Eagle County’s hidden illness
Originally, it was called an “artistic temperament.” In 1595, as the pope was about to honor him with a laurel crown for his epic poem, “Jerusalem Delivered”, Torquato Tasso died in St. Anne’s Hospital for the poor and lunatic.Starting at 19, when his first work was published in Venice, Tasso was accepted as the greatest poet of his time and lauded at every court in Italy, but he never seemed to be satisfied. When he first arrived in a place, his creative output would startle his hosts. His energy was boundless; his confidence extraordinary, but from one day to the next, his countenance would change, and suddenly he was despondent, angry, and ungrateful. Soon enough, he would leave, and the pattern would begin again.As the field of psychiatry developed, Tasso was retroactively diagnosed as “manic depressive,” a term that has since been phased out and replaced with “bipolar disorder.” The symptoms are suggested by its name. Sufferers vacillate from one emotional extreme to another, experiencing “manic” highs, periods in which they feel capable of anything, to the point of having delusions of grandeur, and then back across the spectrum to days of severe depression; the anguish they experience seems permanent. No solution presents itself. Sometimes, it ends in suicide.In a 2001 study on suicide (the ninth leading killer in the state), the Colorado Trust, a Denver-based nonprofit organization, found that, out of the 63 Colorado counties, Eagle County has the second highest percentage of residents with a psychiatric illness. One of those 13 “psychiatric illnesses” that the study refers to is bipolar disorder, and according to Colorado West Mental Health Center staff psychiatrist Dr. Robert Chalfant, the illness is widespread in Eagle County.Chalfant arrived from Tennessee six years ago to accept the unique position of being the only state-funded psychiatrist who services Eagle County (in fact, he’s the only state-funded psychiatrist for Summit, Lake and Grand counties as well), and soon realized that a disproportionate number of his patients were bipolar. At first, he thought he was doing something wrong.”There was a point when I became uncomfortable diagnosing someone as bipolar because I was doing it so much,” he says, “but then I realized there are just that many people here (with the illness).”Out of all the counties in Colorado, it may seem ironic that Eagle County has demonstrated such a propensity for bipolar disorder, but for Chalfant it makes sense.”Those are the folks that would pick up and go to the mountains,” he says. Like modern-day Tassos.The happy valley?Tim Sullivan, a practicing psychotherapist in Eagle County for the last nine years, says therapists from other places always ask him what he possibly has to treat in such an Eden-like valley. He believes that image contributes not only to the number of bipolar sufferers who escape here, but to the invisibility of the illness.”There’s a tendency in our community to over-focus on athletics as the marker of health,” he says, which not only obscures the importance of mental health, but can also cause a mental breakdown in the event of an injury. If skiing or biking is taken away from someone who defines himself by that activity, the resulting stress can be overwhelming.Like Chalfant, Sullivan hypothesizes that people with a secret mental illness, a debilitation that they don’t feel comfortable sharing, would want to come to a place that plays to their strengths, and in doing so, are perhaps cutting themselves off from the one resource that can save them: familial bonds.”There’s a lack of generational support here,” says Sullivan. “We may have our children but not our parents near us, or we’re out here alone.”Many bipolar sufferers cite the close connection to their family and friends as the one resource that kept their depressive episodes from staving off suicide, what author Susan Rose Blauner calls “a permanent solution to a temporary problem.” As Sullivan explains, when push comes to shove, casual friends are insufficient to the task.”Talking about mental illness is awkward,” he says. “It’s more difficult to share.”The problem, according to Chalfant, is that people don’t look at mental illness as a disease, like, say, diabetes something that needs to be regulated not only by the sufferer but also by the people surrounding them.Until that perception changes, he says, the mentally ill are in danger of consoling themselves other ways, for instance through drug and alcohol abuse. According to both Chalfant and Sullivan, that’s the worst behavior to add to bipolar disorder. Like stress, the use of mind-altering chemicals exposes the brain’s weaknesses and increases the severity of its extremes, and, according to Chalfant, “because this is a resort town, drug and alcohol abuse is widespread.”Peaks and valleysHolly Woods, as a new resident and a doctor in the health and behavorial sciences, has noticed all of these aspects of Eagle County the athletic bias, the isolation, the absence of family in her work studying suicide among local teenagers. But it’s her experience as a sufferer of bipolar disorder that causes her to understand their impact.Woods lived for 38 years before she was diagnosed, just thinking she “wasn’t normal.” Normal people don’t give birth to two children and move twice in the course of getting their doctorate, while simultaneously working a full-time job. Normal people don’t severely sprain their ankle falling off of a glacier and then climb Mount Rainier, elevation 14,410 feet, 13 days later (with a stomach ulcer as well). But Woods isn’t normal. No one is, she says; we’re all different, and for a long time, she believed