Listen to God

 

And to Adam He said, “Because you have listened to the voice of your wife and have eaten from the tree about which I commanded you, saying, ‘You shall not eat of it,’

Cursed is the ground on account of you;
    in hard labor you will eat of it
    all the days of your life.
 Thorns and thistles it will bring forth for you,
    and you will eat the plants of the field.
 By the sweat of your face
    you will eat bread
until you return to the ground,
    because out of it you were taken;
for you are dust,
    and to dust you will return” – Genesis 3:17-19

I’m sure many of us have listened to someone against our better judgment and regretted it.  Adam listened to Eve who encouraged him to eat the fruit which both of them were forbidden to eat.  God had told them that if they ate it they would surely die.  There were no ifs, ands or buts.  The consequences for disobeying Him would cost them their lives and more.

Adam knew where Eve got the fruit from.  She had taken a bit and was giving it to him.  She must have told him what the serpent had said.  And the fact that she was still alive may have persuaded Adam that eating the fruit was not a bad thing to do.  God had said that they would die if they ate it but Eve wasn’t dead.  She was there before him, her eyes sparkling and her face flushed.  She looked more beautiful than he had ever seen her.  The serpent must be right.  There was no harm in eating the fruit.  So, he took it from her and ate it.  The moment he tasted the fruit, things changed.

Why do we tend to listen to other people instead of God?  His Word is there to guide us, to keep us safe yet we tend to listen to and follow bad advice.  And we place our love for our spouses and children above our love to God.  The Bible says, “If you love Me, keep My commandments.”  We show God we love Him when we obey Him even when we are pressured or tempted to do otherwise.  Our loved ones may try to get us to do something that is contrary to God’s will but we have a choice to make.  We can choose to listen to God or listen to them.  No one can force us to do anything.  Eve didn’t force Adam to disobey God.  He chose to do so.  And the consequences of that choice were far-reaching and as a result sin, suffering, death came into the world and their relationship with God and each other changed.  The family dynamics changed.  The husband became the head of the home and the wife was to be subject to him.  Childbirth was not meant to be a painful experience but it is and working for a living was not supposed to be hard but it is.  And we were not supposed to experience death but we all will.  Our choices can affect not only us but others too.  God knew what tragedies disobedience would bring to Adam and Eve and the world if they didn’t listen to Him.

Today, choose to listen to God.  Don’t let anyone persuade you to do anything that would draw you away from God.  Let your spiritual walk be such that when God comes looking for you and calls out, “Where are you?” you can show yourself and say, “Here I am, Lord.”

 

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18 Million Street Children

Imagine that you are discarded, abandoned and abused.  You are forced to beg or turn to drugs.  Imagine being separated from your family.  And if you are a girl, imagine being abandoned by your parents.

These are the sad realities for millions of children in Asia.  They live in the streets where they are vulnerable or fall prey to kidnappers who sell them into bonded labor and the sex trade.  Those who manage to avoid the kidnappers fall into gangs, drugs and alcoholism.  Distrust and pain are their constant companions.  Everyday is a struggle to survive.

I encourage you to watch this video which will help you to better understand the plight of these children and what is being done by Gospel for Asia to change their circumstances and bring them hope.

You can offer these children a safe haven by supporting Gospel for Asia who has a home for runaway and abandoned children.  You can partner with the ministry so it can continue to develop programs to help these children.  You can change their lives forever.  Through your generosity and compassion, you can show them that there is a God who loves them and has not abandoned them.

When my father and my mother forsake me, then the LORD will take me up – Psalm 27:10

Source:  Gospel for Asia

Street Children

Leave your fatherless children, I will preserve them alive – Jeremiah 49:11

Usually before I retire for the night, I check on my son.  I make sure he’s nicely tugged in.   He has a home.  He has his own room.   He doesn’t have to take the bus to school.  His Dad drives him there.  He doesn’t have to worry about anything.  He is well cared for.  In fact, he has a lot to be thankful for.  He is living a life of luxury compared to other children.  There are children out there who would gladly trade places with him.  These children are “street children”.  Who are they?

