US Court ruling “Bipolar Disorder is physical disorder and not a mental illness” :
Implications for discrimination by insurers against mental health problem
(Article from Equilibrium website) http://www.bipolar-foundation.org/index.aspx?o=1354
This case revolves around the increasing and incontrovertible evidence from various areas of research that bipolar disorder is not ‘merely’ a ‘psychological disorder
It has reluctantly been accepted by individuals suffering from bipolar disorder (manic-depressive illness) and other mental health disorders that they face problems with regard to insurance of all types. Life insurance, personal income insurance and motor insurance are all affected by history of pre-existing ill health of any type but some policies specifically exclude cover for the de-novo development of ‘mental illness’ during the term of the policy, treating it differently from ‘physical disorders”, as well as imposing larger premiums or imposing other limitations on people with known mental health problems.
A court ruling on this issue in the US which is of considerable significance in this area has not been picked up at all by the popular media or the professional literature either within or outside of the US. Although not of direct legal impact outside of the US, we believe this case raises important issues about the way both employers and insurers deal with claims arising from the development of mental health problems. It also raises more general issues regarding differential stigma of ‘mental’ versus ‘physical’ ill health. This case revolves around the increasing and incontrovertible evidence from various areas of research that bipolar disorder is not ‘merely’ a ‘psychological disorder’.
The Case: Fitts v. Fannie Mae[1]
The ruling by the United States District Court for the District of Columbia involves an employee of a major mortgage company who developed bipolar disorder and whose employee disability insurance provider stopped paying disability benefits after 24 months on the grounds of bipolar disorder being a ‘mental illness’. The policy provided cover until the age of 65 for physical disability. Ms. Fitts had worked for the company for 13 years before she was first diagnosed with bipolar disorder in 1995. The employee- Ms. Jane Fitts, successfully brought a case against both the employer and the insurer arguing that bipolar disorder did not clearly fall in the category “mental, emotional or nervous diseases or disorders of any type”. The court awarded “prejudgment interest on all sums due her and the costs of this action “.
Three pieces of evidence were presented to back this argument, and two expert witnesses, including Miss. Fitts’ own psychiatrist, provided evidence:
1. Ms. Fitts’ father and brother showed symptoms of the disorder and so a hereditary predisposition coupled with having the disorder showed the genetic nature of the disorder, which must therefore have a physical basis.
2. Brain scans of Ms. Fitts showed excessive age-controlled atrophy of the left parietal lobe and abnormal wave activity on the left side of the brain.
3. Ms. Fitts suffered from physical symptoms such as headaches, chest pains, and insomnia that were ascribed to bipolar disorder.
Prof. Frederick T. Goodwin from the George Washington School of Medicine stated: “bipolar disorder is a physical illness because it is a neurobiological disorder that affects the physical and chemical structure of the brain”. He supported the claims listed above, also making the point that susceptibility to pharmacological therapy suggest a physical cause. Ms.Fitts’ psychiatrist maintained that while the clinical features of the disorder are mainly behavioural and emotional, they are due to physical changes in the brain.
Ms.Fitts’ psychiatrist maintained that while the clinical features of the disorder are mainly behavioural and emotional, they are due to physical changes in the brain.
The defence team argued that bipolar disorder clearly falls within the “mental illness” category because previous judgments had ruled it to be such on the manifestation of the symptoms and because it appears in DSM-IV.
This case was an appeal on a previous judgement against Ms. Fitts’s claim. The first filing of the suit focussed on violation of the Americans with Disabilities Act (ADA) and the District of Columbia Human Rights Act (DCHRA), and breached certain contractual and common law duties. This court dismissed all of Ms. Fitts’ claims except her Employment Retirement Income Security Act (ERISA) claim. ERISA requires all policies to be written in unambiguous language and given that bipolar disorder did not clearly fall within the definition of mental illness in the insurance policy, the court was bound by the doctrine of contra preferentem, which has been applied as federal common law to ERISA. The doctrine states that in ambiguous definitions the ruling should be against the drafter of the contract.
Other cases
Another case ongoing in North America illustrates the unfortunate consequences of stigmatisation of bipolar disorder leading to an understandable reluctance by those affected to openly disclose to employers a history of pre-existing mental illness. The Canadian insurers of the television series The Dead Zone filed a suit against star Anthony Michael Hall to recoup more than $612,000 for failure to disclose he suffered from bipolar disorder, AP reports. The suit claimed production of the series, shot in Vancouver, was halted from May to August 2001 when Hall was treated for “bipolar affective disorder depression with psychotic features” for which the production company submitted a claim and received money. The case is waiting to be heard at The Supreme Court of British Columbia. (Source: Vancouver Sun)
In a case in New York, which does not have parity legislation, a court ruled that a disability insurance policy is not discriminatory because it provided only 24 months of cover for disability due to unipolar depression, rather than cover to the age of 65 years as it would have done for disability due to physical injury. The appellant, a Charlene Polon, continued to suffer with unipolar depression and has not been able to claim disability allowance under her policy from 1996. The case was made under the Insurance Law, and the court ruled that the law only protected from discrimination “with regard to her eligibility for and access to insurance” and not within the terms of the policy[2]. This case demonstrates that many instances of discrimination continue to occur and that even the covering statutes are unclear
For the rest of the article, follow this link:http://www.bipolar-foundation.org/index.aspx?o=1354
Research shows that people with mental health illnesses are more likely to be the victims of violence than the general population. (Graham Thornicroft - Shunned). One study showed that people with mental illness were two and a half times more likely to be the victims of violent crime than the general population (8.2% compared to 3.1%). There are many, many studies trying to determine which category of people are most likely to be violent and these studies vary in their conclusions. The role of alcohol or drug use appears to be a stronger predictor for violence than does having a diagnosis of a severe mental illness. As Prof Thornicroft points out, there aren’t studies of the prevalence of violence amonst “the physically ill”….
