LONG-TERM EFFECTS

Family life is very commonly affected, leading to conflict with parents and siblings during childhood and adolescence with spouses (or partners) and children in adulthood.

Tumultuous romantic lives -- extreme and sudden passions, multiple divorces or affairs testify to the emotional instability of many people with MDI.

In children we often observe frequent changes of school, school failures or dropouts, as the emotional instability can interfere with adequate or consistent functioning in school. Among adults, the work history is chaotic with frequent moves from job to job due to the person quitting or being fired.

Instability is also clear in the handling of finances: debt, impulsive spending, gambling and sometimes bankruptcy is common in the history of patients with MDI.

Interpersonal relationships suffer a great deal being affected by the recurrent episodes of illness. Friendships and family ties can often end due to an episode of MDI. The periods of Depression with social isolation and withdrawal can strain some relationships, but is usually the irritability and aggressiveness of Mania/Hypomania that creates the greatest difficulties. The overall effect is the loss of social support, the accumulation of losses and the social isolation that results from it.

When this chaotic pattern is life long, the changes are usually attributed to circumstances or external events by the patient and often also by family and friends. This contributes to the common belief that the problems are not due to a disease but to bad luck or a ‘personality disorder’. Sometimes, one can appreciate the devastating effect of MDI only after a person is diagnosed with this illness.