SATURDAY, Feb. 1, 2003 (HealthDayNews) -- On the eve of the biggest game of his life, pro football player Barret Robbins apparently suffered an emotional meltdown.
The All-Pro center for the Oakland Raiders was suspended from the team just prior to last Sunday's Super Bowl, after missing a team meeting and a final practice the day before the game.
The 6-foot, 3-inch, 320-pound lineman, who has a history of depression and bipolar disorder, had apparently stopped taking his medication. In published reports, he had once described his struggle with mental illness as "a battle within your head. It's not an easy thing to deal with."
How common is a decision like Robbins' to stop taking necessary medication at just the wrong time?
Too common, say mental health professionals, adding that much remains to be learned about bipolar disorder, a disease that affects an estimated 2 million American adults.
"This is the fourth National Football League player [with bipolar disorder] who this has happened to," says Xavier Amador, a Columbia University psychologist and author of I'm Not Sick, I Don't Need Help, a book about bi-polar disorder.
"These players get medication but don't get psychotherapy and education to help them get more understanding of their illness," says Amador, who has worked with other pro football players with bi-polar disorder.
Another obstacle confronting many people with the disease, he adds, is that they don't think they're ill.
This means they'll take drugs until they feel better, and then they stop, which is most likely what happened to Robbins, Amador says.
"Non-compliance [with drug therapy] is a big issue, especially for people with bi-polar disorder, because with medication it's not just not feeling depressed, but also not feeling so high," says Matthew Silvan, a psychology professor at Columbia University.
Bi-polar disorder is characterized by intense mood swings, from feeling worthless and depressed to feeling irrationally powerful and competent, Silvan says. And the pleasure of the high feeling is often "sufficiently enticing that people don't want to give it up," so they give up their medication instead, Silvan says.
That decision can lead to devastating consequences.
According to a report in the San Francisco Chronicle, a man who claimed he was among a group with Robbins the day before the Super Bowl said the player became despondent and suicidal after drinking heavily.
"He was crying and totally depressed about his life and the pressure he was under,'' said Cartier Dise, the owner of a car customizing business popular with some Raiders players.
"This guy was messed up. All he could think about was his family, his two daughters. He was talking about killing himself, saying he was disappointing people and he had a lot of people to support financially and he was letting them all down,'' the Chronicle quoted Dise as saying.
Silvan says, "This is just speculation, but if you are depressed and see yourself as worthless, you might find the presence of millions of people staring at you too much."
Bob Carolla is a spokesman for the National Alliance for the Mentally Ill. He also has bi-polar disorder.
"Stress, pressure and anxiety can aggravate the underlying illness of bi-polar disorder," Carolla says.
Those with the illness can respond to stress in several ways, he says.
People with bipolar disorder must take a virtual cocktail of different
medications, including mood stabilizers, anti-depressants and drugs that treat the side effects of those drugs. Under stress, however, remembering to take all the pills in the proper doses at the proper times of day can seem an insurmountable task, Carolla says.
"People can get frustrated and the temptation is to say, 'To hell with it,' and stop the medicine. Or they just lose track and may skip dosages," he says.
What they need, he says, is the people around them to know about their illness and be alert to the symptoms. That way they can help if the patient stops his or her medication, becomes restless, or acts in inappropriate ways.
More understanding of the disease is also crucial, Amador says.
"Bi-polar disorder is a lifelong illness, rather than just a brief episode of illness, which is a hard pill to swallow," he says. "People need psychotherapy."
More information
A description of the various medications available for treatment of mental illness can be found at the National Institute of Mental Health. To learn more about bipolar disorder, visit this NIMH site.