However, there are many studies which point to the prevalence of domestic violence perpetrated against the mentally ill. Some might say that living with a person with a mental health problem “causes” them to become angry/frustrated/fed up with the sufferer and that they are “pushed” into becoming violent towards them or that they are “defending” themselves against the mentally ill person’s “attack” (verbal or physical). The huge problem with domestic violence is seeing through the issue of “who started it” much like a parent has to see through which child hit the other first or which child started the argument. What is obvious, however, (and supported by a lot of research) is that many sufferers of depression and anxiety have such low self esteem that it is very easy for them to become victims of bullying, intimidation, harrassment, ill-treatment etc as they find it very difficult to stand up for themselves or to believe in themselves sufficiently well to be assertive with those around them. People with mental ill health are often told that they have “lost their reason or judgement” and they therefore doubt themselves when their spouse is telling them that they are wrong/stupid/unreasonable/selfish/uncaring/lazy/irresponsible etc etc. They lack the certainty that their own perceptions and judgements are correct as they are constantly reminded that they are “ill”. This makes it very easy for an abuser to get to the core of their victim and succesfully abuse them, hold power over them and undermine them to the point of cruelty. The “mind games” that a spouse can play over their mentally ill partner can be devastating.
This has been my own experience. My ex husband played with my mind in exactly this manner. I now see this and can compare it directly with my experience with my partner of the last 3 years. My partner plays none of these games, nor does he try and control, manipulate, bully or abuse me in any way. I am fortunate enough to have formed such a close bond with another person to enable me to make these comparisons.
Researching the link between mental ill health and domestic violence has been hugely helpful to me in making my recovery. I can distinguish between those behaviours of mine which were destructive and those behaviours which resulted from being abused by my ex husband. Reading the profiles of an abuser helps to recognise a pattern of behaviour or dynamic in a domestic violence relationship. As a result, a person can disentangle those behaviours which are attributable to their own personality and those which resulted from being abused.
One such piece of research is an article from Mr Lundy Bancroft. This article rings so true for me as it is so close to the truth of my own experience. I have highlighted in bold those sentences which are exactly like my ex spouses behaviour. Read the entire article by clicking on the following link or by visiting the Justice for Mothers website:
Here is an except from Mr. Bancroft’s article:
An abuser’s desire for control intensifies as he senses the relationship slipping way from him. He focuses on the debt he feels his victim owes him, and his outrage at her growing independence. (This dynamic is often misread as evidence that batterers have an inordinate “fear of abandonment.”) He is likely to increase his level of intimidation and manipulation at this point; he may, for example, promise to change while simultaneously frightening his victim, including using threats to take custody of the children legally or by kidnapping. Those abusers who accept the end of the relationship can still be dangerous to their victims and children, because of their determination to maintain control over their children and to punish their victims for perceived transgressions. They are also, as we will see later, much more likely than non-batterers to be abusive physically, sexually, and psychologically to their children.
The propensity of a batterer to see his partner as a personal possession commonly extends to his children, helping to explain the overlap between battering and child abuse. He tends, for example, to have an exaggerated reaction when his ex-partner begins a new relationship, refusing to accept that a new man is going to develop a bond with “his” children; this theme is a common one in batterer groups. (Marie: My ex took out a Prohibited Steps Order against my new partner claiming that he was a danger to my children simply becuase he suffered from Bipolar too). He may threaten or attack the new partner, make unfounded accusations that the new partner is abusing the children, (Marie: there were numerous threatening letters sent to my new partner accusing him of all kinds of behaviour), cut off child support, or file abruptly for custody in order to protect his sole province over his children.
A batterer who does file for custody will frequently win, as he has numerous advantages over his partner in custody litigation. These include, 1) his typical ability to afford better representation (often while simultaneously insisting that he has no money with which to pay child support), (Marie: my ex spent earns over £450k pa but maintains that he cannot afford to pay maintenance to me). 2) his marked advantage over his victim in psychological testing, since she is the one who has been traumatized by the abuse, 3) his ability to manipulate custody evaluators to be sympathetic to him, and 4) his ability to manipulate and intimidate the children regarding their statements to the custody evaluator.
There is also evidence that gender bias in family courts works to the batterer’s advantage. (Massachusetts Supreme Judicial Court Gender Bias Study) Even if the batterer does not win custody, his attempt can be among the most intimidating acts possible from the victim’s perspective, and can lead to financial ruin for her and her children.
I am still living in my brother’s spare room, 18 months after being ordered to leave the matrimonial home whilst he remains in our 7 bedroomed house. This means that the children’s home with me is still my brother’s spare room where we all share a bed. I have no car of my own ( I have to borrow my boyfriend’s) whilst he has just bought a new BMW people carrier. I have been awarded 12% of his income whilst he keeps the rest. I am over £450k in debt.
Would this happen if I were not “mentally ill”? If I had been strong enough to stand up for myself, and/or didn’t have a set of medical records and a condition that would be used against me in court, would I be in the situation I’m in? I don’t think so. Many of my readers have given similar accounts of how they have been abused by their spouses due to their own lack of self esteem arising from their mental health problems. There are many articles, comments, forum chats where people have said the same thing ie that they have been abused by their partners because they have suffered from a mental health problem which their spouse has used against them to take control, intimidate, manipulate and ultimately punish by taking their children away from them.
Any similar stories out there? Anyone who disagrees with this perception/research? As usual, any feedback gratefully received….
