Like many Americans, Kim and Peter Fanelli of Lakewood, Colo., are struggling to stay afloat during the current economic crisis. As an added burden, the couple has bipolar disorder. Peter's chauffeur job is offering fewer shifts, but he needs to stick with it because he becomes eligible for health insurance in February. Kim needs to be in the right frame of mind to offer numerology readings, and she hasn't been. Lately, her depressive state has included suicidal thoughts. The Fanellis are getting by on Peter's wages; Kim's Social Security disability payments; and cost-saving tricks like making more homemade refried beans, cutting out all leisure activities, and driving less. "The fear is palpable," says Kim. "Our current situation is quite bleak."
Many bipolar people already live in a boom-or-bust financial cycle, independent of the current economy. Spending sprees, after all, are common during manic periods. However, mania can be triggered by stress, which is naturally higher during an economic crisis like the one Americans are facing now.
"There's no question this is a time when people are really struggling with depression," says Ken Robbins, MD, a clinical professor of psychiatry at the University of Wisconsin–Madison.
Harder times ahead for everyone
In October, the World Health Organization warned that the global financial crisis is likely to cause increased mental health problems and even suicides as people struggle to cope with poverty and unemployment. In the United States, it appears that the economy isn't going to improve anytime soon. "The recession we are currently in will get worse before it gets better," says Greg McBride, senior financial analyst at Bankrate.com. "Were in for a long slog and if 2008 wasn't the year you made adjustments, then 2009 will be."
To relieve stress, some bipolar patients find themselves spending money they don't have. Christi Engle of Tyler, Texas, racked up more than $5,000 in credit card debt buying stuff that she didnt want or need at Wal-Mart.
"When Im spending, I feel good. I get bubbly, the paranoia doesn't matter, and I get out of my depressive mood," she says. During those episodes, Engle says she can convince herself that the overall economy, and her personal finances, are fine. Currently, Engle is not working. Her husband has two jobs and now controls the family's purse strings.
In the current credit crunch, going beyond one's limits can have serious consequences. Credit card companies are taking preventive measures and focusing in on customers who teeter on the brink.
"Right now, there is a real domino effect for those with negative credit, and it goes beyond purely financial relationships," says McBride. Failure to pay bills on time can lead credit card companies to lower limits, or raise the interest rate to a punitive level like 25% on an outstanding balance. Ultimately, these actions can hurt a credit score, which can add stress by affecting insurance premiums, potential job searches, or apartment rentals.
Frederick K. Goodwin, MD, a research professor at the George Washington University in Washington, D.C., and a former director of the National Institute of Mental Health, says the current anxieties about the economy are exacerbated in bipolar patients. Sleep loss is the most common trigger of manic or depressive episodes, and it begets absenteeism, which becomes an even bigger issue when companies are shedding jobs. During depressive states, patients' memories and cognitive abilities are also affected, which doesn't help prove employment value during mass layoffs.
The impulse to spend "never goes away"
Andy Behrman, the author of Electroboy: A Memoir of Mania, says that at the height of his bipolar disorder, he would drop $25,000 at Barneys New York, the upscale retailer, and take taxis to the airport in the middle of the night to buy a full-fare seat on the next international flight. He would spend constantly, eventually running up a $2 million tab and serving time in prison for art forgery. Today, Behrman has paid off all of his debts and is a writer and mental health advocate in Los Angeles. He says hes got his spending impulse under controlat least more than beforebut it never disappears; in fact, the need for money to burn acts as a career motivator.
"Bipolar people are the only ones helping the economy, because to us, there is no recession," Behrman says with a laugh. "There is a home decoration store near me that has a sign reading 'Save the EconomyShop!' Every time I go by there, I have to buy something."
How bipolar patients can avoid overspending
The following steps may help bipolar patients weather the current economic storm, primarily by helping them avoid episodes of uninhibited shopping. Most of the tips are valuable to everyone during tough financial times, but they are doubly important for those with bipolar disorder.
- Do what you can to avoid mania. Regular sleep patterns, exercise, and meditation all help reduce the stress that triggers an episode.
- Talk to a financial expert. Getting the advice of a financial expert can help you come up with a game plan to avoid overspending and defuse the feeling of helplessness.
- Find a support group. Dr. Robbins says that brooding and keeping your emotions to yourself wont help. Support within a community helps patients understand they are not alone. In addition, support groups can be a good resource for information on jobs, health care, and other issues. The Depression and Bipolar Support Alliance is a good place to start.
- Turn off Mad Money. The 24-hour news cycle may, in fact, be driving you mad. "Sound bites wont help you acquire wisdom or knowledge, and television news is contaminated with negativity," says Dr. Goodwin. Overstimulation can also trigger mania. If you want to learn more about the economic crisis, he suggests in-depth articles that allow for reflection and analysis.
- Hit up the drug companies. Most pharmaceutical companies give away free medications to bipolar patients who meet certain economic criteria, Dr. Goodwin says. If your current financial state is problematic, consider this option. Your doctor should be aware of the application process.
- Consider setting up a durable power of attorney. This allows a bipolar patient to designate another person to act as legal authority on their financial behalf, in the case that they become incapacitated. The power of attorney can be tailored to the patient's specific requests.
The economic outlook doesn't look good these days, but there is one silver lining to the current financial gloom. "In some ways, bipolar sufferers are not as likely to panic, because they've already been through some really bad days," says Dr. Goodwin.