why do the mentally ill die younger?

I just read this interesting article and thought I would share it:

http://www.time.com/time/health/article/0,8599,1863220,00.html

[cowgirlnerd]

Good Lord, Girl!  You find some topics as morbid as I do!!!  Just joking.  Thanks for the information - I will check it out.  

I know if I hadn't gotten diagnosed and etc., I would have died younger - without a doubt.  Bipolar can be a terminal illness - easily - if left untreated.  And, I think you might know what I mean....

Racheal

[jen21287]

Well, the article is about physical illnesses such as diabetes, obesity, heart disease, etc. It also touches on the fact that doctors do not take people with mental illnesses seriously when they have physical complaints. A 25 year shorter life expectancy is huge...

[cowgirlnerd]

You are so right.  It's amazing to me - I have always had that problem.  I honestly think my hysterectomy when I was 35 was because of pains that I had due to depression.  As a result of not being taken seriously and sometimes not to be seen as a whiner or complainer-I will wait to go to the medical doctor until I am REAAAALLLY sick.  

Have you been able to find the information about the Washington state thing?  That's bothering me big time.  

[jen21287]

The only that I could find was related to gun control. Apparently people who have been involuntarily committed to a psych hospital with severe mental illnesses are put on a database that does not allow them to buy guns. That is the only thing I could find related to people with mental illnesses being put in a database. Unless you have been convicted of a crime and/or involuntarily committed, you are not on the database - huge relief for me! But who knows, that could easily change to include everyone and I know people are trying to do that.

I am sure this will upset some people on here, but I do not think people with severe mental illnesses should own a gun... I hate guns, period. No one should own one. And I think someone who is severely unstable should not be allowed to own one. But I do not like the idea of a database for the mentally ill and it would be impossible to enforce those laws on everyone, so they shouldn't exist. Guns cause so many problems...

This country needs to get its act together though. It is getting absurd with all of these laws that take away the very freedoms that this country was founded upon.

[cowgirlnerd]

I would agree with you on the handgun.  As a child, we didn't have a gun in the house and it was because my Dad (who is dead now but I am convinced was BP) was always threatening suicide - what's worse is we were scared of him when he would "go off".    We controlled that (or my Mom did) about him not having a gun, but I was always afraid he would get one and kill us all.  Of course, I guess it depends on the situation.

The database is really scary. Not to mention that bp's have paranoia in the first place, but to put us out there as damaged in some way and are freaks of nature.  Just infuriates me.

My best friend that died from suicide shot himself in the head.  Don't care for them myself, personally.    I don't own one myself because of my suicidal tendancies.  My exhusband has them, but keeps them locked and I don't know the combination and don't want to know.   I wouldn't trust myself being in a manic state with a gun.  

Oh well!  You are only 2 years older than my son - how did you get so grown up!???  ;)

[ILADVOCATE]

  Lots of factors. Obviously the untreated depression of bipolar leads to suicide at times. Also yes people in a depressive and/or manic state can neglect their health or make poor judgements. But also since because of the psychiatric disability and also the discrimination of society people with bipolar (or any psychiatric disability) are less likely to get jobs and end up below the poverty line and then not have access to health care. I do agree about the issue with guns for sure but someone who is suicidal will find a means regardless (will not detail in case anyone posting here experiences that, all I know is I have a friend with schizoaffective who has not recovered and keeps going off medication and has self medicated with recreational drugs and alcohol and says of his multiple suicide attempts "I tried everything and nothing worked", that's the scariest thing I've heard because it means he will eventually "succeed" ).
   I haven't had any problems with my doctor (I always think its good if people refer to a doctor as a doctor, a psychiatrist of course has an M.D. but its confusing when people refer to them as a "doctor") neglecting my physical health care. I did run into some abusive situations in poorly run psychiatric hospitals (not in well run psychiatric hospitals of course) and there are some hospitals, usually state psychiatric hospitals where the conditions are neglectful (there is one particular one in N.Y.C. but I won't post which one but it made the headlines). That's partially due to the quality of staff and pay and also due to the lack of staff. You can't always blame the psychiatrists there. They see a person for a five minute consult and interns who are untrained take over and they are going through 24 hour shifts and panic and don't know what to do when someone is psychotic and then their physical health concerns are not taken seriously.
   There are also the physical effects of medications. Atypical antipsychotics often lead to diabetes. And a few medications have particular side effects that are long term and dangerous. A friend of mine got Barrett's esophigitis from Topomax (topamax). With the phase II experimental antipsychotic I am on glycine, a glutamate antagonist, so far there are no long term dangerous side effects but 5 years in study won't confirm it but by not causing diabetes and weight gain, that is a big one. And through not causing tardive dyskinesia (which doesn't shorten life expectancy and though usually has brief tic like motions but in myself without treatment would be fatal) that's another.
   But as for what we can do (as with mental health parity).
1. Advocate for new treatments that have a safer long term side effect profile
2. Better affordable health care for all people
3. Making sure all our concerns regarding not just long term side effects of medications but physical health in general are taken seriously by providers
Some things require legislative change, some research and development of newer classes of medications but as for what we can do immediately right now as consumers with our providers, I did post in my latest journal entry how the consumer/provider model and "parterning on recovery" works, not just for myself but everyone and actually benefits the provider and has a better recovery rate in general.
   And remember what a psychiatrist knows, a physical doctor might not. That's why its never good when to cut costs they have a physical doctor prescribe psychiatric medications. There are so many different specialists they send people to and a psychiatrist is not just a "specialist" but a neccessity. My doctor will do physical exams for psychiatric medication side effects (such as for Orap and Geodon I needed an EKG or bloodtests yearly or on medications like Lithium monthly or Clozaril weekly, in the past) but he will not adjust my psychiatric medications. He is a knowledgable provider but not about psychiatric medications. I was explaining to him about glycine, which naturally he wouldn't have heard of but he was astonished when I told him about current antipsychotics and he said "you mean they all cause tardive?" and I said "yes" and explained. But I trust him with my health overall. But my mind and its functioning has to be taken of by my psychopharmocologist and I do believe I am in good hands there as well but if I didn't have any insurance I couldn't afford either of them. So all of these issues are part of the same picture.

[Lizz67]

I've not read the article you mentioned yet, but wanted to comment anyway.  Other things I can think of is related to poverty.  Many MI people can't afford alternative preventative care such as chiropractic, podiatric, fitness classes or equipment, healthy food.  I couldn't afford dental care until recently when I needed an expensive root canal.  The dentist asked me why I hadn't had the cavitiy filled before it got so bad and I had to ask her, "Would you have done it for free?" I'm off to check out your article now.

[LeftCoastChick]

BP does get worse with age, left untreated I can understand that the age of mortality could be much younger - but many live to a ripe old age if followed well.

[ILADVOCATE]

Yes that's correct. Before psychiatric medication was invented besides the suicides from the depressive aspect of bipolar, people in an extreme manic state would stop sleeping which will eventually cause death as well as the standard neglect of self care skills that are part of extreme depression or mania. Its rather obvious that bipolar is not thinking in a speeded up way but affects the body as well (psychomoter agitation is the clinical term, that's why it appears people who are manic are racing around). Now they are theorizing that in depression the aches and pains some people experience are not part of an obsession with negativity that's part of depression but very real. My psychopharmocologist informed me of studies confirming this in Europe but all of this is new to medical science but clearly bipolar does not just change someone's affect but perhaps their body functioning as well. It should be noted that almost all mood stabilizers besides Lithium started off as anti-convulsants so clearly there is some hyperactivation of the brain in mania that is similar to the extreme activation during seizures but as for exactly what is going on science is just beginning to understand.