Street children are minors who live and survive on the streets. They often grow up in public landfills, train stations, our under the bridges of the world’s major cities – Humanium

Why do they live on the streets?  There are several reasons such as family, poverty, abuse and war.  Economic, social and political factors can also play a role.

Children end up on the streets for a number of reasons, many of which are rooted in family instability and poverty.  In the region where we work, children most often leave home because they are fleeing instability or have been rejected and abandoned by their families for various reasons (disabilities, disease or disobedience).  Many of the children we have worked with have left their homes to flee domestic violence, abusive relatives or neglectful families.  Others have done so because their families live in severe economic distress, either in rural villages or city slums, and are unable to care for them – The Street Child Project

Life on the street is fraught with danger for these children. They are vulnerable to abuse, trafficking and sexual exploitation.  Some of them end up in gangs.  This is heartbreaking because all these children want is a better life–something they didn’t have at home.

…the most vulnerable are those who actually sleep and live on the streets, hiding under bridges, in gutters, in railway stations.  While they may have small jobs such as shoe-shining or market-selling to pull through, may also end up dying on the pavement, victims of drugs, gang rivalry and disease.  Without some form of basic education and economic training, the future is bleak for these street children and their life expectancy terrifyingly low – Unesco

Poor nutrition is another problem street children face.  They can’t get food because they don’t have money.  And those who can buy something to eat, they choose unhealthy foods such as ice cream, cakes.  Since they don’t have access to sanitary facilities they are often dirty and infested with fleas.  Lack of hygiene makes them susceptible to diseases.

I wish I had my mother or father with me, Nandi thought, weeping in the corner of the room. They would have never allowed anybody to beat me like that.

Nandi is a little boy who never knew his real parents.  He was adopted but his adoptive parents treated him like a servant and beat him.  They got angry when he called them “mother and father”.  I can’t begin to imagine what life must have been like for this child.  He longed for his real parents, believing that they would never allow anyone to mistreat him.  He longed for their love and protection.  As parents, we are responsible not only for raising our children, teaching them and disciplining them but we are supposed to love and protect them.  They should feel safe at home.  Nandi didn’t experience love, protection or security.  All he knew was unkindness, abuse and forced labor.  Unable to take the abuse any longer, he decided to run away and boarded a train to a big city.

We know that a big city is no place for a child.  Not surprisingly, Nandi soon ended up begging at the roadside all day long.  Like Oliver Twist, Nandi met his Fagan.  This man took the money Nandi got for begging and in exchange, gave him little food.  When Nandi didn’t want to do this any more, the man became incensed and beat him.  The next day when Nandi again refused to beg, the man beat another boy in front of him.  His will broken and gripped by fear, Nandi obeyed.  God would have to intervene and He did in an unexpected way.

Nandi was crossing the street one night when a car ran over his foot.  A police officer rushed over to where the injured boy was and took him to a hospital.  Nandi stayed in the hospital for more than six months, recuperating.   He had a visitor–a woman who asked him if he wanted to go to a children’s home.  Initially, Nandi refused because he was afraid .  New people and places intimidated him. However, when he saw how kind she was, he changed his mind and she took him to Gospel for Asia’s home for abandoned and runaway boys.

It took a while for Nandi to get used to being there.  During his first days there, he was overwhelmed by the new faces and structured lifestyle.  He broke down in tears and was comforted by the staff members. They assured him, “Don’t worry, because we are here like your mother and father.”  What a change from the life he had known before then.  While he had been with his adoptive parents, he had craved parental love and here he was receiving it from strangers.  The women brought him food and medicine when he wasn’t able to move around much because he was still recovering from his operation.  They stayed with him at night when he couldn’t sleep.  Much like a mother stays with her child until he or she falls asleep. The love of these people touched this little boy’s heart.  Maybe a mother or father would do the same things these sisters are doing, he thought.  Through the loving care of these women, God revealed Himself to a child who had been starved of love all his life.

