
people start talking reallyfast, they're just on the go
doing all sorts of things theywouldn't normally do. And so
people can have thesefluctuations in their mood.
It's not necessarily day to day. I think that's how some
people think of it. It'sgenerally sort of weeks to
(02:24):
months on end and blocks.
Exactly, exactly. So
Speaker 2 (02:28):
Is is the elevated move , is that sort of the
opposite of depression? It
Speaker 3 (02:32):
Is, yeah .
Speaker 2 (02:32):
And that's why bipolar to polls .
Speaker 3 (02:34):
Exactly.
Speaker 2 (02:35):
So I do sort of know the answer to this, but I want
you to help our listeners evena little bit more about why is
that bad? Mm-hmm
Mm-hmm
opposite of depression. Mm-hmm
a good thing? Well, it
Speaker 3 (02:48):
Can feel good. So certainly sometimes for a
period of time people feel goodwhen they're, we call it manic
or, or hypomanic is kind of theless severe version of that.
The problem is, is it canbecome very disruptive for
people's lives because for onething, it can be hard for
people to understand whatthey're saying 'cause they can
be talking so fast, have allthese ideas that some of it
(03:11):
just starts to not even makesense. Sometimes people start
to do really impulsivebehaviors that they wouldn't
normally do. So I have peoplewho have spent their life
savings in, you know, a shortamount of time they think that
they're gonna start a newbusiness. So they might quit
the job that they're working.
Sometimes people do thingstotally outta character, like
they use drugs or they have sexwith people that they normally
(03:33):
wouldn't. And when it getsreally severe, sometimes people
can even get what we callpsychotic. And that means that
they aren't really connectedwith reality anymore. So
sometimes they might believethat they're a superhero or the
president and you know,sometimes people do dangerous
things because of that. So it ,it can feel good but it can
(03:55):
become incredibly disruptive totheir life.
Speaker 2 (03:57):
Why do you think it's important that we are even
talking about this? Why, youknow, why should the public
know about bipolar disorder?
Speaker 3 (04:04):
Well, it doesn't impact a small number of
people. So the prevalence isanywhere between about one to
3%, which in the United States,they think is about 6 million
people. 6 million people. Yeah.
And so that's a lot of people.
Mm-hmm
disorder are higher risk forcertain, like cardiac illnesses
(04:28):
for being a victim of crime.
There's sometimes higher riskfor being incarcerated. Their
lifespan can be shorter. So wehave a lot of room, both as a
society and in healthcare tokind of make interventions and
try to improve these people'slives.
Speaker 2 (04:43):
When, when they're in the various swings of mood,
you say they kind of come inblocks, is the depression part
more common or is the maniapart more common? Mm-hmm
Speaker 3 (04:53):
Most people spend more time of their life in the
depression part, which that canactually be the more
challenging part of the illnessto treat. And that also can be
part of why it doesn't alwaysget identified right away.
Because sometimes when peopleare having that elevated mood,
that mania, well they don'treally seek out help at that
(05:13):
time 'cause they're feelinggreat. They're like, I don't
need to go to the doctor. Whenthey come and seek out help,
it's when they're feelingdepressed. And then it can be
hard to kind of parse outwhat's really going on.
Speaker 2 (05:23):
Do we know what causes it?
Speaker 3 (05:25):
Like most things in psychiatry, it's a mixture in
comparison to some of the otherdisorders we treat. It is
thought to have more hereditarycomponents. And unfortunately
we haven't really been able tonail that down to, oh, here's
one gene. But if somebody has afirst degree relative with
(05:46):
bipolar disorder, so that wouldbe a parent sibling, they're
actually about five times morelikely to develop bipolar
disorder than someone in thegeneral population. So the risk
is still, you know, it's about5%. So it's not a guarantee,
but still much higher risk.
People who have what we calllike adverse childhood
(06:08):
experiences seem to be higherrisk for developing this. So if
people unfortunately experiencetrauma, they experience abuse.
