Death Becomes Her - Let's Hope Not

Dr. Mark Goulston's picture
Posted by Dr. Mark Goulston on February 8, 2008 11:54 AM PST
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It is speculated that Britney Spears has bipolar disorder
and if so, untreated bipolar disorder given that she recently signed out of
UCLA. Part of the allure of that story
is not just her celebrity status, but the fact that she appears so vulnerable,
impaired in judgment and because of these two factors, so in danger. And that part of the story speaks to many
readers and viewers who either have bipolar disorder or know and care about someone who does.

I can’t confirm it, but I have heard through some credible
sources that her obituary has already been written with the only thing left to
be added being cause of death (by the way that is not an unusual practice for
media outlets when someone in the public eye is seen to be close to death).

According to the National Alliance on Mental Illness, “approximately
10 million Americans live with bipolar disorder, but the number affected by
this disorder is even greater. Approximately 25-50 percent of people with
bipolar disorder attempt suicide at least once; this is one of the highest
rates for any psychiatric illness. The mortality rate for people with untreated
bipolar disorder is higher than it is for most types of heart disease and many
forms of cancer.”

From my clinical experience as a psychiatrist for thirty
years, the times when people are most vulnerable to dying during untreated
bipolar disorder occur mostly at four points in the course of the disease.

  1. When
    the person is most depressed and sees no way out and has the energy it
    takes to actually kill themselves. This may mean not when they are at the lowest point, because at
    that point they usually do not have the energy to bathe, eat or do
    anything. It occurs when they are
    beginning to get some energy back (as during the early treatment with
    antidepressants), but before the hopelessness lifts.
  2. When
    after a manic episode has left and they start to head into a depression
    and see the deep dark “black hole” they are heading for. At that point some bipolar patients will
    think, “I can’t bear to go into that again and I still have the energy to
    prevent it from happening by killing myself.”
  3. During
    a manic high filled with psychotic delusions about meeting “God” or worse
    thinking of killing others at “God’s command.”
  4. When
    in the throes of a manic episode they are hell bent on acting on an
    impulse without regard for danger or consequences and the more people try
    to stop them, the more belligerent they become which adds to agitation and
    further impairs their judgment (think of being chased by paparazzi and
    needing to get away from them at all costs).

These are the times when family members, friends, health and
mental health professionals need to be ever vigilant. This duty is not for the
faint of heart, because ironically -- and sometimes tragically -- these are the times when patients with bipolar
disorder need you most and want you least.

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Wow, to already have an obituary written for you is so completely tragic! I really hope we don't read that anytime soon, she is so young and has children that need her. Although I am not a big fan of her work, I do wish her the best and hope that she can stop the downward spiral and be there for her boys.

Apryl's picture

It's tragic enough when someone is suffering as much as Britney clearly is. It's doubly tragic when the media and the paparazzi won't leave her alone and even Dr. Phil had to poke his nose into her business. Her fame makes her no less a person and I wish the world would give her the privacy she so needs.

ShelaDean's picture

People whine about the media this and the media that and yet they do nothing about it because, unfortunately, we depend on the media and rely on them more than we ought to. We trust them to tell us the truth while knowing that they spin stories to sell their magazines. We count on fair, unbiased journalism while supporting Fox 5 by watching American Idol, which is a sickening distraction from the fact that Fox 5 is about as unfair and as totally biased as it gets. When Heath Ledger died, one of those entertainment tonight shows wanted to air old footage of him talking about illegal drugs during a party at Chateau Marmont, a popular celebrity-hangout. An astonishing amount of celebrities--some you never would have guessed even cared about the topic-- contacted the station and demanded that they show some class and have respect for the dead. The television "news" program listened and scrapped their plans to profit off the pain of others because they realized that in the end, it would not be PROFITABLE. Why don't more people do that? Does the media know something that we don't want to admit to ourselves? That we secretly can't live without the reality show soap-operas? That we're an envious society that relishes in seeing our idols topple from the top? The media is a sad reflection of our culture-- that's the only truth worth printing!

Amanda's picture

No other disease describes more perfectly what it means to be a human being. Bi-polars are gifted with the dis-ease of the range of emotions that all humans have the capability of feeling. The uneasiness of handling or sometimes even pinpointing what emotions we are experiencing becomes an impossible feat. Cycling in rage , anger and depression then jumping to joy and ecstacy without awareness or control is more than some can reckon with, thus suicide attempts and successes are often the only means of relief. But my little sister, gave me a book called "Ask and It is Given" by Ester and Jerry Hicks which changed my life and allowed me to take back my own personal power over my emotions. Yes, I truely believe that with hard work and focus and constantly reaching for a better feeling thought with a desire to feel good and take responsiblity for myself, I can only speak for myself when I say it has improved every level of my being, and given me back what has been rightfully mine all along. Yes, I have Bi-polar disorder, but I believe we are all bi-polars. Some of us have simply had the priveledge to live the experience and teach others about it.

pc3's picture