That accident was God’s way of getting Nandi off the streets and putting him in a place where he would be cared for and receive a good education and learn about Jesus.   Now, Nandi wants to serve Jesus by singing.

As one whom his mother comforts, so I will comfort you – Isaiah 66:13

Manjulika’s life was much different from Nandi’s.  She knew her parents.  She and her sisters lived with them.  One day, Manjulika’s world was turned upside down.  She woke up to learn that her mother was dead.  She had died in the hospital.  From that moment on, Manjulika became a mother to her younger sisters.  Their father worked long hours as a rickshaw driver.  He would go home drunk and sometimes he beat them.   As Manjulika struggled to raise her siblings, she thought of her mother and how she had done so much for them.   She missed her.  She missed her mother’s love and care, especially as she and her sisters didn’t receive any love from their father.  In fact, he had no problem letting the government take them to a Gospel for Asia home for at-risk girls. The girls would soon come to know another Father. One who loves them.

The moment Manjulika walked into Gospel for Asia’s home for abandoned girls, she knew that she was in the right place.  This was a place where she would receive love and care.  She was no longer burdened with the responsibility of raising her siblings.  She had help.  The staff was there to provide for their needs.  They got food, school supplies and clothes.  And most importantly, they received the kind of love they had once received from their mother.   The staff was like a mother to the girls.  They sat with Manjulika whenever she got sick and helped her to eat.  They celebrated her birthday.  Manjulika had never had a birthday party before.  The staff enrolled her in a good school and helped her with her homework.  Things were looking up.

Manjulika thinks about her mother again but this time it is without sadness.  “These sisters care for us, and they meet all our needs.   If my mother were alive, she too would have done the same things the sisters are doing to me.”  She is again experiencing the kind of love she once had when her mother was alive and missed when she died.

He administers justice for the fatherless and the widow, and loves the stranger, giving him food and clothing – Deuteronomy 10:18

Today, Manujika wants to be a teacher and share her knowledge with children.  She also wants to tell others about Jesus.  She wants them to know that he loves them regardless of their background.

Nandi and Manujika had happy endings to their stories but there are children out there who are still living on the streets and in danger of exploitation, drugs, violence and premature death.  Please lift them up in prayer.  Pray that God will intervene in their lives as He did with Nandi and Manujika and take them off the streets.  Children are precious in His sight.  They deserve to have quality life.  They deserve to have a bright future.  They deserve to have love, protection, care, education and knowledge of Jesus.

Learn more about Gospel for Asia’s Street Children Ministry and how you can make a difference.

For in You the fatherless finds mercy – Hosea 14:3

Sources:  Gospel for Asia; Wikipedia;  Humanium; The Street Child Project; Unesco

Fanny Kemble

If you stand up and be counted, from time to time you may get yourself knocked down. But remember this: A man flattened by an opponent can get up again. A man flattened by conformity stays down for good – Thomas J. Watson

I never heard of Fanny Kemble until I recently read a devotion, The Unlikely in Our Daily Bread which mentions her work as an Abolitionist.  She was a British actress in the 19th century who married Pierce Butler, an American fan.  Fanny didn’t know that he was soon to inherit two plantations.  Had she known, most probably she would not have married him.  Little did she know that she would soon be fighting her own civil war.

Fanny Kemble was born in England in 1809 into a prominent family of actors.  Although she was very accomplished in her acting, it was not her true love.  Writing was her passion and throughout her she would write plays, journals, poetry, letters and memoirs.  Her most famous authorship would be that of Journal of a Residence on a Georgian Plantation which many consider to be the closest, most detailed account of the harsh conditions of plantation slavery.