Private mental health clinic states rising demand for services from stressed out city types. How will the stress of these people get passed on to their families, especially their children? Does the stress “fallout” from these people amount to the same kind of “fallout” from people who are already suffering from mental health problems and, if so, is their own parenting brought into question? I very much doubt it. Do they fall into a different category somehow because their symptoms are caused by external events rather than internal chemistry? Probably. People will see these people as sufferers of the financial crises and, rightly in my view, feel sorry for them as they face losing everything they’ve worked so hard to achieve. (I don’t personally subsrcribe to the seemingly widely-held view that these people deserve everything they’re getting because it was their own fault somehow for being “greedy”. You simply cannot tar them all with the same brush.) Whatever your view on whether they deserve to lose out or not, their children don’t deserve to have this visited on them yet they will often bear the brunt of the fallout whilst they feel the strain and stress at home.
Yet, I think it highly unlikely that social services or CAFCASS or any judge would hold that these people are “incapable” of looking after their children as a result of any depression or anxiety resulting from these job losses. This depression and anxiety is likely to be looked on sympathetically by those people in total contrast to how they would perceive someone with a mental health diagnosis such as Bipolar who suffers from the same level of depression and anxiety. Would this then be discrimination?
Is this fair? What do you think is the difference between the effect of a depressive illness brought on by job loss compared to a depressive episode in Bipolar? Should they be treated as resulting in an inability to parent their children? If not, why not? If so, why? Your views and perceptions would be gratefully received.
Link: http://www.guardian.co.uk/society/2008/oct/08/mental.health.financial.crisis
The text of the Guardian Article:
An independent mental health hospital located near London’s banking district has identified a new disorder sweeping through the devastated ranks of City bankers and hedge fund managers.
The clinic says it is seeing more and more cases of “square mile syndrome”, a term it is using to describe stress-related mental health problems faced by City workers as the credit crunch chews through the financial sector, leaving a trail of redundancies in its wake.
Capio Nightingale Hospital, a private clinic, says it has witnessed a 33% increase in the number of City workers seeking advice for anxiety, depression and stress since July, and a 30% rise in patients seeking help for drugs and alcohol addiction - often the result, says the clinic’s medical director, of recreational drug use tipping into full-blown dependence during times of stress. There has also been a 27% rise in inquiries about its eating disorders programmes.
“We’re seeing 25-year-old bankers waking up with acute anxiety and stress, and realising that the job they thought they had for life and the bonuses they had come to rely on had literally disappeared overnight,” says Capio Nightingale’s medical director, William Shanahan, who is quick to point out that “square mile syndrome” is not a medical or diagnostic definition.
“Hopefully, we can encourage more people to come and get help,” he says. “We can draw worrying comparisons with the Black Wednesday days of the 1990s, when we saw a sudden spike in the number of City workers who suffered mental health problems after the bottom fell out of the market. We want to try to avoid this happening again.”
Shanahan says there is still not enough recognition of the mental health problems faced by employees in high-pressure jobs. The clinic is offering a deal where patients who can produce a P45 issued after September 1 can pay for their treatment once they find work.
“Things have got better, but there can be a reluctance to admit you have a problem when you’re in a high-flying job where you are expected to deal with stress day after day,” Shanahan says. “If we don’t watch out, square mile syndrome could be a timebomb.”
Alasdair Campbell told Tony Blair that he suffered from repeated bouts of depression and had had a drink problem. Blair had responded “I’m not worried if you’re not worried”. Campbell had had a breakdown, had taken to drink and had suffered from severe depression. Yet the Prime Minister asked him to work for him. Regardless of whether you think Alasdair did a good job or not, it says a great deal about Blair that he is willing to encourage Campbell to take on the role that he did.
Or does it? It is highly likely that Blair already knew that a relatively high proportion of MPs suffer with mental health difficulties and he was simply accepting of the fact. According to research, published on the Stand to Reason website, One in Five MPs experience mental ill health and are forced to hide their problems…..http://www.standtoreason.org.uk/goals
The report published on 16 July 2008 by Stand to Reason in conjunction with the All Party Parliamentary Group on Mental Health, with support from the Royal College of Psychiatrists, Mind and Rethink has shown that one in five MPs surveyed has experience of a mental health problem but fears disclosing this because of the stigma and discrimination associated with mental health issues.
An anonymous questionnaire completed by 94 MPs, 100 Lords and 151 parliamentary staff has revealed that:
- 19% of MPs had personal experience of a mental health problem (17% of Peers, 45% of staff)
- 94% had family or friends who have experienced a mental health problem
- 86% of MPs said their job was stressful
- 1 in 3 said work-based stigma and the expectation of a hostile reaction from the media and public prevented them from being open about mental health issues.
The report shows that despite significant numbers of people working in Parliament experiencing mental distress, over half of MPs did not think they had sufficient understanding of the Disability Discrimination Act to make reasonable adjustments for a staff member with mental health problems and only 17% had received any mental health awareness training.
President of the Royal College of Psychiatrists Dinesh Bhugra said: “Sadly, stigma is still widely prevalent. Mental illness comes in many forms across the age span, and is everyone’s business. Mental health and physical health cannot be parted. We applaud this effort to start talking more openly about mental illness. MPs occupy a privileged position in the public eye, and greater openness has the potential to lead to a better public understanding of mental health issues.”
I am strangely comforted by the high number of MPs who have or are suffering from mental health problems as it gives me hope that they may be prepared to challenge the legislation and case law governing custody issues where a parent suffers from a mental health problems as presumably, some of these MPs are parents themselves. If the legislation was handed over to them to change, where would they draw the line in terms of assessing someone’s ability to parent? If changes to legislation were handed over to those within Parliament and the legislature who had direct experience of mental health, I wonder how they would chose to re-draft or re-frame some of the legislation governing mental health issues. If their own parenting was being scrutinised with the threat of their own children being taken away from them due to their mental health problems, would they seek to re-draft the legislation?
