Jane Pauley in August of 2004 went public with the fact that she has bipolar disorder and takes a mood stabilizer (Lithium). She details the development of her illness in a new book, Skywriting. How did the "all American girl" become "mentally ill?" I don’t like the term mental illness. It has too many pejorative connotations, including insanity and craziness. Even in patients with schizophrenia the label "mental illness" implies a hopelessness and pessimism about treatment.
So l will rephrase. How did Jane Pauley develop a serious mood disorder that for a time resulted in impaired reality testing and caused her to go many months before she could return to work? While hospitalized for a manic episode she said she cried for the loss of Jane, the "most normal girl on TV." WHY?
Probably most important is genetics. Her father was a closet alcoholic. She had evidence of biorhythmic sensitivity, suffering from severe hives on a 7 year cycle at ages 7, 14, 21, and 49. She reports having thyroid problems, which increase mood swings. And she was perimenopausal. Then, while doing a feature article about her father she was forced to deal with the reality that in some ways her "whole life had been a lie" since she had spent most of it in denial about her father’s alcoholism. The stress of this and her seven year cycle caused a severe outbreak of hives which required 2 courses of steroid treatment.
Bipolar episodes are more likely precipitated by hormone changes or certain medications, especially steroids and antidepressants. Jane Pauley’s second round of steroids caused symptoms of depression, and she was prescribed an antidepressant. The beginnings of hypomania induced by steroids and antidepressants cause problems with sleep, and lack of sleep is one of the most powerful mood destabilizers in susceptible individuals.
The fact that she had genetics for bipolar disorder is not the reason that she decompensated. Were it not for the steroids and antidepressant, she may never have developed overt bipolar disorder. The brain has remarkable plasticity (adaptability), and a lot of our genes never get turned on or are modified by experience. In the future we will know who is vulnerable to certain kinds of treatments, and hopefully be able to protect the Jane Pauleys of the world from bipolar and other dreaded diseases.See Bipolar Newsletter
