Bipolar disorder, or manic-depression - a fatal illness?

[Huckleman2000]

Today's tragic shooting of an airline passenger, alledgedly with bipolar disorder, raises frightening issues for those of us with mental illnesses. The passenger had, apparently, gone without medication for an extended period. His behavior was alledgedly threatening enough that air-marshalls onboard the aircraft shot and killed him in the jetway.

I have been diagnosed, at various times, with Dysthymic Disorder, Major Unipolar Depression, Anxiety, and Atypical Depression. The last, in particular, has many similarities in treatment regimen to Bipolar Disorder. The main similarity is the addition of medication that directly affects mood - in most cases, stabilizing it. For Atypicals, the goal is to keep the bottom from dropping out. For Bipolars, the goal is to keep mood within a 'normal' range. I have not, however, experienced the "mania" or manic episodes that characterize Bipolar Disorder, so I can't really speak to that experience.

I've experienced exceedingly bizarre behavior in a diabetic co-worker, who became hypoglycemic and ran through the lunch room, pretending to throw a football to himself and catching it in a graceful leap at the other end of the room. He then left the office and picked a fight with the building superintendent, who called authorities. They took him to the hospital, where he recovered rapidly with an IV. Another diabetic co-worker (we did not know the first one was diabetic) immediately recognized the symptoms, in retrospect, but found it very strange that a diabetic would allow himself to get to that level of imbalance. This second diabetic would carry sugar packets with him, or drink orange juice, or ingest other things as needed when work or other occasions disrupted his regular eating schedule.

I mention the diabetic episode mainly to give an example of a non-mental illness that nonetheless effects behavior in odd ways.

I don't know how I feel about this. I don't think I know enough about today's circumstances to make any judgement; yet, I know enough to realize that I can readily imagine today's circumstances as a not-too infrequent situation, at some level of public disruption. Not every bipolar who is out-of-sorts is going to run around talking about a bomb, but some degree of freaking-out is probably a fairly regular occurance.

I don't know.

 

[shereads]

Huck, I know people who get along quite well on medication and others who suffer looking for one that works for them. I only know of one person - the son of an old friend - whose bi-polar disorder causes him to refuse the medication that keeps him well and his family safe. He's also the only one I know whose symptoms include paranoia and threats of violence.

The boy's mother is also bi-polar, takes medication, and holds down a job as a nurse.

I don't know very much about bi-polar disorder, other than that there are degrees of seriousness, and degrees of responsiveness to treatment, as with other illnesses. If you're well enough to be concerned about your own mental state, and if you're seeking rather than rejecting treatment, I don't think you should worry that you're in the same league with that poor man. If you have family or friends who beg you to accept treatment, and are afraid of you - or afraid for you - that's a different story. But if that were the case, you would probably not be well enough to make a connection between this tragedy and your own illness.

As the saying goes, knowing you're crazy is a sign of sanity. Which makes me one of the sanest people I know.

Today's tragic shooting of an airline passenger, alledgedly with bipolar disorder, raises frightening issues for those of us with mental illnesses. The passenger had, apparently, gone without medication for an extended period. His behavior was alledgedly threatening enough that air-marshalls onboard the aircraft shot and killed him in the jetway.

I have been diagnosed, at various times, with Dysthymic Disorder, Major Unipolar Depression, Anxiety, and Atypical Depression. The last, in particular, has many similarities in treatment regimen to Bipolar Disorder. The main similarity is the addition of medication that directly affects mood - in most cases, stabilizing it. For Atypicals, the goal is to keep the bottom from dropping out. For Bipolars, the goal is to keep mood within a 'normal' range. I have not, however, experienced the "mania" or manic episodes that characterize Bipolar Disorder, so I can't really speak to that experience.