My guess is that they probably would. My next piece of research is going to be to try and find out some more about who these MPs are and whether or not they have children. I wonder how many of these MPs may have been diagnosed with Bipolar rather than depression. I think I shall attempt to find out the same with the Judiciary. However, I know that people with mental health problems are not permitted to be magistrates, so I now need to determine whether Judges can be Judges if they have mental health problems. If MPs have to step down having been sectioned, I wonder if the Judiciary have to too? If there are MPs and Judges who have retained custody of their children and yet suffer with a mental health problem, it begs the question of the test that is being applied to determine who is a “fit” parent and who isn’t. I’m sure there must be some method in their madness…..I just need to establish what it is….
For the relevant articles, see the links below:
http://news.bbc.co.uk/1/hi/uk_politics/7508128.stm
My daughter showed her chronic shyness yesterday, which I believe is a manifestation of the affect my absence is having on her and the ongoing lack of insight of her that my ex has. Her views and opinions are often ignored by him - something that I have both experienced when I’m with her and him, as well as being recounted by her on numerous occasions which she relates graphically and with a depth of feeling that is manifest in her lack of self esteem and anxiety. Yesterday was a case in point. She was being shown around her prospective new school by children who were barely older than herself yet she could not communicate with them. She clung on to me throughout, despite being with both me and her father, largely ignoring him and not once taking his hand. This is striking behaviour given that she has been largely in his care now for the past 18 months. She is now over 10, but behaved more like a terrified toddler hiding behind her mother’s skirt, than a confident child about to enter her teens. She would not step into any of the classrooms on her own - she clung on to my arm and pulled me into them with her, burying her head into my shoulder as much as she could. She asked questions of me, quietly, so that nobody else could hear and would not look at any of the other children in the eye. Even when were being shown around the art room where she saw the pottery and the art class of pottery skills led by a cheerful, friendly, bright young female teacher, she could not bring herself to share her own enthusiasm for the activity she loves most. Instead, I had to ask the questions for her. Very ocasionally she spoke to others but it was with a manifest lack of confidence.
She has always been a relatively shy child but this has been attributed by her father as being the effect that my continuing presence, my Bipolar and my fundamental personality has had in the children’s lives when I was the caregiver. Now that he has been the main carer for the past 18 months, her shyness with others has increased, not decreased as he asserted in court. If he was the right person for her to live with, then why should this state that she is in have continued? It is clear to me: he cannot relate to her in the way she needs him to. He has a fundamental lack of understanding and empathy with my daughter’s shyness and high levels of sensitivity as her behaviour is so alien to his own. Her high levels of sensitivty both to the affects of her environment on herand to her interaction with others is very similar to my own and I therefore have an inherent empathy and sympathy with this trait of hers. He however has no experience of feeling like this and has not shown any willingness to accomodate this - rather he prefers to tell her that she “is being over-sensitive” or “over-reacting” or “imagining” certain experiences that she has. He dismisses her perceptions of her world to such an extent that she is now highly reticent to assert herself with him. I observe all this and feel helpless as I am not there to help her respect her own feelings and teach her assertiveness. Only having small amounts of time with her doesn’t support the kind of understanding and nurturing she needs to help her validate herself.
Most mothers fundamentally know their child and have an inherent understanding of their fundamental personality and nature. Of course their are exceptions, but it is widely acknowledged by most people that this is the mother’s natural ability and is the result of the close bond that a mother and child have. The net result of this lack of a mother’s input - a mother who fundamentally understands her child - is to produce a child lacking in self esteem, a child who no longer trusts their feelings and instints when their main carer (my ex and his nanny) ignores, dismisses and makes light of their experiences. When I try to teach them how to stand up to him, they tell me that they are “too frightened” of him and his anger and that “he doesn’t listen” even when they do try to tell him their feelings.
An example is that my son was told off by his nanny for being naughty when he ate some crisps and hadn’t restrained his friends from eating them too. The fact that he was having a hypo and therefore could barely function, let alone take his friends to task, was not recognised by the nanny at all. Unsurprisingly, he felt misunderstood, resentful and mistreated. Her lack of understanding of his nature and her lack of experience of his condition has a profound affect on him. He grows increasingly resentful of the limits she places on him with regard to managing his diabetes, with the result that he is now angry about his condition and feels that he is not having the support from her that he needs. This is in stark contrast to how he feels when he is with me, as he knows that I understand his feelings and respect them.
I know these things that my children are relating to me to be true as I experienced my ex husband’s reaction to me over many years when I tried to explain to him my own feelings about the world and the people I interacted with. His usual response was that I was “over-reacting”, was “far too sensitive”, that I “imagined it” and that it was my attitude, personality and behaviour that provoked any conflict with others rather than attributing any behaviour on other people;s part to any difficulties I may be experiencing.
When someone is told this time and time again, it knocks their self esteem and devalues their experiences resulting in lack of trust of their own perceptions. Over time, it is an extremely toxic experience which ultimately can lead to severe anxieties and depression due to the lack of ability to follow through on their need to assert their wishes, needs and feelings.
This is exactly what is happening to my eldest daughter and is beginning to happen to my son too who is also telling me that he is frightened of his father and therefore can’t tell him how he truly feels.
I cannot bear watching all this happening and having to stand on the side-lines unable to intervene to support what they are saying and feeling other than when they are being looked after by me. Given that they are with me so rarely, I cannot provide the validation that they need on a regular basis. This is resulting in my children becoming increasingly uncertain of their interactions with others and a lack of ability to assert themselves in challenging situations.
This is highly damaging to them and, in my view, is causing the “significant harm” that the law refers to in the Children’s Act.
Proving it as a causation, however, is fraught with difficulties as proving a link between his attitude and behaviour to them as being the main cause of these problems is still in debate in the on-going “nature versus nurture” debate. What is certain though is that a child’s personality which is a mixture of both parents, needs to be understood and nurtured by the parent who’s personality best matches that of the child. Certainly, in my eldest daughters case, her personality is much more like mine and she would benefit far more from being with someone who understands her than with someone who doesn’t.