Fanny was a strong, spirited woman with no formal training in acting but she managed to captivate audiences.  She had what were considered to be masculine traits: she was independent, physically strong and highly intelligent.  She was talented, spoke French fluently and was accomplished in music.  She embraced life and enjoyed exercise, specifically riding.  To her the best way to was to break “my neck off the back of my horse at a full gallop on a fine day”.  This reminds me of my former boss whose wish was to die being mauled to death by a polar bear.  Whatever happened to wanting to die peacefully in one’s sleep?

Fanny met her future husband Pierce when she and her father went on a two-year theatre tour in America.  It wasn’t her desire to experience life in America but she did it to please her father.  She was well received by the Americans and captured the ardent attention of Pierce Butler, a man born into wealthy and prominent family from Philadelphia.  His grandfather was Revolutionary War veteran Major Pierce Butler.  Major Butler was a U.S. Senator from South Carolina and the author of the Constitution’s fugitive slave clause.  He owned two plantations in Georgia, one was on St. Simon’s Island where sea-island cotton was grown and the other was on Butler Island where rice was grown.  One day, his grandson would inherit this mass fortune, making history as one of the largest slaveholders in the nation.

Pierce, infatuated with Fanny, followed her while she toured and she fell in love with this charming and attentive man.  She married him as a way of escaping life in the theatre which was beset with her family’s unstable financial future.  She was marrying into wealth but didn’t find out what the source of that wealth was until after they got married.

It was a marriage that was doomed from the beginning.  She believed that he would always be devoted to her and he believed that he could control her.  And their differences on slavery did not help matters.  He thought he could get her to see the benefits of the institution while she thought she could get him to free his slaves.  When she tried to publish an antislavery treatise she had written, Pierce forbade her to do so.  After he and his brother John inherited the Georgia plantations, Fanny wanted to see the plantation and begged but Pierce to take her with him but he refused.  Then in December of 1838 he took her and their two daughters and their Irish nurse to Butler Island.  Nothing could have prepared Fanny for  what she witnessed at this place.  Inspite of the beautiful surroundings, she could not escape the ugly presence of slavery.  She said, “I should like the wild savage loneliness of the far away existence extremely if it were not for the one small item of the slavery.”

Fanny and Pierce clashed over their views of slavery and their marriage began to deteriorate.  In 1845 Fanny left Pierce and children and returned to England where she resumed her stage career.  Pierce sued for divorce, claiming that she had “willfully, maliciously, and without due cause, deserted him on September 11, 1845”.  Three years later, on April 7, 1848, he filed for divorce.  Fanny returned to America to defend herself against his charges and after a long and painful court battle, the divorce was granted a year later with Pierce having full custody of the girls.  Fanny was allowed to spend two months very summer with them and receive $1500 yearly in alimony.

While Fanny was able to support herself in the U.S. and Europe with her Shakespearean readings, Pierce fell into financial ruin, gambling away his fortune.  He ended up in huge debt which led to the selling of the mansion in Philadelphia and the liquidation of other properties.  Unfortunately, this was not enough so the trustees turned their focus on the property in Georgia where the slaves were.  This led to the largest single sale of human beings in United States history and the event known as “the weeping time” as slaves were separated from their families.

After the war Pierce and his daughter Frances returned to Butler Island where he arranged for former slaves to work for him as sharecroppers.  He later contracted malaria and died.  Fanny moved to Philadelphia where she continued to perform dramatic readings.  She travelled and published her journals.  On January 15, 1893, Fanny died peacefully in London.

Notes to Women want to acknowledge this woman who spoke out against an institution and practice which violated the rights of people based on their race.  Moved with compassion and a sense of decency, Fanny set out to reform the plantations.  She set up a hostel and nursery for those in need and paid the slaves who personally tended to her.  She improved the hygiene of the slave children by rewarding cleanliness with small prizes.   Her critics saw her efforts at reform as foolish and sided with her husband but we applaud Fanny for the stance she took against slavery and her resolve to do what she could to help the slaves and for raising awareness through her firsthand observations.  If you are interested in reading about her experiences, you can read them in her diary here.