what set her apart was her mania.The accomplishments of manic people are legendary. Ted Turner is bipolar and occasionally stops taking his lithium (the same medication Woods is on now), because he feels it deadens his creativity. The actress Carrie Fisher, most known for her portrayal of Princess Leia in the original Star Wars trilogy, is bipolar and wrote an autobiographical novel about it, “Postcards from the Edge”, that was adapted into a film with Meryl Streep. Now a respected writer and Hollywood script-doctor, Fisher credits her mania with many of her successes, but also notes that it led her into drug abuse. At one point, she was taking 30 percodans a day to “balance herself out.”This is the ironic aspect of bipolar disorder, “the one illness that can increase your socio-economic status,” says Chalfant, while simultaneously destroying you from the inside out.Woods says the people around her have always admired her accomplishments and wondered enviously “how she does it all.” We live in a society, she says, that promulgates mania, and therefore, there’s no push for its diagnosis. Woods herself continues to look back on her manic periods wistfully, even though the illness has come very close to killing her.”Not all of my previous life was bad,” she says. “I could think with such precision and efficiency I can’t push myself physically like I used to.”There are several works in literature that have dealt with this moral paradox, notably “Touched With Fire” by Kay Redfield Jamison and the play “Equus” by Peter Schafer. The former asserts that many artistic geniuses have been (and are) bipolar and questions the necessity to eradicate it; the latter questions the entire idea of “mentally ill” and wonders if passion isn’t more essential than sanity.Talking with Jodi Fleischman, 17, a peer counselor at Battle Mountain High School and one of the teenagers helping Woods research local suicide, it’s easy to understand why the superhuman achievements of bipolar people are idolized, envied, and forgiven.Besides being a peer counselor, Fleischman is an excellent student, a competitive volleyball player, a volunteer for various local organizations, and the president of her class, and yet she says she’s under tremendous stress to get accepted to the college of her choice.”They require so much,” she says. “You have to do something extravagant.”Her impersonal use of the word “they,” instead of “colleges,” seems unconsciously appropriate because it’s not just colleges that exhibit an undue amount of expectation.As Chalfant notes, bipolar disorder is half caused by neurological failings and half by environmental influences. Like a hemophiliac whose genetic disorder only becomes a problem when his skin is cut, a bipolar person is fine until the outside world introduces stressful influences. For Woods, those stresses include the welfare of her children, her physical health, and can even be something as small as someone honking at her in a roundabout. As she describes it, when stress begins to overtake a non-bipolar person, the brain releases neuro-transmitters to correct the imbalance in mood. Her brain, however, gets easily overrun, a condition which the medication, in combination with therapy, hopes to correct.Keeping in mind the importance of outside influence to mental health, it’s interesting to note that depression has doubled in the world’s population since World War II, and by 2020, according to the World Health Organization, it’s expected to be the second most debilitating disease after heart disease (it’s already ranked first among women). Woods believes this isn’t simply due to an increase in diagnosis; she thinks the world has changed. Indeed, in 1999, U.S. News and World Report announced that, with more than 18 million Americans suffering from depression at any one moment, we are entering an “Age of Melancholy.”Depression is, of course, different from bipolar disorder. People with a healthy functioning brain can experience depression under circumstances of duress without being bipolar, and so the numbers do not suggest that the frequency of people with bipolar disorder has increased. But, going back to the metaphor of a hemophiliac, they do suggest that the number of cuts the world is making into our psyches is increasing, therefore exposing more and more people with genetic dispositions to the illness, and perhaps, increasing the severity of the extremes.The cost of sanity”Treatment,” says Woods, “is an art, not a science.”If so, Eagle County is lacking in affordable artists. Though bipolar doesn’t discriminate based on economic status, mental illness is extremely expensive to control. Even Chalfant, who explains that Colorado West charges on a sliding scale for therapy, characterizes his price as “high.” Medications are not cheap, and the problem, unlike a broken leg, does not necessarily get better over time. Add these realities to the fact that workman’s comp does not cover mental illness, along with certain insurance plans, and the options for the working class poor are severely limited, he says.The current economic climate is not helping. On Jan. 16, 1,000 people rallied near the state Capitol in Denver to protest cuts to mental health coverage that Gov. Bill Owens is proposing (the exact figure isn’t known, but $14.5 million is the one most discussed). These cuts would be on top of the 4 percent cut to every state department that he ordered last year.Chalfant says that the demand in Eagle County could support a full-time psychiatrist (he’s here only on Tuesdays), but the money just isn’t there, which either makes Eagle County one of the most passionate places in Colorado, or one of the most dangerous.Perhaps both.