How do I prove this? Ultimately, it will be her choice that counts. By that time, however, she may be so full of self-doubt that her ability to make that choice will be greatly hampered as she may no longer trust her own feelings. Only time will tell…..
If any of you want to help out at your school or work with children or vulnerable adults, you will need to go through a Criminal Records Bureau (CRB) check here in the UK (I don’t know what the corresponding test in the UK is - any feedback gratefully received).
The CRB is a government body which has been set up to help organisations in the public, private and voluntary sectors by identifying candidates who may be unsuitable to work with children or other vulnerable members of society. Given the number of high profile cases where sex offenders or other criminals have ended up working with children, the Government has issued guidance to schools and care homes, to ensure that they conduct proper checks on applicant’s backgrounds to determine whether or not they should be working with children and vulnerable adults.
A reader of this blog has said that, because she was sectioned by the police under the Mental Health Act, that she is afraid that it will show up on her CRB check. Because she works with children, she is now afraid that she won’t be able to work with them.
If any of you have ever been sectioned by the police, does this mean that it would show on your CRB check?
I have now researched this and, so far, my research says that being sectioned in relation to a non-criminal act will not show up on a CRB check because merely being sectioned is not a “crime” or an “criminal offence”. The fact that the police were involved does not make you a criminal.
If, however, your sectioning was as a result of a criminal act, then it may well show up. If that’s the case then you need to determine what type of offence it was as there are varying degrees of severity and varying types of offence. So, for example, if it was any kind of sexual offence, then clearly that will be far more serious then a lesser offence. If you have any questions or doubts about your rights, you can go on the CRB website and it will tell you.
On a personal note, I do not have any criminal records, although I was arrested once when I was a University student - the details are at the end if you want a laugh! Nothing to do with any criminal act on my part, I hasten to add.
the worst I have ever done was when I was a University student, in Oxford. My crime was to try and reason with a policeman who was then trying to arrest my drunken Rugby playing boyfriend following a Rugby team strip tease at a friends 21st birthday party - not unusual behaviour for Rugby players or for undergraduates but the local police were not amused! The policeman’s wife had been offended by the sight of so many bottoms (she was driving behind the bus containing the Rugby team) that she insisted on them being arrested!). I told the policeman that he couldn’t arrest my boyfriend unless he could identify him in court; given that my boyfriend’s bottom was the only part of him that his wife had seen, the police would never have been able to identify him!!! The policeman got so cross when I was telling him the law, that he arrested me and threw me in a cell for the day to teach me a lesson!!! I hadn’t sworn, nor threatened, nor touched him but I had told him the law and clearly that didn’t impress him…….
So, apart from that, I’ve never been a criminal, so my CRB check should be clear.
September 2008: Edinburgh University is conducting a study of people who are related to someone with bipolar disorder and are between the ages of 16 and 23. The following lines give a description of what the study is for. Information sheets are available for download here
Bipolar disorder is a psychiatric disorder affecting approximately 1% of people at some point in their lives. The cause of the disorder is not known, although genetic factors are thought to play a large part and a few specific genes have also been discovered which appear to increase the risk in some studies. Unfortunately, we still don’t understand how these genes act upon the brain to make people more susceptable to illness. We hope to better understand these mechanisms by studying the relatives of people with the disorder.
Although most people who are related to someone with bipolar disorder will never develop the same illness, a few people will. We hope that by studying a large number of young relatives of people with the disorder, we might be able to predict who will become unwell later using a combination of scans, memory tests and a sample of blood for genetic testing. We are hoping to recruit the following groups of people:
- People age 16-23 with a mother, father, brother or sister with a diagnosis of bipolar disorder, but with no history of psychiatric illness themselves.
- People age 16-23 with no close relatives with bipolar disorder and with no history of psychiatric illness themselves.
People who agree to take part will be assessed by a psychiatrist and a psychologist, receive a blood test for genetic testing and undergo a brain scan. The tests will be repeated again after 2 years. The information sheets explain the study in more detail and exactly what is involved. To download an information sheet click here. If you would like to take part after reading these, please contact us using the details at the bottom of this page.
If you are interested, you need to contact Dr Andrew McIntosh
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Telephone +44 (0)131 537 6274 |
What is really annoying me about this whole Bipolar thing is that I might not even have the wretched illness!! For all I or anyone else knows, I could have been misdiagnosed. My friends and family and others who meet me are all still adamant that I don’t have the condition as I don’t exhibit any of the symptoms. Even my partner, who is himself Bipolar, does not think that I have the condition as I am “too well”.
This makes it very difficult to accept the fact that my children have been told that I am not capable of looking after them full time. If I don’t have this condition, then presumably I’m capable of looking after them. It would also clear my medical records enabling me to find work and drive without all the scrutiny that I am currently subjected to.
So, I’ve been doing some research about whether there are other tests available to prove or disprove the presence of any Bipolar condition that I may have. If I do have it, then it may indicate the severity or mildness of it. If I don’t have it, them I’m off back to court to challenge the decision.
The following paragraphs are based on various articles that I have read but I haven’t attributed them as they were wrong in places so I have edited them eg they state that “all Bipolar sufferers have extreme and severe mood shifts from mania to depression.” As you and I all know, that is simply not true for all of us sufferers who experience a very individual set of symptoms. Anyway, do read on….
Bipolar Disorder and the Brain
Bipolar disorder and the shifts in mood that come with it can ruin lives. It often goes unrecognized as an illness and people can suffer for years before it’s properly diagnosed and treated. Now, however, new research that analyzes the bipolar brain could lead to better diagnostic techniques and improved treatment. Recently researchers discovered that abnormalities in certain brain areas that govern emotion can occur in those with the ailment. These findings and others may eventually provide researchers with new tools to diagnose and treat the ailment earlier and more effectively.