I've experienced exceedingly bizarre behavior in a diabetic co-worker, who became hypoglycemic and ran through the lunch room, pretending to throw a football to himself and catching it in a graceful leap at the other end of the room. He then left the office and picked a fight with the building superintendent, who called authorities. They took him to the hospital, where he recovered rapidly with an IV. Another diabetic co-worker (we did not know the first one was diabetic) immediately recognized the symptoms, in retrospect, but found it very strange that a diabetic would allow himself to get to that level of imbalance. This second diabetic would carry sugar packets with him, or drink orange juice, or ingest other things as needed when work or other occasions disrupted his regular eating schedule.

I mention the diabetic episode mainly to give an example of a non-mental illness that nonetheless effects behavior in odd ways.

I don't know how I feel about this. I don't think I know enough about today's circumstances to make any judgement; yet, I know enough to realize that I can readily imagine today's circumstances as a not-too infrequent situation, at some level of public disruption. Not every bipolar who is out-of-sorts is going to run around talking about a bomb, but some degree of freaking-out is probably a fairly regular occurance.

I don't know.

 

[zeb1094]

In retrospect it is a sad tragedy that is regretable to say the least. I am also sure that the Air Marshal is feeling even worse than we could possibly imagine. But try putting yourself in the place of those passengers on the plane or in the jetway. What would you have a law enforcement officer of the caliber of the Air Marshals service do with an immenant threat that he has to assume is real in this day and age.

I feel sorry that the man had to die, it is very sad.

I now feel sorry for the poor Air Marshal who will have to live with the fact that he was compelled to to kill someone who was no real threat, in retrospect.

 

[Stella_Omega]

Sadly, yes- Bipolar syndromes can very often be fatal. And sometimes, to someone other than the sufferer...
It is horrible and horrifying to have to stand by and watch when you can do nothing to save or stop someone's mad spiral. Horrible.

 

[LadyJeanne]

I think the climate of fear around terrorism has certainly made it easier for tragic mistakes like this one to be made. Our society has never been particularly comfortable with mental illness to begin with or kind to those who suffer from it. Add vigilance against terrorism, and all erratic behavior becomes suspect, especially in airports and on planes.

Air travel is very scary these days, and not so much due to actual terrorists. Every time I go through security, I continually have to remind myself not to make a scene when the TSA people get too offensive. And after a too-intimate-for-comfort leg pat-down complete with ankle fondling in Chicago, as well as a near-strip search in San Francisco, I no longer wear boots or underwire bras when flying. Guilty until proven innocent is the prevalent attitude, and no apology is forthcoming when you are proven innocent.

 

[shereads]

And after a too-intimate-for-comfort leg pat-down complete with ankle fondling in Chicago, as well as a near-strip search in San Francisco, I no longer wear boots or underwire bras when flying. Guilty until proven innocent is the prevalent attitude, and no apology is forthcoming when you are proven innocent.

No, but there might be one if you file a complaint with the FAA. They don't expect you to keep quiet about sexual abuse disguised as a security search. You and the agent both know the difference between a pat-down and copping a feel; it's part of their training.

 

[LadyJeanne]

No, but there might be one if you file a complaint with the FAA. They don't expect you to keep quiet about sexual abuse disguised as a security search. You and the agent both know the difference between a pat-down and copping a feel; it's part of their training.

I was too stunned, flustered, embarrassed, outraged, what-have-you to jot down names and badge numbers at the time. I just wanted to get away from those people and catch my plane. That it was done in the midst of crowded airports with other TSA people looking on, however, just made it that much more shocking. My brain shut down.

Fortunately, it wasn't long after those incidents that they made it a rule that a female TSA must do the screening for females and male TSAs for males. It's still a stressful process, but hasn't been sexually abusive since then. Not to me, anyway.

 

[rgraham666]

Sadly, yes- Bipolar syndromes can very often be fatal. And sometimes, to someone other than the sufferer...
It is horrible and horrifying to have to stand by and watch when you can do nothing to save or stop someone's mad spiral. Horrible.

Almost all mental illnesses are fatal sooner or later to someone.

And watching isn't fun. But being caught inside the spiral is Hell on earth. It happened to me.

 

[kendo1]

And if the guy did have a bomb?

I'm more sorry for the air marshall.

