May 3rd, 2011
07:21 PM ET
Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.
Question asked by May from California
I have bipolar disorder type 2. My mood is almost always influenced by the season and this winter I went through one of the worst depressive episodes I have ever experienced. When I mustered up the courage to tell my mom that I felt trapped and that I was desperate for help, she dismissed my symptoms as "something every teenager goes through" and that things will get better.
She keeps telling me that everyone is depressed once in a while and that's just how life is. I'm better now, but I'm constantly scared about the next depressive episode I'll have to go through. It's been about three years since my diagnosis, and I think my mom has been in denial ever since. I've tried my best to convince her that this isn't normal but she refuses to see the truth. Even when I attempted suicide about a year ago, she lectured me about how selfish I was being and refused to even consider hospitalization or medication.
How do you convince an unsympathetic parent that you need help?
You know, lots of times people send in questions that don't contain enough information for me to make definitive suggestions. Fortunately, you've done a great job of outlining your situation, which is sadly common, and all too often not adequately treated.
Before we talk about your mom, let me tell you a little about your condition. First, many people who fit a diagnosis of bipolar II disorder have exactly the seasonal pattern to their symptoms that you describe. In fact, a major difference between bipolar conditions and what psychiatrists call "unipolar" depression (and which I sometimes refer to in this column as "regular old depression") is that people with bipolar conditions are much more sensitive to the changes wrought by time than are people with unipolar depression, whether these time changes are measured in the cycle of day and night or the longer cycle of the seasons. Most unipolar depressions are caused by psychosocial stress. Many bipolar episodes are caused by the stress of time's changes.
The vast majority of people with a seasonal pattern to their moods, whether they are classified as bipolar II disorder or seasonal affective disorder, suffer depressions in the winter and then either normal moods or abnormally elevated moods in the spring and summer. I don't know whether this would comfort you, but many, many great artists and writers have some degree of seasonal mood change. In fact, a famous researcher named Kay Jamison (who has bipolar disorder herself) found that musicians, writers and artists tend to do all their best work in the spring and summer when their winter depressions have lifted.
I don't know your mom so I can't suggest exactly what the best course of action is. If she is at all reasonable, education can make a big difference. If she understood how much we know about your condition and how greatly it can be helped, she might be more supportive of your efforts to get appropriate care. If she is really dead-set against you getting care, let me make one simple suggestion. People with winter depressions are often helped tremendously by treatment with a bright light.
These lights are widely available on the Internet and don't cost too much. You should get one that is rated as at least 10,000 lux. If you sit in front of it for 30 minutes each morning starting in the fall when you feel the first stirrings of your depression, it is very likely that you can greatly reduce the pain of your depression.
Let me make a couple of final comments. Your mom is right about one thing. Seasonal depressions are much more common in young people than in older folks, and in women than men. You can't change your sex (or at least not easily!) but as you get older it is likely that the seasonal pattern to your moods will diminish. Finally, if you live somewhere with gray winters, you might consider heading south to live when you are old enough to do so. I know a number of people who really improved their winter depressions simply by living someplace sunny.
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