More than 2 million Americans and around 1 million Britons have bipolar disorder and the shifts in mood that come with it. Those with the illness in its most severe form (Bipolar 1) can cycle between episodes of manic highs and severe depression that can damage relationships and job or school performance. Those with the less severe form (Bipolar 2) have fewer marked mood shifts but they too can benefit from treatment.
People with bipolar disorder can suffer for years before their illness is properly diagnosed and treated. This may soon change, however, thanks to new research that analyzes the bipolar brain. The findings are leading to a better understanding of the cause of bipolar disorder.The development of biology-based diagnostic techniques that could identify the disorder early and provide insights into how to improve treatment.Currently, bipolar disorder cannot be identified biologically with a simple blood test or brain scan. Instead, a diagnosis is made primarily on the basis of symptoms discussed in the doctor’s office. The disorder often goes unrecognized as an illness for years, but once diagnosed many people with bipolar disorder can be treated with medication. Commonly doctors prescribe drugs that stabilize mood, such as lithium, along with drugs that ease depression.To help speed detection and improve treatment, scientists recently began to scrutinize the bipolar brain and uncover biological signs of the disorder. Some research reveals abnormalities in areas that govern emotions. For example, techniques that imaged the brain indicated that emotional areas deep inside, known as the amygdala and hippocampus, can be smaller in both adolescents and adults with bipolar disorder. This suggests that brain changes are an early feature of the disorder. Other studies that examined brain anatomy and brain activity indicate that those with bipolar disorder can have abnormalities in areas toward the front of the brain that process emotions, including the orbitofrontal cortex and the anterior cingulate. In other work, researchers uncovered some early insight into the roots of these abnormalities by studying genes. Our genes guide the production of proteins that run brain development and function. One study found evidence that a variation of gene, known as BDNF, which produces a factor involved in the development of brain structures like the ones found to be abnormal in bipolar disorder, may increase a person’s risk of developing the illness. Researchers also are examining possible links to many other genes involved in cell survival and development. With continued study, this research may help scientists find ways to detect bipolar disorder earlier and intervene earlier. For example, researchers imagine that in the future they will be able to develop a simple brain scan that identifies suspect brain alterations or devise a blood test that signals that brain changes exist. And perhaps once the genes behind the disorder are clarified, a test could be developed to detect them early.The discoveries surrounding the biological contributors of bipolar disorder also highlight where to focus new treatment development and could help doctors modify existing therapy regimens to match an individual’s particular abnormality. In the end, the research may translate into more peaceful days and longer lives for many.
Research reveals that people with bipolar disorder can harbor abnormalities in brain areas that govern emotions, including the orbitofrontal cortex, which lies behind the eyes and aids complex emotional thinking. In one imaging study, researchers examined brain activity while people with bipolar disorder and healthy individuals conducted a task that tests thinking ability. In general, the activity in the area was abnormal in bipolar patients compared to the healthy participants. Researchers also found that when patients were experiencing depression the activity was abnormally high, shown by the yellow and red coloring at the top of the left brain image. When patients were experiencing manic highs the activity was abnormally low, shown by the blue and purple coloring in the right brain image.
The U.S. Equal Employment Opportunity Commission
FOR IMMEDIATE RELEASE CONTACT: SIDNEY B. CHESNIN
March 18, 2003 SR. TRIAL ATTORNEY
(214) 655-3330
HOLLY COLE
SR. TRIAL ATTORNEY
(405) 231-5853
TTY: (214) 655-3363
Worker with Bipolar Disorder to Receive $91,000
in Disability Discrimination Case Settled by EEOC
Employer’s Motion to Dismiss Lawsuit Rejected by Court in Rare EEOC Litigation on Issue of Psychiatric Disability
DALLAS - The U.S. Equal Employment Opportunity Commission (EEOC) announced today the settlement of a disability discrimination lawsuit against Lincoln, Nebraska-based Voss Electric Company (Voss) for $91,250 on behalf of a former worker with bipolar disorder. Voss is a distributor of commercial lighting products, with 12 branches and 16 sales locations located throughout the central United States.
In its lawsuit, case number CIV-02-92-C in U.S. District Court for the Western District of Oklahoma in Oklahoma City, the EEOC charged Voss with violating the Americans with Disabilities Act of 1990 (ADA) by terminating a long-time employee of its Oklahoma City facility who needed in-patient care due to bipolar disorder, a psychiatric disability. Rather than allow the employee the additional time off recommended by his physicians, Voss fired him by taping a termination letter to the front door of his home, the EEOC said in the suit.
Voss had filed a motion requesting the Court to dismiss the EEOC’s lawsuit, but the Court ordered that the case be tried. On February 28, 2003, the Court, in a detailed 17-page opinion, ruled against Voss on all arguments raised against the EEOC, and held that the EEOC’s claims should be submitted to a jury for trial.
The Court ruled that the EEOC had submitted evidence that the former employee’s mental illness, at the time of his termination, severely impaired a number of his major life activities, including thinking, interacting with others, communicating with others, and the ability to take care of himself. Voss then argued that, at the time of his termination, the former employee was unable to perform the essential functions of his job.
The Court, however, ruled that a jury should determine whether the employee was entitled to a reasonable medical leave to enable him to recover sufficiently to return to his former position. After the Court’s ruling, the parties reached an agreement embodied in a Consent Decree approved and signed by the Court.
“For years I did a good job for this company, but soon after I became ill they discarded me as I was trying to get well, which just compounded my struggles,” the fired employee said. “I am thankful to the EEOC for standing up for me and obtaining a fair settlement.”
Robert A. Canino, Regional Attorney of the EEOC’s Dallas District Office, said, “We should credit the sound legal analysis by the Court in this case. This is a difficult area of law to enforce due to interpretational issues challenging the courts, but the EEOC will not shrink from the task of educating the public about the ADA through the pursuit of civil actions when necessary. Decisions like this one which allow a jury to apply the law to specific facts can give victims of disability discrimination confidence that their voice will be heard.”