There also does seem to be somecorrelation to that. If people
are using substances,especially cannabis, that that
might kind of exacerbate theillness or they might develop
the illness earlier than theymight normally have. So it's
(06:32):
kind of a mixture. There's notreally kinda one thing that we
can pin it down on.
Speaker 2 (06:36):
I like what you said, like a lot of things in
psychiatry.
Speaker 3 (06:39):
Yes. We, we
Speaker 2 (06:39):
Live in the , the human brain is complicated.
Speaker 3 (06:42):
We live in the gray area. There's not a lot of
things that are black and whitein psychiatry.
Speaker 2 (06:47):
What are the first signs of it? In other words,
how, what are the symptoms thatpeople should look for or that
you look for? Especially early,
Speaker 3 (06:54):
Most people at first they'll present with
depression. And so that's whyit's hard because when you meet
with a patient, we'll alwaysask them if they've had a
history of kind of a manic orhypomanic episode. And usually
what I do with that is I kindof describe what that might
look like. It can be helpfultoo, to talk to people's family
(07:15):
or friends. 'cause sometimesthey might have observed a
change in someone's behaviorthat maybe they don't remember
or didn't notice.
Speaker 2 (07:22):
And you said they're not usually seeing you for the
first time during a manic
Speaker 3 (07:25):
Episode? Not usually, although
unfortunately, especially ifthe mania becomes severe,
sometimes the firstpresentation people have is
actually in the hospital.
'cause they might be doingsomething kind of disruptive in
the community. They, you know,maybe were trying to jump over
the airport security orsomething that totally kind of
out of their character. And sothen their first encounter with
(07:48):
us is actually in the hospitalsetting.
Speaker 2 (07:50):
Is it possible that someone could have this for a
long time and not know it?
Speaker 3 (07:54):
You could. I mean there's definitely patients
who, especially individuals iftheir symptoms are more mild
and if they're still able tomaintain their work or their
relationships, there's probablyindividuals who can go a
lifetime without reallyinteracting with a healthcare
provider. Probably that's theminority of people though,
Speaker 2 (08:14):
Right? Right. Most people come to the attention
of, of the healthcare system ortheir family. Mm-hmm
Mm-hmm
professionals, are theredifferent types or is it all
bipolar? You have depression,you have mania, that's the
type,
Speaker 3 (08:27):
There are different types. So bipolar one disorder
is kind of what we think of asclassic bipolar disorder. So
that's where people haveepisodes of depression and
those episodes of mania that wetalked about. And the episodes
of mania are quite pronouncedfor those individuals. So it is
a noticeable difference.
(08:49):
They're behaving in a way thatis noticeable to other people.
They're talking really fast.
They might be psychotic, theymight get hospitalized. There's
also a disorder called bipolartwo disorder. The main
difference with that is that,so they also experience
episodes of depression. Theyhave what we call hypomania,
which is really just a fancyterm for, they have periods
(09:12):
when their mood gets elevated.
They might be a little moreirritable, they might not sleep
as well, but it's not asdisruptive or as noticeable.
And they don't generally losetouch with reality like someone
can during a full blown manicepisode. There is kind of this
subset, there's this disorderif people really dig or read
(09:33):
into things, there's somethingcalled psychia , which is sort
of this interesting disorderwhere people don't really quite
meet criteria for manicepisodes and maybe they don't
even have full-blowndepression. But they sort of
have this, I guess, moodlability or some changes in
their mood. But it's kind ofmore of a rare disorder and
(09:54):
it's not something that wenecessarily see as often.
Speaker 2 (09:57):
Yeah . A lot of our listeners like to learn new
medical terms. Cyclo, thia .
Yes . Cyclo sounds likecyclical. Yes. What's thia ?
Speaker 3 (10:04):
Thia So is essentially someone's like
temperament or mood. So in theold days and sometimes still
we'll say someone can bedysthymic and that is kind of
another in a bad mood. Yeah,yeah. They're kind of depressed
or they're in a bad mood.