In Fanny’s eyes, acquiring wealth from the forced labor and enslavement of others is unconscionable. She was convinced that slavery was wrong and inhumane and refused to be silenced on the matter.  She stuck to her convictions and today, her journal continues to be a primary source of education on the reality of slavery.

[On disagreeing with her husband about his slave-holding:] I cannot give my conscience into the keeping of another human being or submit the actions dictated by my conscience to their will.

I have sometimes been haunted with the idea that it was an imperative duty, knowing what I know, and having seen what I have seen, to do all that lies in my power to show the dangers and the evils of this frightful institution.

In the north we could not hope to keep the worst and poorest servant for a single day in the wretched discomfort in which our negro servants are forced habitually to live.

I said I thought female labour of the sort exacted from these slaves, and corporal chastisement such as they endure, must be abhorrent to any manly or humane man.

The Southern newspapers, with their advertisements of negro sales and personal descriptions of fugitive slaves, supply details of misery that it would be difficult for imagination to exceed. Scorn, derision, insult, menace – the handcuff, the last – the tearing away of children from parents, of husbands from wives – the weary trudging in droves along the common highways, the labor of body, the despair of mind, the sickness of heart – these are the realities which belong to the system, and form the rule, rather that the exception, in the slave’s experience.

A good many causes tend to make good masters and mistresses quite as rare as good servants…. The large and rapid fortunes by which vulgar and ignorant people become possessed of splendid houses, splendidly furnished, do not, of course, give them the feelings and manners of gentle folks, or in any way really raise them above the servants they employ, who are quite aware of this fact, and that the possession of wealth is literally the only superiority their employers have over them.

Though the Negroes are fed, clothed, and housed, and though the Irish peasant is starved, naked, and roofless, the bare name of freemen-the lordship over his own person, the power to choose and will-are blessings beyond food, raiment, or shelter; possessing which, the want of every comfort of life is yet more tolerable than their fullest enjoyment without them.

When marriage is what it ought to be, it is indeed the very happiest condition of existence.

Sources:  PBS, Pabook Libraries, New Georgia Encyclopedia; Brainy Quotes; AZ Quotes; Stand Up Quotes

A Mother’s Hope

Children are our future.  It is our responsibility–no, it should be our mission to provide them with the tools that will enable them to have the future that God meant for them to have.  It is every mother’s hope to see her child rise above adversity, poverty and all the social ills that would oppress and impede progress.  Every mother has a right to believe that her child can have the life that she wants for him or her.  Nothing is impossible, especially when God is involved.  Mothers, keep the faith.  Teach your children to dream big and to reach for the stars. 

It’s every mother’s hope for her child to have a bright future.  It was Hannah’s hope that if God were to bless her with a son, he would serve the Lord all of his life.  What a wonderful prophet Samuel turned out to be!

While I was carrying my son, I tried to imagine what he would look like.  I dreamed that he would have huge dark eyes in a sweet face.  I was right.  I will never forget the day in the hospital when he looked up at me with those big beautiful eyes.   My heart melted, of course.  I wanted him to have the best that life could offer.   I wanted to keep him safe and care for him as best as I could with God’s help.  I am blessed to have a husband who is a terrific father and role model for our son.

My son is seven years old now and nothing has changed.  My hopes for his future are still the same.  My husband and I want him to have the best education we can afford so that he can grow up and be whatever he wants to be.  We encourage him to work hard.  I tell him that there are children in other parts of the world who cannot go to school because their parents cannot afford to send them or in some families only one child is able to go to school and it’s usually the boy.  I tell him that he has so much to be thankful for.  He lives in a house and has his own room while there are children who live in poverty.

