Surviving Heat Waves with Bipolar Disorder

Did you know that more people are murdered at 92 degrees Fahrenheit than any other temperature? I read an article once. Lower temperatures, people are easy-going, over 92 and it's too hot to move, but just 92, people get irritable.

That's what the sheriff said in an opening scene of It Came from Outer Space. Set in Arizona -- even in black and white, you could feel the heat rolling off the sand. And throughout the movie, they attributed people's reports of strange sightings to heat-induced lunacy.

As I read that quote from 1953, I think -- 92, if only!

Everybody is irritable right now in -- how shall we put this? -- the coolest summer we will experience for the rest of our lives. Everybody is exhausted. But some of us more than others.


The health department reminds us to check in on the old folks, to remember the pets. The newspaper reports on the location of cooling stations for the homeless. But it falls to us loonies to remind each other to watch out for fellow loonies.

The DSM doesn't mention it, no doctor ever responded with a simple acknowledgment when I brought it up, but part of bipolar is difficulty with temperature regulation.

Makes sense, doesn't it? There's more to bipolar disorder than up and down, more than happy and sad. It's about balance, or rather, lack thereof. Our brains are not good at maintaining homeostasis. Translation: they can't adjust to changing conditions for a whole range of normally fluctuating levels (hormones, blood pressure, appetite, energy, and yes, temperature).

Natasha Tracy's article in reports on meta-analyses of studies on the effects of heat on people with mental illness. More people are murdered, the sheriff said? It turns out that suicides go up in high heat. Wow. 

Here is one such study that showed a link between the temperature outside and hospitalizations for bipolar.

Let's layer on, like an ugly sweater, the effect of medications that many of us loonies take. Anticholinergic drugs, tricyclic antidepressants and antipsychotics among them, decrease the production of sweat. There goes our number one cooling mechanism offline.

What about lithium? Anyone who takes it has been warned about the dangers of lithium in hot weather. Lithium is a salt, with a narrow range of acceptable blood levels. So if you do sweat and become dehydrated, you risk becoming toxic.

Well, weigh lithium's toxicity against its protection against suicide. It may still be your best choice.

What to do? What to do?



Catch heat exhaustion in its earliest stages, with light-headedness, fatigue, dizziness, nausea, muscle cramping. Move to an air conditioned place, remove extra clothing, take a shower or cover yourself with a wet towel, lie down, drink fluids -- the kind that do not have alcohol in them!

Heat stroke, what you get when you don't pay attention, is a life threatening condition. Once you get there, with headache, confusion, no sweating, rapid heart rate, hot red dry skin, nausea or vomiting, loss of consciousness, you are likely unable to notice the problem, let alone get yourself the help you need. But if you notice somebody else with heat stroke, call 911 -- yes, this is a medical emergency -- use the shower or wet towel trick, and do NOT give fluids.

Even better, try PREVENTION!

With the outside temp at 104 and still rising today, as I write this, I am sitting inside my house, which is well-insulated and holding at 84, but has no air conditioning. I have a wet towel around my neck. I have another wet towel under my bare feet, doubled over, with ice cubes between the layers. I have a glass of water next to me, with no ice, because tepid water is better at cooling than iced, for some reason. I will be leaving shortly to spend the night with my in laws. They do have AC.


Public libraries, movies, grocery stores -- a few more ideas. If you don't have AC, now would also be a good time to avoid alcohol, which is dehydrating.

Take care, dear readers, and check up on your loonie neighbors!

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