Speaker 2 (10:19):
Okay. Um, you already told us that maybe one
to 3% or 6 million people haveit in the United States alone.
Is it more common in certainsubgroups of the population or
is it equal across the country?
Across age, across men, women,
Speaker 3 (10:34):
It's equal amongst men and women. Um, so we don't
really see any differencesthere. It does seem more common
in higher income countries,which is interesting. I did
some digging into this. I don'thave a good answer for you why
that is. It could be that wejust detect it more. It could
be something to do with lifeexperiences, genetic factors.
(10:57):
Typically the onset of theillness is in early adulthood,
so 18 to 20, 20 to 30 kind ofdepending on the source you
look at. And this is consideredwhat we call a a chronic mental
illness. So it is classified ina group that we call serious
and persistent mentalillnesses. So once somebody is
(11:17):
diagnosed with this, it issomething that they generally
are coping with lifelong.
Speaker 2 (11:23):
You talked about it as being a mood disorder, the
other big one being majordepression. How is that
different from uh ,schizophrenia? Mm-hmm
because you did say thatsometimes people with bipolar
disorder can also have somepsychosis. Mm-hmm
Speaker 3 (11:40):
Are different. So individuals with bipolar
disorder will only have apsychotic episode if they're
also in like a mood episode. Soduring times when their mood is
good, life is going well,they're feeling good, they will
not have an episode ofpsychosis. The other difference
is that individuals with theillness that you mentioned,
(12:02):
schizophrenia, even outside ofpsychosis, they tend to
struggle more kind of withtheir thinking. Sometimes they
become kind of less motivated ,uh, less interested in things
they used to. They can havekind of what we call like a
flatter affect . So they'rejust not really as responsive
to the world. Whereas that'snot really seen as commonly
(12:23):
with bipolar disorder.
Speaker 2 (12:25):
It's more about the mood. It is,
Speaker 3 (12:27):
It
Speaker 2 (12:27):
Is breast mood, elevated mood and the things
that are associated with your
Speaker 3 (12:30):
Mood. Exactly.
Speaker 2 (12:31):
How do you diagnose it?
Speaker 3 (12:33):
So unfortunately we don't have any magical tests
yet. So sometimes I havepatients who say, can you just
scan my brain? Right , right.
Can't you just look at it andtell me what's going
Speaker 2 (12:45):
On ? Is there a blood test? Isn't there an
x-ray? Isn't there an MRI scan?
Not
Speaker 3 (12:48):
Yet. But basically we just do what we call a
really good clinical interview.
So when we have initial visitswith patients, they're
generally at least an hour longand we're sitting down with
them and we are going over allof their symptoms. We're asking
a lot of questions like Imentioned, if we can, we often
(13:08):
will try to talk with family ora friend or someone who can
kind of give us theirobservations. There are some
psychological tests or somekind of questionnaires that we
can use to help us narrowthings down. But ultimately
it's just sitting down, talkingwith someone, getting their
story and then trying to put itall together.
Speaker 2 (13:27):
We're talking with Dr. Vanessa Stump. We're
talking about bipolar disorderand we're gonna take a short
break, but when we come backI'm gonna ask you Vanessa, to
talk about how bipolar affectsreal people. We've talked a
lot, some about the data, theprevalence, what might cause
it. We're gonna talk about whatit's like to live with bipolar
and I'm gonna ask you to sortof reflect on what you've seen
in your patients and listeners.
(13:49):
We're gonna talk about how youcan support either yourself or
a loved one who might havebipolar disorder. Stick around,
we'll be right back
Speaker 3 (13:58):
When
Speaker 4 (13:59):
Hennepin Healthcare says we are here for life. They
mean here for you, your lifeand all that it brings.
