Suicide Is Not The Only Way Manic Depression Kills Us

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“In Canada, suicide accounts for 24 percent of all deaths among 15 to 24 year olds and 16 percent among 16 to 44 year olds. Suicide is the second leading cause of death for Canadians between the ages of 10 and 24.”
The Canadian Mental Health Association

Over 23,000 Canadians are hospitalized each year for a suicide attempt.
Canada Safety Council

“In clinical samples, about 50% of persons with bipolar disorder (BD) were found to have a history of a suicide attempt. In the largest epidemiological study on the topic to date, the suicide attempt rate in persons with BD was twice that of individuals with unipolar depression.”
Suicide Attempts and Completions in Patients With Bipolar Disorder; May 1, 2007

“The causes of physical illness and death among psychiatric patients are much the same as those in other groups — cigarette smoking, obesity, diabetes — and are treatable. The problem is that people with serious mental illness tend to be low on the socioeconomic totem pole and often don’t get the best available health care. Frequently, their own doctors pay little heed to their patients’ physical health.”
Time Magazine: Why Do the Mentally Ill Die Younger? Dec. 03, 2008

I was diagnosed with manic depression in 1989 in a pre-Internet era when information regarding the disease was almost impossible to find. But I knew the basics. Some days I felt like dying, and some days I didn’t.

It has been twenty years since, and I am only now becoming aware of the damage done to my body over that time. I’ve only recently begun the basics of trying to repair my body from the damage done by living so long untreated and unmedicated.

That process of trying to change, even just modify, the damaging behaviours which have become my life has been slow. And it’s only within the past few months where I’ve begun to realize most of the damage is permanent, and will be the cost.

And the cost of resisting treatment, of misunderstanding what the disease is, and my outright general ignorance, will be a severely reduced life expectancy, not of days or years, but of decades. According to several recent studies into mental illness, the cost will be my death from natural causes decades too early.

“Anxiety and major depression are both markers of increased cardiac risk, it is imperative that these patients receive the best treatment for both their cardiac and psychiatric conditions”, said Dr. Nancy Frasure-Smith in a 2008 article. Frasure-Smith was the principle author of a research paper called “Depression And Anxiety Can Double Chances Of Heart Ailments”. She’s a professor at McGill’s Department of Psychiatry and a researcher at the Centre hospitalier de l’Université de Montréal (CHUM) and Montreal Heart Institute.

Her conclusion was, left untreated severe depression, clinical or bipolar, increases our chance for heart attacks, and doubles our chance of having a second heart attack. In a separate study it was found “the cardiovascular mortality was 6.6 times higher in clients of the Massachusetts Department of Mental Health” than the general population.

In that 2006 American study, Morbidity and Mortality in People with Serious Mental Illness (MMPSMI), it was found people with a serious mental illness, such as manic depression or schizophrenia, “are now at risk of dying 25 years younger than the general population, compared with 10 to 15 years younger just two decades ago.”

We’re dying earlier, and our life expectancy is dropping faster than ever, and that’s not taking into account the numbers of us dying from our own hands. Close to 60 percent of these premature deaths are from natural causes such as cardiovascular and pulmonary disease and other so-called “natural causes” brought on by the side effects of having an untreated mental illness.

The causes in these jumps are simply increased levels of poverty, and a lack of resources and treatment.

According to the Canadian Community Health Survey, “30% of people with a diagnosed mental illness in Ontario did not work in 2003. This is a conservative figure because the survey did not include persons with a diagnosis of psychosis who were unemployed.

“In 2006, there were 77,430 people receiving income support through the Ontario Disability Support Program (ODSP) with a serious mental illness, representing 1 in 3 ODSP recipients. Individuals on ODSP are 34% below the poverty line, while those on Ontario Works (welfare) are 63% below.”

People who are considered permanently disabled by mental illness, such as myself, receive less than $1000/month (£500 or US$900) in support from the government ODSP program. According to the Canadian Council on Social Development the poverty line in my part of Canada is $14,000.

Mental illnesses breed poverty, and poverty breeds early death. Poverty breeds diabetes, it breeds addictions, it breeds obesity, it breeds respiratory diseases, infections, insomnia and failure.

There’s also deaths caused by smoking. Nearly half of all cigarettes smoked in Canada and the United States are consumed by people diagnosed with a mental illness, and nearly 75% of us smoke.