 

[Kate.E]

From what I gathered in news reports - he said he had a bomb, was challenged about it, then said it again. He'd been called out by the gun-carrying guys who acted upon the safety of the passengers.

If someone shouts, 'Ive got a bomb' on a plane, the last thing going on in said Marshall's mind (one would imagine) is whether the dude has bipolar syndrome. What if it was a real bomb? Ok, it would only have been Americans, but they still count.

 

[zeb1094]

From what I gathered in news reports - he said he had a bomb, was challenged about it, then said it again. He'd been called out by the gun-carrying guys who acted upon the safety of the passengers.

If someone shouts, 'Ive got a bomb' on a plane, the last thing going on in said Marshall's mind (one would imagine) is whether the dude has bipolar syndrome. What if it was a real bomb? Ok, it would only have been Americans, but they still count.

Gee thanks Kate.

 

[cloudy]

From what I gathered in news reports - he said he had a bomb, was challenged about it, then said it again. He'd been called out by the gun-carrying guys who acted upon the safety of the passengers.

If someone shouts, 'Ive got a bomb' on a plane, the last thing going on in said Marshall's mind (one would imagine) is whether the dude has bipolar syndrome. What if it was a real bomb? Ok, it would only have been Americans, but they still count.

I suppose his wife screaming, over and over again, "He's bi-polar, and off his meds!" doesn't make any difference, huh?

 

[zeb1094]

I suppose his wife screaming, over and over again, "He's bi-polar, and off his meds!" doesn't make any difference, huh?

Well...What if she was in it with him, suicide bomber have been known to travel in pairs. If you where there would you want the only person(s) that would be able to save you from death by explosion to hesitate? I know I wouldn't. It is easy to think about things to do other than what happened after it's all over and all the infomation is in. All the information that wasn't available at the time. A split second decision had to be made. I feel sorry for everyone involved, but I especially feel sorry for the Air Marshal.

 

[cloudy]

Well...What if she was in it with him, suicide bomber have been known to travel in pairs. If you where there would you want the only person(s) that would be able to save you from death by explosion to hesitate? I know I wouldn't. It is easy to think about things to do other than what happened after it's all over and all the infomation is in. All the information that wasn't available at the time. A split second decision had to be made. I feel sorry for everyone involved, but I especially feel sorry for the Air Marshal.

I feel bad for him, sure, but his spouse isn't dead.

 

[zeb1094]

I feel bad for him, sure, but his spouse isn't dead.

No, but now that he knows what he knows ( that the man really was bi-polar ) he will carry the knowledge with him the rest of his life, a hard thing to carry around inside your mind.

 

[Stella_Omega]

We seem to have a hard time accepting that some things are fatal.

Cancer is often fatal. Driving while drunk is often fatal.

Screaming "I have a bomb" while on a plane- may very well be fatal.

That should be accepted as a fact of life by now.

 

[Huckleman2000]

I don't know very much about bi-polar disorder, other than that there are degrees of seriousness, and degrees of responsiveness to treatment, as with other illnesses. If you're well enough to be concerned about your own mental state, and if you're seeking rather than rejecting treatment, I don't think you should worry that you're in the same league with that poor man. If you have family or friends who beg you to accept treatment, and are afraid of you - or afraid for you - that's a different story. But if that were the case, you would probably not be well enough to make a connection between this tragedy and your own illness. ...

Thanks for the kind words, Shereads!

I'm not too concerned about my own mental illness going the direction that this poor man's did, though. I think it's more of the nature that I'm no danger to anyone but myself, and I've got that bit of it under control.

My concern was more for what this says about the times we live in. Our fear is constantly stoked by the government and the media, often irrationally. I mean, you're more likely to get hit by lightning than killed by a terrorist.

Still, lighting doesn't exactly go running down the hallway of a crowded plane threatening everyone before it strikes. I don't think I've ever heard of a terrorist doing that either, though. Maybe no one has survived those instances where it happened like that. Like the guy in the London subway, this man had darker skin and black hair and carried a backpack, and he didn't respond to the air marshalls' commands. And they aren't trained to shoot to wound in that situation, probalby so that a wounded terrorist couldn't still detonate a bomb.