Hennepin Healthcare has ahospital HCMC and a network of
clinics both downtown andacross the west metro. They
provide all the primary careand specialty care you would
expect to find. But did youknow they also have services
like acupuncture andchiropractic care available at
(14:21):
many of their primary careclinics and at their
integrative health clinic indowntown Minneapolis? Learn
more@hennepinhealthcare.org.
Hennepin Healthcare is here foryou and here for life.
Speaker 2 (14:36):
Hey everybody, we are back talking with Dr.
Vanessa Stump about bipolardisorder. Vanessa, let's talk
about treatments. We've talkedabout what it is, how common is
it? What do you do about it?
Yeah,
Speaker 3 (14:46):
So fortunately we have a lot of treatment options
now and in psychiatry I alwaystell people we kind of have
three buckets of things thatwe're working on. So there's
the biological stuff, so that'sthings like medications,
interventional treatments,there's the psychological
stuff. So that's things liketherapy changing kind of how
(15:08):
you think about yourself, howyou think about the world. And
then there's the social kind ofbucket and that's things like,
can we help you get back intoemployment? Can we support you
with school? Can we help youform healthy friendships? All
of those things. So bipolardisorder is best managed if
people are on some kind ofmedication. And usually this
(15:31):
looks like a class of medicinesthat we call mood stabilizers.
And then there's also a lot ofmedicines called
antipsychotics, which I thinkis kind of a misnomer 'cause we
honestly use them for a lot ofdifferent things. And a lot of
those medicines can be reallyhelpful for individuals with
bipolar disorder as well. Sotypically they're gonna be
working with a psychiatricprovider who's gonna be helping
(15:51):
to manage these medicines. Andwe do know that for individuals
who are on medication, that itdoes reduce the number of
episodes they have of bothmania and depression. It can
reduce the severity of theepisodes if they do happen. And
it also seems to prolongpeople's lifespan. So it , some
of the other things that peoplewith bipolar disorder can
(16:15):
struggle with, like theirphysical health, heart disease,
these other things. It actuallyseems to be better when people
are taking medication. What
Speaker 2 (16:22):
Do you say to people who are maybe understandably
nervous about takingmedications for something they
can't see And you know there's,you know, it's not like an
antibiotic. I got this bug,you're treating it , the bug
goes away. Mm-hmm
national discourse a little bitin the country. You know,
sometimes people say, yeah ,I'll use psychiatrists. You
just want to give a pill toeverything. How do you respond
(16:43):
to that?
Speaker 3 (16:44):
Well I always frame medications as you know, it's
kind of one tool in yourtoolbox. So I certainly don't
sell to people that medicinesare the be all end all for
treatment. There are otherthings that are important to
do, but the way that I look atit is it's , it's kind of like
if someone has diabetes and ifyou ask someone with diabetes
(17:05):
who needs insulin not to useinsulin, well that's just not
gonna work. Or sometimes Ithink of it as, I'll tell
people it's like running amarathon and you break your leg
but you don't get to have acast so everybody else gets a
cast but you don't, so your legis just gonna heal at all these
weird angles,
Speaker 2 (17:21):
You know ? I like that. Yeah, I like that. Yeah.
Both the diabetes and therunning thing, you know, there
are some basic things that arepart of the treatment that you
need.
Speaker 3 (17:28):
Absolutely. And you know, I tell people that you
know, these medicines areworking on biological things in
our brain that we might not beable to see. But we know from
science that they do work. AndI also normalize for people
that, you know, I understandthat taking medication might
not be what you were hoping foror envisioning for your life.
(17:50):
And I say, let's find somethingthat's a good fit for you.
Let's work together to find amedicine that agrees with your
body that you feel okay takingand then we can just have it
there. We won't have to worryabout it anymore. And then
let's focus on your goals andthe things that you wanna do
and how being on that medicineand feeling well can help you
with the goals that you wannaaccomplish.
Speaker 2 (18:11):
Makes complete sense. That's a great, that's a
great response I think. Okay,so it's not just medications,
there's two other buckets yousaid?