The EEOC filed suit after exhausting its conciliation efforts to reach a voluntary pre-litigation settlement. The Consent Decree settling the suit provides monetary and prospective non-monetary relief, including training of all Voss employees, officers, managers, and supervisors on the requirements of the ADA, and the posting of a notice informing employees of their rights under federal law at all of its locations.
“Mentally disabled employees are protected under the ADA just as those who are physically disabled,” said Sidney B. Chesnin, lead trial counsel for the EEOC. “Disabled employees are entitled to consideration of a reasonable accommodation for their disability. By simply giving a worker a reasonable period of leave to adjust to a medical condition related to a disability, the employer can often pave the way for the return of a productive employee.”
In addition to enforcing Title I of the ADA, which prohibits employment discrimination against people with disabilities in the private sector and state and local governments, the EEOC enforces Title VII of the Civil Rights Act of 1964, which prohibits employment discrimination based on race, color, religion, sex (including sexual harassment or pregnancy) or national origin and protects employees who complain about such offenses from retaliation; the Age Discrimination in Employment Act of 1967, which protects workers age 40 and older from discrimination based on age; the Equal Pay Act of 1963, which prohibits gender-based wage discrimination; the Rehabilitation Act of 1973, which prohibits employment discrimination against people with disabilities in the federal sector; and sections of the Civil Rights Act of 1991. Further information about the Commission is available on the agency’s web site at www.eeoc.gov.
A quote from a mother not coping with her toddler: “I was so angry with my toddler son when he was tantrumming and refusing to eat, that I grabbed a tuft of hair on the back of his head and pushed his face into his bowl of spaghetti! His face was covered in spaghetti sauce! The look on his face was of total shock but I was still so angry that I did it a second time”!
A group of mothers who had young children got together over coffee one morning. One of them bravely started to confess her worst behaviour with her children and recounted the above situation with her toddler.
Another mother then said “I was so angry with my toddler who was screaming and screaming that I rammed his pushchair into a wall. I knew it wouldn’t hurt him because the front wheels would hit the wall first and I just wanted to give him such a shock that it would stop him from screaming. He wasn’t hurt but I was still raging so I slammed him into the wall again.”
One of the funniest mums then burst out laughing and said “It’s amazing what you will do to get your kids to stop them from their tantrums. My son was throwing a tantrum in the queue in Asda and everyone was staring at him and at me. He was really letting rip. He had done this so many times, and I had tried every parenting tip in the book and nothing I could say or do stopped him from throwing these tantrums. This time, something snapped inside me: I threw myself on the floor beside him and threw my own tantrum. I pounded the floors with my fists, I kicked and kicked my heels into the ground, I thrashed my head back and forth all the time screaming at the top of my voice. Everyone was stunned into silence including my young son who stopped his own tantrum and looked on dumbfounded at his mother throwing her own almighty tantrum! Eventually, he bent down and said in her ear “Mummy, can you get up, you’re embarrasing me!”. She said that he had not thrown a tantrum since! Her strategy worked!!
One of my ex husband’s friends (who is a trained criminal psychologist) related to me the time when one of her babies had been screaming for such a long time that she could no longer tolerate the sound. She went into the baby’s room and thumped the pillow a few inches from her child’s head with frustration. She said she thumped it several times til she had got her rage out of her. She said that she did this because she was so enraged with her baby’s screams that she had wanted to hit her child; this was the closest she came….
All these women are from very good, solid, middle-class homes, with educated, profesionally qualified mothers….They are not from impoverished, drug/alcohol addicted backgrounds and all of them live in comfort with the average amount of stress.
These are all true stories from friends I know in Kingston. None of them have Bipolar; in fact, none of them have been diagnosed with having any form of mental disturbance. None of them have had their children taken from them. During this coffee morning, all the mothers there were laughing at the stories and thanking each other for their honesty. Each mother there said that they had done simarly awful things when they have been at their wits end with their children.
I’m not conding these mothers’ behaviour, nor am I saying that their treatment of their children is acceptable or normal. I was shocked to hear these things yet, if I’m honest, also strangely comforted to hear that other mother’s lose it with their kids too at times.
I haven’t done any of these things and yet I’m the one who’s been told that, because I have Bipolar, I am more at risk of harming my children. None of these mum’s have been told that they have something wrong with them.
So what are the worst things I’ve done as a parent? I’ll be honest here, painful as it is and you can all be judge and jury as to whether the things I’ve done are so unusual in parenting experiences that the children shouldn’t be with me.
When my eldest daughter was a baby, she screamed so much one night that I screamed back with all my might. I didn’t shake her or hit her, I just screamed too. Then I put her in her cot (gently) and left the room, slamming the door and phoned my mum sobbing with frustration feeling a total failure and feeling terrible for shouting at my baby who, after all, was only being a baby.
When she was a toddler and I had my second son who was only a few months old, all of us came down with a bad bug. Both she and my son were waking me several times a night; she with her illness, he to feed every hour and a half (breastfeeding) and me with my chest infection. I had just fallen pregnant with our third child and was exhausted from the first few weeks of pregnancy as well as from looking after a 2 year old, a 6 month old baby and my third on the way. I felt exhausted, ill, feverish, resentful, desperate…One morning, at around 6am she woke up and threw an almighty tantrum on the stairs. Her tantrums often lasted for an hour at a time. My son then woke up wanting to be fed. My husband wasn’t there to help and my mother was just about waking up in bed. I was trying to cope with all this on my own. I lost it with her. I picked her up roughly and put her in the “time out” place which was our downstairs loo, yelled at her to stay in there until she stopped tantrumming and slammed the door. I was so enraged that I thumped the door (I didn’t hit my daughter at all). Unfortunately, the bit of the door that I hit was glass and I lacerated the tendons in my hand and had to undergo plastic surgery to my hand. My daugher, understandably, was totally shaken by the experience of watching her mother put her hand through the door.
