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What does bipolar disorder look like? This photographer will tell you.

Bipolar disorder affects over 5 million Americans, but actually living with it is a story in and of itself.

What does bipolar disorder look like? This photographer will tell you.

A few months after Danielle Hark had her first child, she fell into a deep depression.

Photo from Danielle Hark, used with permission.

Danielle is a professional photographer and writer. While everyone gets bad moods sometimes, this was different. It wasn't just a bad day or even a bad week. For two years, it felt like a weighted blanket had fallen over her. She had to fight that weight every day. Even simple things like getting out of bed or walking the dog required extra effort.


Meanwhile, her brain was whispering that she was a burden to the people around her. She pushed people away — friends, family, even her husband — not out of disaffection, but out of a misguided desire to save them from having to deal with her.

Eventually Danielle went to a doctor to try to get help overcoming this depression. They had a different diagnosis though: bipolar disorder.

We all have things we have to carry, and mental illness wasn't new to Danielle. She had been diagnosed with depression and anxiety in college. Still, bipolar disorder ... that felt like too much to accept.

"I pushed against it at first," said Danielle. She pictured bipolar people as violent or unstable. "I was like, no, that's not me."

But when Danielle looked closer, the diagnosis perfectly matched her symptoms.

For some of us, "bipolar" probably conjures up images of Two-Face, the half-scarred Batman villain, whose mood can change on a coin flip. But the disorder actually looks a lot more human. Imagine someone suffering from clinical depression, except, every so often, their brain decides to throw an extra wrench into the works.

That wrench is mania. Mania is like the weird, upside-down cousin of depression and it can cause someone to feel jumpy or energetic. Some people feel overly irritable or prone to risky behavior, while others might get a rush of creative ideas.

Danielle will sometimes combine lights and clocks with long exposures to create light paintings like this one. Photo from Danielle Hark, used with permission.

As it turns out, that actually fit with Danielle's experience. Danielle said there were periods, especially when she was younger, that she'd find herself barely able to sleep. Instead, she'd pace around the house, feeling revved up and bombarded by ideas. During those times, she'd be compelled to take pictures, thousands of pictures — not stopping until the camera's SD card ran out. To her doctor, that sounded exactly like a manic episode.

Bipolar disorder sucks, plain and simple. And Danielle isn't alone in having to deal with it.

About 5.7 million Americans have some form of bipolar disorder, sometimes known as manic-depressive disorder.

It affects all races, classes, and genders in equal numbers, though there are actually a few different forms of the disorder. Some people get faster cycles, for example, or might get a milder version of mania called hypomania. Age-wise, it often appears in a person's mid-twenties, but can strike at any point in a person's life.

As for how and why it happens, medicine is starting to figure out both, but slowly.

Photo from Danielle Hark, used with permission.

Research suggests that bipolar might happen when there are changes in how a person's brain processes chemical signals between cells or when there are subtle changes in the wiring between brain regions.

Genetics isn't destiny ... there still needs to be some event or stress in a person's life to trigger the disorder.

As for why it happens? We do know it's at least partly genetic. We've known for more than a hundred years that bipolar disorder can run in families. Today, more than 80 genes have been identified that might contribute to someone's risk level.

This might seem like good news, scientifically, but for a mom like Danielle, it added a whole new layer of stress.

"Many people think that people with bipolar disorder shouldn't have children," said Danielle.

That said, genetics isn't destiny. There have been cases of identical twins, for instance, where one had it but the other didn't. Science suggests that some people who carry the genes may even have special changes in their brain's wiring to help avert the illness.

Experts think that while genes are a major contributor, there still needs to be some event or stress in a person's life to trigger the disorder.

Bipolar disorder is chronic, which means, unfortunately, most folks have to come to terms with it being part of their lives forever.

"The real struggle for me was accepting that I have bipolar disorder and accepting that that’s just a small piece of who I am," said Danielle. It's something she has to live with, but it doesn't take away from her identity as a photographer, or a mom, or a wife.

Photo by Danielle Hark, used with permission.

She says that she sees now that the diagnoses aren't meant to be labels, they're meant to be treatment plans. And medications, like lithium and antidepressants, can help, as can doing things like pinpointing and avoiding triggers or stresses and avoiding drugs or alcohol. Certain therapies, like dialectical behavioral therapy, can work too.

Danielle says she's actually found her photography work to be helpful as well. When she's stuck chasing intrusive thoughts, looking through a camera lens helps her focus on what's directly in front of her, breathe, and come back to the present moment.

Photo by Danielle Hark, used with permission.

Thanks to these techniques, Danielle's learned how to not only weather both the manic and depressive episodes, but head them off before they begin.

This is a story about bipolar, but it's also a story about humanity because we all have heavy things to carry.

Sometimes they're external, but sometimes they're internal too — like a brain that just decides to go a bit haywire. And the truth is, bipolar disorder is tough. It sucks. It's a difficult hand that's dealt to a lot of people who don't deserve it.

I wish this is something we could cure right now, but we can't — we can manage, but not cure. As research goes forward, though, we're continually getting better at understanding where it comes from and how to deal with it.

But for now, for this moment, what can we do? We can respect each other's loads.

We can try to practice a little empathy by listening to the stories of people like Danielle. We can help out where we're able. And, hopefully, we can all find a way to carry our own things just a little more lightly.

This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

Keep Reading Show less

This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

Keep Reading Show less
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Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."