Speaker 3 (18:17):
Yeah, so the psychology bucket is, and this
can be a variety of things, butthis kind of goes with what we
call therapy or psychotherapy.
And this is how people canlearn stress management skills.
'cause we know that if someonegets really stressed, that can
be, you know, it can impactyour sleep, it can impact your
mood. And that's when kind of amood episode can start to
(18:40):
unravel. So learning stressmanagement and also just
learning about the illness,getting education about it and
kind of learning how peoplethink about themselves. 'cause
there can be a lot of shamethat comes from bipolar
disorder when people are in themidst of these mood episodes.
And so it can be helpful to sitdown with someone
professionally who can reallyhelp kind of tease that apart
(19:03):
and really look at it and kindof change how we think about
it. And then the social pieceis , well I mean some of this
can kind of go in the otherbuckets too, but especially for
bipolar disorder, exercise,sleep, eating, well obviously
those are important foreveryone. But for bipolar
disorder it's like medicine.
It's very important to helpeducate individuals on how to
(19:26):
kind of live a healthylifestyle and get good sleep.
And then also just learning,yeah. How to go back out into
the world. You know, how do youform friendships now? How do
you have relationships? What doyou want that to look like? You
know, maybe when you were inthe midst of a mood episode,
that was something that youwere struggling with. So how
can we work on maybe evolvingor repairing some of that? Um,
(19:48):
or maybe you lost your job whenyou had a manic episode. Well
let's help you get back in,let's help you find a job. So
it
Speaker 2 (19:53):
Sounds like a holistic approach. There's
medications, there's therapy,there's social supports. Does
it always get worse? Doessometimes it get better? Um,
uh, and, and this is a hardquestion, but is it life
threatening?
Speaker 3 (20:06):
So your first question, you know, does it,
does it get worse? Does it getbetter if people do not treat
it? People can start to havemore episodes or more severe
episodes over time. Sotypically we expect it to be
sort of chronic or even kind ofget better with time. But if
someone's not treating it, wecan kind of see an increase in
(20:28):
that frequency or the severityof episodes. It can be life
threatening. And so this issomething where when we're
working with patients, therecan be a lot of joy in the work
we do together. And you know,we can have a lot of humorous
moments. And also kind of likeI mentioned earlier, this is
classified as something that wecall a serious and persistent
(20:49):
mental illness. When people arediagnosed with this,
unfortunately we don't have acure. We have ways of managing
it, but we don't have a cure.
And there are a subset ofpatients, I mean up to a fifth
of patients with bipolardisorder may attempt suicide in
their lifetime. Which is,that's a serious statistic.
That's something we really haveto take seriously.
Speaker 2 (21:09):
That is a serious statistic. It is . You are so
right.
Speaker 3 (21:12):
Yeah . Yeah . So there can be complications and
you know, like any seriousillness, when we're sitting
down with people we say, youknow, these could be
complications and at the sametime, look at all these
strategies we have for managingthis . Let's focus on kind of
the pieces that we can controland taking charge over it and
taking control of the disorder.
Speaker 2 (21:33):
Let's talk in our last segment about impact on
people's lives. Can people livelike a normal life or what are
your reflections from your ownpractice about of the impact of
bipolar disorder on realpeople? Mm-hmm
Speaker 3 (21:46):
Individuals with bipolar disorder absolutely can
live a, a quote unquote normallife. I don't really know
exactly what a normal lifemeans. Yeah , it
Speaker 2 (21:54):
Was a normal life.
I'm not exactly sure what that, I dunno what a normal life is
. You live a normal life. Idon't think either one .
Speaker 3 (21:57):
I'm sure I do, but certainly they can. I always
say if you've met oneindividual with bipolar
disorder, you've met one personwith bipolar disorder, the
illness is incredibly differentin different people and comes
in varying degrees of severity.