It's difficult to fault the air marshall given the circumstances as we know them; I guess the lesson is, if you're going to freak out, it better not be on a plane. Five years ago, though, this would have just been a weird story, and no one would be dead.

 

[BlackShanglan]

I suppose his wife screaming, over and over again, "He's bi-polar, and off his meds!" doesn't make any difference, huh?

It's a little tricky to piece together from the news reports, but it seems that she was inside the plane and he was in the jetway when he was killed. Given that the attention of the air marshals was likely focused on the man running up the aisle yelling that he had a bomb, and that they may have been a considerable distance from the wife, it seems at least possible that they might not have heard her.

Shanglan

 

[Huckleman2000]

It's a little tricky to piece together from the news reports, but it seems that she was inside the plane and he was in the jetway when he was killed. Given that the attention of the air marshals was likely focused on the man running up the aisle yelling that he had a bomb, and that they may have been a considerable distance from the wife, it seems at least possible that they might not have heard her.

Shanglan

Y'know, Shang, sometimes you take the makings of a really good disagreement, and just deflate them.

I love you, in that anonymous Internet sort of way, but you can be such a putz!

 

[BlackShanglan]

Y'know, Shang, sometimes you take the makings of a really good disagreement, and just deflate them.

I love you, in that anonymous Internet sort of way, but you can be such a putz!

So sorry. Pray do pretend I never posted.

 

[Huckleman2000]

So sorry. Pray do pretend I never posted.

Oh, I can't take it that far!
And moderating influences are far too rare, particularly those who express themselves with such clarity and dignity.
Would it be strange to say that someday, I'd like to ride you and give you free rein? I'm sure there would be a line for that.

 

[cloudy]

from MSN:

Passengers: Shot suspect mentioned no ‘bomb’
Federal agents say man made threat on jetway before he was shot to death

The airline passenger shot to death by federal marshals who said he made a bomb threat was agitated even before boarding and later appeared to be desperate to get off the plane, some fellow travelers said.

One passenger said he "absolutely never heard the word 'bomb' at all" during the uproar as the Orlando-bound flight prepared to leave Miami on Wednesday.

Federal officials say Rigoberto Alpizar made the threat in the jetway, after running up the plane's aisle from his seat at the back of the jetliner.

They opened fire because the 44-year-old Home Depot employee ignored their orders to stop, reached into his backpack and said he had a bomb, according to authorities.

Alpizar's brother, speaking from Costa Rica, said he would never believe the shooting was necessary.

"I can't conceive that the marshals wouldn't be able to overpower an unarmed, single man, especially knowing he had already cleared every security check," Carlos Alpizar told The Orlando Sentinel.

Some passengers said they noticed Alpizar while waiting to get on the plane. They said he was singing "Go Down Moses" as his wife tried to calm him.

Others said they saw him having lunch and described him as restless and anxious, but not dangerous.

"The wife was telling him, 'Calm down. Let other people get on the plane. It will be all right,'" said Alan Tirpak, a passenger.

Passengers saw no threat

Some passengers, including John McAlhany, said they believe Alpizar was no threat to anyone.

McAlhany, a 44-year-old construction worker who was returning home from a fishing trip in Key West, said he was sitting in Seat 21C when he noticed a commotion a few rows back.

"I heard him saying to his wife, 'I've got to get off the plane,'" McAlhany said. "He bumped me, bumped a couple of stewardesses. He just wanted to get off the plane."

Alpizar ran up the aisle into the first-class cabin, where marshals chased him onto the jetway, McAlhany said. McAlhany said he "absolutely never heard the word 'bomb' at all."

"The first time I heard the word 'bomb' was when I was interviewed by the FBI," McAlhany said. "They kept asking if I heard him say the B-word. And I said, 'What is the B-word?' And they were like, 'Bomb.' I said no. They said, 'Are you sure?' And I am."