People with our conditions die an average of twenty-five years earlier than others, and now it has been shown a huge majority of these premature deaths are from natural and preventable causes such as diabetes and severely limited lifestyle options.

So, it’s a question I have to ask again…

Why are our doctors not bringing dietitians into our appointment if diet is so important to our recovery? Why are we not being handed massive amounts of Vitamin D along with our Lithium? Why, if sleep is so all fucking important to our recovery, are we not being handed a sleep aid along with our Lithium and Vitamin D?

A Perfect World Would Start With An Intervention; Jan. 12, 2007

Why are we not being given the tools which will help us recover at the time of diagnosis? Where are the programs designed to help us maintain our employment, or find new employment, or get retrained?

Jobs, even part-time, are critical to our recovery. According to Statistics Canada, “275,317 persons in Ontario with a serious mental illness are unemployed”. Work, according to the Canadian Mental Health Association, is central to the recovery of most people from mental illness.

Even with a sporadic or erratic work history, people with a mental illness who have the opportunity to work recover faster and have fewer relapses than those who don’t have the opportunity.

And with the vast majority of people with a mental illness unemployed and relying solely on government assistance, those people are slowly dying from poverty which they, for the most part, had no hand in creating.

People with a mental illness need more of everything, it is not shocking that every health care unit across the world is underfunded and over used. But, it seems to me the deaths of a lot of people could be prevented very easily, and at least the small burden of our care could be lifted off the health care systems simply by paying more attention to the health concerns we all share which are not directly related to the psychiatric ones.

Money. Food. Shelter. Work.

When I was diagnosed with Type-2 Diabetes, Ontario’s disability program started giving me an additional $50/month to cover the costs of my special diet. According to the diet guidelines given to me by my doctor which, if followed, will help me keep my feet and prevent my heart from deteriorating, the money from ODSP barely covers the cost of my recommended monthly intake of apples.

I live in chronic poverty, and have for almost my entire life. Diabetes, which I’ve had at least since 2002, causes heart damage. Chronic depression, which I’ve suffered from since I was a child, causes heart damage, and the eighteen years I smoked causes heart damage, respiratory illnesses and cancers.

How many years can I look forward to being hooked into longterm health care, disabled from heart, lung, circulatory malfunctions, plus kidney damage and probable amputation from the diabetes? After she’s borne, how many healthy years will I have with my daughter? Because, right now, I think I’m looking at ten or fifteen.

I can almost understand how we could have been diagnosed in the pre-WWW era, and then set free into the wild with nothing but a prescription and a promise we’d do our best to take the pills. But we know now how we’re effected by things beyond the disease. We know our mental illness doesn’t exist in a vacuum.

If the mental health system is changing, maturing, it’s moving far too slowly.

According to Frasure-Smith, anti-depressants, even with their side effects, helped people with chronic depression to avoid the risks associated with our potential cardiac as well as our psychiatric conditions. But in a 2007 interview with New England Psychologist Magazine, the author of the MMPSMI study went further.

“The stopping smoking is huge,” said Dr. Joseph Parks, medical director of psychiatric services for the Missouri Department of Mental Health president of the Medical Directors Council for the National Association of State Mental Health Program Directors. “Forty-four percent of the cigarettes that are smoked in this country are smoked by people with mental illness.”

Parks would like to see mental health officials ask us about our smoking habits, and urge us to stop.

“It’s going to take a lot of little interventions,” Parks says. “We’re going to have to get into smoking, activity, diet. You can successful treat somebody’s anxiety or depression only to have them die of a heart attack. What kind of treatment is that? That’s like winning the battle and losing the war.”

“It goes to thinking about the whole person. Otherwise we don’t serve our clients well. Health is an integral part of mental health.”

Poverty is the root of all the evils we experience. Treating manic depression, getting it under control, takes years and must be the first step in our recovery. Our minds must be clear and lucid and able to reason. But during those years we can also be learning how to keep our entire body healthy, so that when we come out the other side we can do more than just die from a heart attack.

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...thanks.

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About Gabriel...

...diagnosed with manic depression in 1989, for the next 14-years I lived without treatment or a recovery plan. I've been homeless, one time I graduated college, I've won awards for reporting on Internet privacy issues. In 2002 I finally hit bottom and found help. I have a 4-year old son, a newborn son, and I'm helping to raise my 8-year old step-son, I’m usually about six feet tall, and I'm pretty sure I screwed up my book deal.
This entry was posted in Bipolar, Bipolar Disease, Bipolar Disorder, Clinical Depression, crazy people with no pants, Diabetes, Health, Living With Depression, Living With Manic Depression, Manic Depression, Poverty, Psychiatry. Bookmark the permalink.