So yes, for some people, youknow, it can become hard for
them to return to school or itcan be hard for them to work or
(22:20):
they might work part-time or doa different job because they
just do have challenges withfunctioning at the same level
as they used to. But I have alot of individuals that
essentially resume theirregular life. And the only
difference is that now theytake some medicine once a day
or twice a day and maybe theycheck in with a therapist once
(22:41):
a week or every other week.
Definitely it can be helpful ifpeople have supportive family
or supportive friends who arewilling to kind of go on their
journey with 'em and learnabout the illness. We know that
people who have supportivefamily and friends really have
a much better outcome with thisillness. So that's something
(23:02):
early on. If we can getpeople's family or friends kind
of engaged and educated, thatcan be really helpful.
Speaker 2 (23:08):
Talk to us if you could, about your own practice.
Yeah.
Speaker 3 (23:11):
So I treat many, many patients with bipolar
disorder. Like I said, varietyof kind of severity that I see.
But , um, many of them, like Isaid, really have been able to
kind of resume their quoteunquote normal life. Um, and
some of them actually have kindof shared with me some sort of
(23:31):
pieces of advice or kind ofexperiences that have been
helpful for them. Are
Speaker 2 (23:36):
You able to share those with us?
Speaker 3 (23:37):
Absolutely. Yep . So this is, this is straight from
the experts. 'cause I alwayssay the the true experts on
bipolar disorder are the peoplewho are living with it. Some of
the biggest things, so one islike education, education,
education. So podcasts likethis are fantastic. Like I was
saying earlier, it's somisunderstood and so much of
(23:58):
the information that people seereally doesn't explain what
this illness is. And unlikesomething like high blood
pressure or a heart attack, nota lot of people really know
what bipolar disorder is. Yeah.
Speaker 2 (24:09):
I think most people don't really know.
Speaker 3 (24:10):
No, they don't really know. So I think finding
whether it's podcasts like thisfrom medical professionals ,
uh, if you can even attend avisit with a loved one and
getting education straight fromtheir psychiatric provider. One
of the organizations that isfantastic is the National
Alliance for Mental Illness orNAMI Minnesota has an
(24:33):
incredibly strong active NAMIorganization in our state. They
have support groups, they haveeducation groups for both
family and individuals livingwith a disorder. They have
really good information onlinethat you can read. They are
just like a gold mine ofsources
Speaker 2 (24:51):
Listeners. I would concur with that and we'll put
a link to that in the shownotes.
Speaker 3 (24:54):
The other thing that people have shared is that it
can be helpful if their friendsor family are kind of educated
on warning signs of whenthey're not doing well. One of
the unique things about bipolardisorder is that there is this
phenomenon that someindividuals really don't have
(25:14):
insight into when they aresick. And it's not that they're
in denial, it's, it's differentthan that. It's truly part of
the disorder that they do notrealize when they are sick. And
that can be challenging becauseof course when they get really
sick, that's when they mightneed treatment or need medicine
and they'll say, I , I don'tneed medicine. There's nothing
wrong with me. I don't have anillness. But if somebody that
(25:36):
they trust who knows them cansay, I know that you don't
think you're sick right now,but you're not the person I
recognize, you know, you're notthe loved one that I know. I
think something's going on.
Maybe can we get some help thatcan be incredibly valuable.
Other things that they'veshared with me, patients have
shared is , uh, it's helpful iffamily members don't kind of
(25:57):
think everything is part of theillness. So they're like, it's
okay. Chalk every single,they're like, I'm allowed to
have a bad day
And I, I think some of thatjust comes with time and , and
living with an illness andlearning things. And it's
understandable that family canfeel anxious when they've, when
they're seeing these changeshappen in their loved one. But
(26:18):
just understanding that theycan have bad days. And then the
other thing I think isimportant to note is that
people are not their illness.