Growing up, to me, my mother was very strict, more so than my father.  I remember once I wrote a very steamy story that somehow ended up in her possession and I knew I was in big trouble.  I was going to get a spanking from my father so I had to think quickly.  I wrote another story and when the opportunity came, I switched it with the other one.  You can imagine her surprise when she gave my father the letter and didn’t get the reaction she expected.  When she read it, she saw that it was a different one.  I don’t know what happened after that but the only thing that mattered to me at the time was that I didn’t get a spanking.  Over the years, my mother and I became very close.   I was very happy when I became a mother and watched as she held her only grandchild in her arms for the first time.  It wasn’t until I was older that she said, “You have your own life to live.”  Perhaps one day I may say that to my son although a part of me doesn’t want him to grow up.  No matter how old he is, he will always be my baby.  I take great comfort in the fact that God has great plans for his life.

It’s not easy being a mother.  It’s especially hard for the mothers in Asia who are struggling to provide for their families.  Imagine your children growing up illiterate, uneducated?  Education is the key to alleviating poverty, illiteracy and saving children from social evils like child labor and prostitution.  Children are God’s gifts and should be valued.  They are not worthless as some would have them think.  They are precious and deserve the best.

Although greater involvement by fathers – in all countries and cultures – is one of the most fundamental priorities for improving the care and upbringing of children, it is in practice the mothers who are the principal providers of care. And the first thing to be said is that however much a mother may love her children, it is all but impossible for her to provide high-quality child care if she herself is poor and oppressed, illiterate and uninformed, anaemic and unhealthy, has five or six other children, lives in a slum or shanty, has neither clean water nor safe sanitation, and if she is without the necessary support either from health services, or from her society, or from the father of her children.

The situation for mothers in South Asia sounds very dismal but true to His nature, God has found a way to reach out to them and their children.  Gospel for Asia has a wonderful program which can change the despair of the mothers in Asia to hope.  It can change the lives of children.  Bridge of Hope has helped more than 72,000 children so far and as a result thousands of families have found faith in Christ.  We can help a mother in Asia to have a Happy Mother’s day by sponsoring her child.  She can see her child get an education, receive a regular medical check-up, wear clean clothes and eat a daily meal.

Nothing pleases me more than to watch my son head into school each morning with his father, carrying a lunch bag and wearing his nice, clean and ironed uniform.  I know that he is going to school to learn so that one day, he will have a career and a future.  One day, he will be taking his kids to school too.  How grateful do you think a mother in Asia would be to see her child walking to school because someone decided to step in and make her hope a reality?

I encourage you to sponsor a Bridge of Hope child in honor of his or her mother.  Make this a Mother’s Day a very special one for a woman in Asia.  Give her the gift of hope–the hope of seeing her child have a great future.

Hope is the pillar that holds up the world. Hope is the dream of a waking man – Pliny the Elder

Hope is the anchor of our souls. I know of no one who is not in need of hope – young or old, strong or weak, rich or poor – James E. Faust

Sources:  Gospel for Asia – Mothers;  Hope Quotes; Unicef

Sin or Die

I lost my husband but God is here to take care of me.

Geeta was married to an abusive man who was also a drunkard.  He earned 200 rupies per day from a manual labor job but gave her only 20 rupies per day to buy and cook food.  He spent most of his earnings on his drinking. The money he gave her from his earnings was not enough for her to cook the kinds of meals he expected.  He beat her horribly every night with a cricket bat and Geeta asked herself why she was married to this man.  One day he disappeared and never came back.  She was left to raise two children.  She got a job but most of the money went towards paying for the rent so that most times she and her children went with hungry.  She managed to get a new job in a hotel which paid better but she still had to struggle.

As I listened to her story, I couldn’t believe the horrors this poor mother had to go through.  She lived in the slums, on a hill near the forest and the hut was made of sticks and plastic tarps.  She was terrified because tigers came out of the jungle at night and there was nothing to keep them from attacking her and her children.

One of her friends gave her a Gospel tract and told her about Jesus, the Saviour who could protect her from danger.  Geeta didn’t waste any time reaching out to Him.  She prayed and asked Him to protect her and her children from the roaming tigers and He did.  After this Geeta went to her friend’s church and soon gave her life to Jesus.  He began to work in her, transforming her and people noticed.