When I was taken to hospital for my hand, the admission nurse asked whether I was post natally depressed. I said I wasn’t sure. I was then assessed and my reading for post natal depression was high and a course of anti-depressants were prescribed.
Social services were informed and my daughter was placed on the child protection register. The health visitor said that I was considered to not be a cause for serious concern because I had chosen to hurt myself in anger rather than hurt my child. I was horrified that I had lost control of my temper in that way. It took my daughter a few weeks before she was back to her normal self.
That’s the worst thing I’ve done to my children.
Other things have included: being so angry with them all, that I shut the door to the house (didn’t lock it) and stormed outside to the end of our drive (about 3 metres in length) and sat in my car with a cup of coffee for 15 minutes to calm down. I could see the house from my car window so I could ensure that they didn’t come out and nobody went in. The children were 8, 6 and 5 at the time. This happened once in total - never again.
I’ve smacked my children when they were toddlers: my eldest daugter when she was a toddler got smacked around 4 times (a smack - not hard hitting), my son around 3 times and my youngest daughter around 2 times. I quickly learnt that smacking ( although highly endorsed by my parents generation and indeed our school system whilst I was still at school where they had the cane), doesn’t work. All it does is to encourage the children to hit each other and others. So I don’t smack. I now resort to shouting when I lose my cool, walking out of the room, slamming doors and being very grumpy.
I have been learning increasingly effective parenting strategies though and gradually I’ve been increasingly able to stop shouting (not 100% yet!) and to walk away when I feel the temperature rising.
According to my exhusband and the Judge, I have also hurt them emotionally by telling them too much about the Court case. Our children were living with my ex husband and I all through the 18 months of litigation and during the actual 10 day High Court hearing. Every day during that Court case, my exhusband and I left the house, caught the train and a taxi and went to the High Court and then came home again the same night. The children knew that we were going to court every day. They knew that the CAFCASS officer had come to see them because they were deciding who the children should live with. They knew that my exhusband was saying that I wasn’t well enough to look after them.
Unsurprisingly, they asked questions - intelligent, perceptive, direct, uncomrpomising questions and asked me to be honest with them in giving the answers. I tried not to give them too much unecessary and upsetting detail, but according to the Judge, I gave them too much information which has caused them distress. I’m not sure how she concluded this given that she hasn’t even met the children, nor was she present to hear the conversation, nor was it recorded…..My children still say that they want me to tell them honestly when they ask questions. I’ve talked with 3 psychologists about how to answer these questions without damaging them emotionally or psychologically, read numerous books on divorce for guidance but apparently I got it wrong.
In short, I have never broken any bones, stubbed out cigarettes, been drunk or on drugs whilst looking after them, left them in the house on their own (which both my ex husband and various nannies have done), not left them in a car on their own (apart from in the garage forecourt whilst paying for petrol), not lost them whilst taking them out, not starved them…….any other thing that I’ve overlooked?
Oh yes there is! I was so cross with them one day that I wrote a long letter describing how I hated their behaviour when they were being so naughty. I described that I felt like hitting them (but stressed that I didn’t do so), that I was such a bad mother, that I was a failure etc. In fact, writing out all the things I was feeling was following the advice of my psychologist who told me that one of the most effective ways to deal with anger is to write it all down on a piece of paper and then throw that piece of paper away. Unfortunately, I didn’t throw it away - my husband found it and used it in Court as evidence that I was an appalling parent.
Yet the two incidents I describe above - the hand through the window and going out to my car for a coffee were brought up in court as classic examples of why I shouldn’t be allowed to parent my children. The letter merely showed as concrete evidence that I was too psychologically disturbed to parent the children.
The fact that my ex husband repeatedly smacked the children when we were married and still does (regularly, I’m told by my children) doesn’t seem to matter. The fact that the CAFCASS report states that my youngest daughter is frightened of him because “he picks me up by my middle and throws me on the bed when he’s angry with me”, doesn’t seem to matter. The fact that he has often shouted at them, threatened them physically, shaken them, slammed the brakes on the car yelling at them that he will “put them out on the pavement” unless they stop screaming, doesn’t seem to matter. The other emotional/psychological things he says and does all don’t seem to matter either.
The fact that my children are scared of him doesn’t seem to matter. They are scared that he will hit them, they are scared that he won’t take their fears seriously and so don’t tell him when they are upset about something, they are scared that he will continue to hurt me. In fact, it was the children who told me that I should go to the Domestic Violence unit because they read the leaflet in the doctor’s surgery and said “Mummy, you should go and talk to these people, because that (the violence) is exactly what daddy’s doing to you.” The fact that the children have witnessed him hitting me and threatening to hit me and shaking me whilst swearing at me and shouting, doesn’t seem to matter. The fact that he hid a knife under his bed together with his porn magazines and videos, doesn’t seem to matter. The fact that, whilst the children are still living with him, he has gone out to lap dancing bars and come home very drunk, doesn’t seem to matter. The fact that he has left the children in the house on their own, doesn’t seem to matter.
Apparently, he’s the “well” one with no mental or psychological problems and is a ”fit” parent, but I’m not.
Well, what do you all think? Are these things I’ve done appallingly bad? Am I misguided in thinking that I am a capable parent?
Let me know you’re honest thoughts and please do share your worst parenting stories or those of a friend - anonymously - and maybe a picture can emerge of what range of parenting misdemeanors are sufficient evidence of such bad parenting that the children should be taken away from a Bipolar parent…..
Phew! That was brave of me to share those things….
My children are telling me that their father is hitting/smacking them when they are with him. They tell me that this is happening around twice a week.
