Ricki Lake recently revealed that her ex-husband, 45-year-old jewelry designer Christian Evans, took his own life last month after a long battle with bipolar disorder.
“I have to spread the word about recognizing this disorder and getting treatment as soon as possible,” the actress and former talk show host told PEOPLE in this week's issue, on newsstands today.
Bipolar disorder is a brain condition marked by severe swings in mood, and affects 5.7 million American adults. Patients experience high-energy, elevated moods during manic episodes, and sad, hopeless moods during depressive ones. Making the condition more complex, people who struggle with bipolar are also more likely to have psychotic symptoms (like hearing voices or having delusions), anxiety, and problems with substance abuse.
Evans disclosed his bipolar diagnosis to Lake when they first started dating, and the couple wed in 2012. It wasn't until 2014 that Lake experienced one of her husband's manic episodes. At first, he simply seemed extra happy and motivated, but later "he thought he could fly. He thought he could cure cancer with his hands," she told PEOPLE. Under the advice of a therapist, she cut off contact from Evans and filed for divorce. Evans was eventually hospitalized, and reunited with Lake when his mental health stabilized. It didn't last long; last fall, Evans slipped into another manic episode and the couple split for good. Then, on February 11, Lake received a text from Evans's sister saying she'd received a suicide note via email. Two days later he was found in his car with a self-inflicted gunshot wound.
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Sadly, Lake's story may sound familiar to those who have a loved one with bipolar disorder. The condition is notoriously difficult to treat. About half of people with bipolar will attempt to kill themselves, and as many as one in five dies by suicide.
The combination of extreme highs and extreme lows is what puts bipolar patients at such high risk for suicide. A study published last month in the journal Bipolar Disorders looked at suicide attempts in bipolar patients over a five-year period and found that they were 120 times more at risk for suicide during "mixed states," when highs and lows were occurring at the same time. “You have a depressed mood but tons of energy to do something about it. That can be incredibly dangerous in terms of suicide risk,” explains Glenn Konopaske, MD, assistant professor of psychiatry at UConn Health.
Other research suggests brain differences put some bipolar patients at higher risk for suicide than others. A January 2017 study from Yale University compared brain scans of teens and young adults with bipolar disorder and found that those who'd attempted suicide had slightly less volume and activity in the frontal cortex, the part of the brain that regulates emotions and impulses. "That can lead to more extreme emotional pain, difficulties in generating alternate solutions to suicide and greater likelihood of acting on suicidal impulses," said senior study author Hilary Blumberg, MD, in a release.
The good news is that bipolar “is highly treatable, and if patients are on the appropriate treatment, they can lead very functioning lives,” says Dr. Konopaske. Doctors typically prescribe lithium, a mood stabilizer. “It definitely helps reduce the risk of suicide,” he says. Research indicates lithium is the gold standard for bipolar treatment, outperforming newer mood stabilizers on the market.
Patients who do the best are in regular therapy, take their medications religiously, and have supportive and involved family members. “It takes a team approach for success,” he says. Still, not all patients will respond to treatment, and there can be a lot of trial and error, Dr. Konopaske says.
As for Lake, she told PEOPLE she plans to honor Evans's life by raising awareness about mental illness. "Christian didn't want to be labeled as bipolar, but he admitted he was in the note he left," she said. "That was him finally owning it. That was him giving me permission to tell his story."