Geeta’s story shows us that becoming a Christian doesn’t mean that our problems will go away.  In fact, Geeta reached a point where she had to make a terrible decision. Her boss owned the room she and her children were staying in.  He wanted sexual favours from her.  How could she do what he wanted?  She was once married. She was a mother.  She was a Christian.  If she didn’t do what he wanted, she and her children would be thrown out of the room.  With nowhere to go, she and her children would be out on the streets begging in order to survive.

During one of her darkest moments, Geeta thought it would be better to face death than face these horrible choices, but when she learned of a neighbour whose suicide left his wife and children begging in the streets, she realized that she could not do that to her children.  And the prospect of her precious daughter becoming a sexual prey to evil men when she grew up filled her with horror.  She had to protect her daughter.

When faced with these choices–become a prostitute, live on the streets or die, Geeta chose to pray.  She trusted Jesus to rescue her from this hopeless situation and He did.  The day before she was supposed to move out of the room, Gospel for Asia came to her rescue and helped her to stay another month while providing food for her and her children.

Thanks to God, Geeta and her children don’t have to beg in the streets in order to survive.   She could stay in the room for a while longer until she could find something better.  What a happy ending to this story.  Geeta did the right thing.  She obeyed God’s Word by choosing not to sin and God came through for her.  She reached out to Him in prayer, trusting Him to deliver her and He did. Now she doesn’t have to choose between sin and death.

If you want to learn more about what Gospel for Asia is doing for women like Geeta who face extremely difficult situations, visit their website.  Find out how you can help to improved the conditions for women who are shunned by their families and abandoned children who are forced to beg in the streets.

Geeta mentioned Bridge of Hope where her children received an education.  Find out more about this program and what you can do to help break the cycle of poverty and illiteracy.  You can make a difference in the lives of women like Geeta and provide a future for abandoned children.

Women and Bipolar Disorder

The first time I was aware of bipolar disorder was years ago in New York.  It was there that I learned that my sister was manic depressive.  She had suffered from a nervous breakdown.  I never knew that she was manic depressive.   It was not evident to me.  She seemed fine to me.

While living in New York, she only had one episode where she had to stay in the hospital overnight but after that she was fine.  She had a good doctor who was diligent in her care.  I have other relatives who suffer from bipolar disorder.  And a co-worker of mine is no longer working because she had a relapse.  The last time I saw her I couldn’t believe it was the same person.  She called me on the phone and she was saying things that didn’t make sense and using language I never expected to hear coming out of her mouth.  I realize that when a person has bipolar disorder, he or she is different.  The illness changes the person.  Things from the past are dredged up, there are resentments and the belief that there is a conspiracy against him or her.

It’s hard to see someone you love suffering from a mental illness.  It’s harder when the person comes off of the medication and winds up back in hospital.  Each time he or she comes off the medication, it becomes harder to get back on track.  And the scary thing is they get into debt or in some cases trouble.  It’s hard for family members to know just how to cope, especially if during these episodes harsh and hurtful things are said.  It’s so disappointing when the person is doing well for a long time and then there is a relapse.  Each time he or she gets better, you are wary, wondering how long it would last.  Each time he or she promises not to come of the medication and vows to stay out of the hospital but something happens and there is an episode.

Even though I am aware of bipolar disorder, I still don’t know much about it.  I thought that I would search the web and gather all the information I could find just to get a better understanding of the illness.

What is Bipolar Disorder?
Bipolar disorder, formerly known as manic-depressive illness, is a brain and behavior disorder characterized by severe shifts in a person’s mood and energy, making it difficult for the person to function. More than 5.7 million American adults or 2.6 percent of the population age 18 or older in any given year have bipolar disorder. The condition typically starts in late adolescence or early adulthood, although it can show up in children and in older adults. People often live with the disorder without having it properly diagnosed and treated.