Added another passenger, Mary Gardner: "I did not hear him say that he had a bomb."

Officials say there was no bomb and they found no connection to terrorism.

Witnesses said Alpizar's wife, Anne Buechner, had frantically tried to explain he was bipolar, a mental illness also known as manic-depression, and was off his medication.

The National Alliance on Mental Illness called on the Air Marshal Service and other law enforcement agencies to train officers if they don't already in responding to people with severe mental illness.

Others said Alpizar's mental health didn't matter while marshals were trying to talk to him and determine if the threat was real.

Federal agents shoot to kill

Shooting to maim or injure — rather than kill — is not an option for federal agents, said John Amat, national operations vice president of the Federal Law Enforcement Officers Association, which includes air marshals in its membership.

"The person was screaming, saying he would blow up the plane, reaching into his bag — they had to react," Amat said.

"The bottom line is, we're trained to shoot to stop the threat," said Amat, who is also a deputy with the U.S. Marshals Service in Miami.

"Hollywood has this perception that we are such marksmen we can shoot an arm or leg with accuracy. We can't. These guys were in a very tense situation. In their minds they had to believe this person was an imminent threat to themselves or the people on the plane."

White House stance

White House spokesman Scott McClellan said the two air marshals appeared to have acted properly when they shot to kill.

Both air marshals were hired in 2002 from other federal law enforcement agencies and were placed on administrative leave, said Brian Doyle, spokesman for the U.S. Department of Homeland Security.

Miami-Dade Police were investigating and the medical examiner's office was performing an autopsy on Alpizar, who was from Costa Rica but became a U.S. citizen years ago.

He lived in Maitland, an Orlando suburb.

Neighbors said the couple had been returning to their home from a missionary trip to Ecuador.

Buechner works for the Council on Quality and Leadership based in Towson, Md., a nonprofit organization focused on improving life for people with disabilities and mental illness, the organization said in a statement.

David Stempler, president of the Air Travelers Association, said he thinks the shooting may prove more "reassuring than disturbing" to the traveling public his organization represents.

"This is a reminder they are there and are protecting the passengers and that it is a seriously deadly business," he said.

Armed police boarded the aircraft after the shooting, with some passengers in hysterics.

McAlhany said he remembers having a shotgun pressed into his head by one officer, and hearing cries and screams from many passengers aboard the aircraft after the shooting in the jetway.

"This was wrong," McAlhany said. "This man should be with his family for Christmas. Now he's dead."

 

[Huckleman2000]

from MSN:

Passengers: Shot suspect mentioned no ‘bomb’

Thanks, Cloudy.

This is what I feared.
A man is dead, his main crime being an unmedicated illness.
Worse, an unmedicated mental illness.
There are a hell of a lot more people out there with unmedicated mental illness than there are terrorists.

Does anyone know what 'maintainance drugs' are standard in a serious first-aid kit? I imaging Insulin is one; maybe some blood-thinning meds. Any psychiatric meds?

 

[TheEarl]

We had this in England a little while ago with the shooting dead of Jean Charles de Menezes, who was basically the victim of an almighty cock up with the police, a mistaken identity, poor procedure, etc.

People did talk about "Why couldn't the policemen have overpowered him or arrested him?" as the family member in Cloudy's article did.

The answer is simple: the evidence may have been erroneous, but they believed that he had a bomb on him. A bomb can be triggered by any motion. A thumb on a button is a milisecond. I've heard of triggers that can be activated by biting down hard. There is no way that you can stop a live suicide bomber and, if you believe he has a bomb and is willing to use it, then you can do nothing but shoot him dead.

It's a split-second action and, if you believe a bomb is present, then you have no choice.

I am sorry for both of the innocent victims, but given the circumstances of each case and the knowledge which the officers had, there was no other action open to them.

The Earl

 

[rgraham666]

Any day now, a bomb is going to be wired to a heart monitor.

The heart stops and the bomb goes off.

On the subject at hand, many stories have no happy ending.