And as I mentioned earlier,sometimes in the bouts of
severe depressive episodes orsevere manic episodes, people
will do things that are way outof their character that really
(26:39):
aren't reflective of who theyare as a person. And I think
it's important to be able todifferentiate that and really
respect that. 'cause that'swhere a lot of the shame can
come with living with thisdisorder is kind of having to
live with the, the consequencesof some of the bad things that
can happen in the midst of amood episode.
Speaker 2 (26:55):
Yeah, I think what the , some of the
misunderstanding around the disthe disorder that it leads to
that stigmatization of peoplemm-hmm
not, they're not acting as theperson that you know them to
be.
Speaker 3 (27:06):
Exactly.
Speaker 2 (27:07):
Are there emergency resources available?
Speaker 3 (27:09):
There are. So most counties in Minnesota have some
kind of crisis team or crisisline. Uh, in Hennepin County.
We're lucky to have what wecall Hennepin County cope,
which is a fabulousorganization. If you call 9 8
8, they will directly connectyou to your county's local
crisis intervention service.
(27:31):
And that doesn't automaticallymean that you're gonna go to
the hospital. Sometimes that'sjust talking with someone.
Sometimes they can get youconnected with more resources.
Sometimes they can meet withpeople kind of doing a little
bit of like therapy or someinterventions for a few weeks
to help them through a toughtime. And
Speaker 2 (27:48):
Then , then that's important. If you're living in
the United States, call 9 8 8,yes. Three digits. Yes. That's,
Speaker 3 (27:52):
That's national.
That's not just in Minnesota.
Here at Hennepin Healthcarewe're lucky enough to actually
have a psychiatric emergencydepartment. It's called acute
psychiatric services. You know,certainly any emergency
department, whatever's closestto you is good, but you know,
if needed, that's also aservice we have available as
well. So
Speaker 2 (28:12):
We're just about out of time. Vanessa, if you could
leave our listeners with anyparting thoughts, what would
they
Speaker 3 (28:17):
Be? Like I said earlier, get educated, find
good resources, ask yourhealthcare provider. Ask your
psychiatric provider. Findpodcasts or, you know, reliable
resources. You know, Reddit isgreat for getting tips on how
to fix your sink, but notnecessarily the best place to
get information about yourhealth. I glad
Speaker 2 (28:37):
You said that. Yeah.
Yeah.
Speaker 3 (28:38):
I think be curious.
I think anytime that you thinkthat you might have this
disorder or a loved one orsomeone you care about has this
disorder seek out help. Um, Ialways tell people, you know,
primary care is kind of ourfirst line , so if you aren't
able to get into a psychiatricprovider immediately, primary
(28:59):
care providers are a greatplace to start and get
connected to someone who canhelp you with care. You know,
even though we talked aboutthat this can be a serious
illness and can havecomplications, I don't want
people to be scared of it.
People with bipolar disorderare not scary. This illness is
treatable. You know, this issomething that every day it's
part of my day-to-day life thatI'm treating people with this
(29:21):
and it can be very routine. Um,so I just don't want people to
be afraid of it.
Speaker 2 (29:24):
Great words to end on. Dr. Vanessa Stump . Thank
you so much.
Speaker 3 (29:28):
Thank you for having me.
Speaker 2 (29:29):
Listeners, just a friendly reminder to please
seek care from your primarycare clinic, seek emergency
care if you need it, 9 8 8 isavailable as well. And thank
you for listening to thisepisode and I hope you'll join
us in two weeks time foranother show. And in the
meantime, be healthy and bewell.
Speaker 1 (29:48):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy matters@hcme.orgor call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. The Healthy Matters
(30:10):
Podcast is made possible byHennepin Healthcare in
Minneapolis, Minnesota, andengineered and produced by John
Lucas At Highball Executiveproducers are Jonathan , CTO
and Christine Hill . Pleaseremember, we can only give
general medical advice duringthis program, and every case is
unique. We urge you to consultwith your physician if you have
a more serious or pressinghealth concern. Until next
(30:31):
time, be healthy and be well.
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