Theodore Finch Essay

Introduction
Theodore Finch was the not-so-average high school bad-boy. What made him different? He unknowingly suffered from Bipolar Disorder (BD). His BD ran in the family--his father had symptoms but was never diagnosed--and was triggered, like most, by childhood trauma and abuse. He began to go through the manic and depressive episodes of BD at an early age, which he referred to as “The Awake” and “The Asleep”. Finch’s BD was left untreated, his dark thoughts left unfiltered, and when his last depressive episode occurred, he committed suicide. Many people with Bipolar Disorder begin showing symptoms at an early age after an emotional event has triggered an episode and, while the disease cannot be cured, there are many treatment options

available to help patients control their manic and depressive episodes. Unfortunately, suicide attempts are also common in BD, therefore, patients and their families should take precautionary measures, like counseling and medications to prevent these suicidal thoughts.
Symptoms of Bipolar Disorder
The National Institute of Mental Health defines Bipolar Disorder (BD) as a “manic-depressive illness...a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks”. People who suffer from bipolar disorder experience trouble sleeping, being easily agitated and participate in reckless activity when having a manic episode. However, they also experience the opposite end of the spectrum: sleeping too much, eating too much or too little, feeling empty, and thinking about death during a depressive episode. Contrary to popular belief, a manic episode in a person with bipolar disorder is not always a period of being “excessively happy”. Often times, these episodes involve the person feeling invincible, not needing sleep nor fearing dangerous things. The manic episodes, often at least 7 days long, are usually much shorter than the depressive episodes, which are at least 2 weeks long. BD can be triggered by a variety of factors, including chemical imbalances in the brain, hormonal imbalances, or some type of trauma, like abuse or death of a loved one. There has been research done on whether “some people with a genetic predisposition for bipolar disorder may not have noticeable symptoms until an environmental factor triggers a severe mood swing” (Medical News Today). Diagnosis for bipolar disorder is often difficult and many children and teenagers are often “diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems, which can make diagnosis more complicated” (Mayo clinic). In the novel All the Bright Places, Jennifer Niven writes from the point of view of a teenage boy that experiences periods where he feels “asleep” and “awake” and doesn’t know that he has bipolar disorder until his school counselor suggested the thought.
Suicide with BD
Throughout the book, Niven describes how the boy, Finch, doesn’t like to sleep or eat a lot, both of which are symptoms of BD, but he goes on long runs, often to other towns, and and even forces himself to attend a suicide support group. He is constantly afraid of “The Asleep”; once, when he takes too many sleeping pills, he goes to the hospital to have his stomach pumped before it’s too late, showing he really wants to live. He does everything he can to stop himself from slipping into a depressive episode, fearing he might not come out of it. Finch attempts to hold it off by sticking to routine and focusing on things that make him happy, which is recommended for patients with BD. Since Finch didn’t want to be “defined by his disorder” he refused to go to a doctor and receive medication, making his episodes more severe and suicidal thoughts harder to ignore. Finch eventually committed suicide a month into his last depressive episode. BD, along with depression, is most commonly associated with suicide; “at least 25% to 50% of patients with bipolar disorder...attempt suicide at least once” (NCBI) and “between 4% and 19% complete suicide” (Inder). The Australian & New Zealand Journal of Psychiatry also confirmed the “lifetime rate of suicide attempts for BD was 29.2% which is twice
the rate of those with unipolar depression”. Suicidal thoughts can increase in patients of BD with “Changing normal routine, including eating or sleeping patterns” and “Increasing use of alcohol or drugs” (Mayo Clinic). Suicide attempts are also more common in women and single or divorced people with BD (Schaffer). Since suicide attempts are common in BD, there are many methods of helping to prevent these thoughts, like regular counseling and medication. There is also a suicide hotline where people contemplating suicide can talk to a live representative any time. Lithium is considered the most effective drug for preventing suicide, but talking to loved ones and a doctor is also effective in alleviating dark thoughts.
Treatment
While there is currently no cure for BD, there is a variety of treatments that are available to decrease the effects.

The treatments aim to “minimize the frequency of manic and depressive episodes and to reduce the severity of symptoms” (Medical News Today); they are not meant to stop the episodes completely. The most common drug treatment is lithium carbonate, but anticonvulsants and antipsychotics are also often prescribed. Since Bipolar Disorder never really goes away, patients must continue treatment even when they feel fine. Stopping treatment presents a high risk of “a relapse of symptoms or having minor mood changes turn into full-blown mania or depression” (Mayo Clinic). Using medication in combination with Psychotherapy or “talk therapy” can also be effective. Versions of psychotherapy include family-focused therapy and interpersonal and social rhythm therapy. Electroconvulsive therapy (ECT) is also used for people with severe symptoms who haven’t shown improvement with medications or when “other medical conditions, improving pregnancy, make taking medications too risky” (NIMH). ECT is much safer than it was in the past and now “uses electric currents given in a controlled setting to achieve the most benefit with the fewest possible risks” (Mayo Clinic), but it still causes some short-term side effects, like memory loss and disorientation. Temporary hospitalization may be advised if the patient is considered dangerous, but patients can avoid severe symptoms by “keeping up a regular routine with a healthy diet, enough sleep, and regular exercise”

(MNT).
Conclusion
Bipolar Disorder has the potential to turn the patient’s life upside down, but with early diagnosis and a wide variety of treatment methods, the patient can be more in control than ever before. There are many early warning signs to watch out for, like reckless activity and decreased activity levels, that can help the person with BD to be diagnosed and treated early on. While suicidal thoughts are common and possibly unavoidable with BD, the suicide hotline, medical professionals, and trusted friends and family are always available for the patient and should be known to them. With treatment and a strong support system, Bipolar Disorder does not have to define the person with it.