8 Responses to Suicide Is Not The Only Way Manic Depression Kills Us

  1. thordora says:

    I think I’m lucky I was able to quit smoking a few years back…I’m certainly glad that I did. But learning all the habits-to eat well, that regular exercise improves my mood immensely, to drink more water….shit, even to wash on a regular basis and change my clothes-it’s damn hard, and no one has given me any guidance, or frankly, even asked.

    I already know my chances of dying are higher based on my brain-being made worse by complications with working, and with my health…it just pisses me off. And yet, I can’t get pissed off because I’m lucky to even HAVE a pdoc to go to…one I only have because I’ve put myself into care in the past…

    sigh…what a fucked up process.

  2. bats0711 says:

    I know trying to afford the medications to help me live life with Bipolar is sending me into poverty.
    You know I also had a thought while reading this, What about all those people whom are misdiagnosed for years and years before they can even look into help, proper treatment? Are they including them in any statistics?
    @thordora, it is a very fucked up process!

  3. Gabriel... says:

    Hi Bats… try asking your doctor for free samples. I’ve had friends in the States who couldn’t afford their pills who managed to get a few months free from their doctors. One of them managed six months worth. Just make sure to say something about your inability to pay… like “sweet mother of Christ, I’m really fucking broke”.

    Some people will tell you we’re all misdiagnosed. But really there are two groups… the significantly smaller of the two are the people who don’t have anything, but are told they do. The other group are people who are told they have one thing, but really have another. This is relatively common. My sister is on her third diagnosis.

    The statistics I quote here are taken from large samples of people, some of whom I’m sure fit into both of my definitions of “misdiagnosed”.

  4. bats0711 says:

    I will definately try that Gabriel and hey I definately won’t be lying! LOL
    Ya I guess when you think about it, most people are diagnosed what with major depression? and then find that the treatment for that isn’t working and then hopefully their doctors dig deeper.
    Jeesh, your poor sister.

  5. exactscience says:

    About three years ago, when I was still attending and doing okay with university, I wrote an essay on this subject. More specifically it was the barriers to entry for getting well, why people with mental illnesses seem to slip through the cracks.The essay prompted me to seek treatment and I got it.

    The big but to this though is that interest in other aspects of my health have dwindled. I guess it makes sense, I can’t remember how many individual attempts I have made on my life. A suicide attempt is I suppose more pressing than a heart attack. But once you get someone with a mental illness stable there should be a bigger push toward improving diet and lifestyle.

    This is an excellent post Gabe.

  6. Gabriel... says:

    Thanks Scott… don’t be afraid to recommend it to your friends.

    There are so many things, aspects of our lives, this disease prevents us from dealing with rationally… relationships with family, friends, random people on the street. Then our general health care. It just seems to me that being dropped in front of our psychiatrists office by our parents and being left on our own and expected to fix ourselves ever after is complete lunacy.

    We need the help of people who understand what we’re going through, and we need a health care system willing to help with the crap we’d otherwise miss… like smoking, obesity, jobs, diabetes, school. It shouldn’t be hard, the system is already pretty much there for people with “physical” disabilities* like spinal cord injuries, loss of sight and amputations.

    *manic depression is a physical disability, the brain is not an illusion.

    Thanks for coming over Scott.

  7. markps2 says:

    I have the same problem buying apples and oranges for my health.
    Authority (Heart and Stroke Foundation) is noticing and might do something to help.

    Healthy food prices vary wildly
    By LISA QUEEN
    February 10, 2009 12:13 PM
    Print Text

    If you’re looking for junk food, you’ll basically pay the same for a bag chips or bag of cookies whether you buy them in Etobicoke or East York.

    But if you’re looking to put healthy choices like fruit, vegetables and lean meat in your shopping cart, you could find yourself paying more at the check-out counter in North York’s Jane and Finch neighbourhood than in Scarborough.

    According to the Heart and Stroke Foundation’s annual report on Canadians’ health released Monday, there are “startling” discrepancies between the cost and accessibility of basic healthy food, even within the same city.

  8. Detached says:

    “Work, according to the Canadian Mental Health Association, is central to the recovery of most people from mental illness”

    Weird. I always felt like I would do better if I DIDN’T have to work!

    Awesome, awesome writing, as usual.

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