What are the symptoms of Bipolar Disorder?
Bipolar disorder causes repeated mood swings, or episodes, that can make someone feel very high (mania) or very low (depressive). The cyclic episodes are punctuated by normal moods.

Mania Episode Signs and Symptoms:

• Increased energy, activity, restlessness
• Euphoric mood
• Extreme irritability
• Poor concentration
• Racing thoughts, fast talking, jumping between ideas
• Sleeplessness
• Heightened sense of self-importance
• Spending sprees
• Increased sexual behavior
• Abuse of drugs, such as cocaine, alcohol and sleeping medications
• Provocative, intrusive or aggressive behavior
• Denial that anything is wrong

Depressive Episode Signs:

• Sad, anxious or empty-feeling mood
• Feelings of hopelessness and pessimism
• Feelings of guilt, worthlessness and helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, fatigue
• Difficulty concentrating, remembering or making decisions
• Restlessness and irritability
• Sleeplessness or sleeping too much
• Change in appetite, unintended weight loss or gain
• Bodily symptoms not caused by physical illness or injury
• Thoughts of death or suicide

Apparently there are several types of bipolar disorder but the two main ones are bipolar I and II.  Bipolar type I disorder is the “classic” form, and patients often experience at least one full or mixed episodes with major depressive episodes. Bipolar type II disorder is where patients have at least one milder form of mania and one major depressive episode.  However, they never get a full manic or mixed episode.  Bipolar II is harder to diagnose because some symptoms of hypomania may not be as apparent. Hypomania is described as a milder form of mania with less severe symptoms.  I believe that my sister displays more symptoms of mania.

All the people I know who have bipolar disorder are women.  Although it is prevalent among men as well, it seems that it is approximately three times more common in women than in men.  For women it is rapid cycling.  Rapid cycling describes incidences where a bipolar patient experiences four or more episodes of mania, hypomania, or depression within a time period of a year (Leibenluft, 1997).

The article explains why rapid cycling bipolar disorder more common in women than in men. Three potential hypotheses to explain the higher prevalence of rapid cycling in women are hypothyroidism incidence, specific gonadal steroid effects, and the use of anti-depressant medications. First, more women encounter hypothyroidism than men do; however, there is not a general consensus on it being a primary cause of increased rapid cycling. Second, gonadal steroids, such as estrogen and progesterone, fluctuate throughout the menstrual cycle. Sixty-six percent of bipolar type I women had regular mood changes during either their menstrual or premenstrual phase of their cycle. They were more irritable and had increased anger outbursts (Blehar et al., 1998). These may set up women to frequent mood changes (especially prior to the menstrual cycle, as noted in the term “premenstrual syndrome”). Increased estrogen may cause women to develop hypercortisolism, which may increase the risk of depression. Stress levels are associated with cortisol level, so this may possibly be the reason for increased risk for depression.

There are risks involved in pregnant women who suffer from bipolar disorder.  Manic episodes and cycling seemed to occur exclusively during pregnancy.  For reasons still unclear, apparent pregnancy poses a question of relapse, which has an important effect on women and the fetus that they are carrying. The fetus can be at risk due to lack of attention to prenatal care, if the woman is not treated for the psychiatric illness. Precipitated episodes in the absence of treatment may be very detrimental to both parties involved. Secondly, the woman would be at risk because with each successive episode, the length of time to following episodes gets smaller. That is, the woman could have manic and depressive episodes more often. This would neither be beneficial to the woman or her child. The effect on the fetus due to many mood episodes is unclear (Viguera et al., 1998). “During pregnancy, a woman’s glomerular filtration rate increases” (Llewellyn et al., 1998). This means that any medication that she takes, such as lithium (discussed below), will be excreted more rapidly. This is very dangerous because if she does not have enough medication in her system, she can fall into relapse.

A dilemma arises in that if she increases her medication amount, she may be exposing her fetus to grave side effects and even danger (discussed below). Moreover, during labor, it is important that women remain fully hydrated. Since the period of time for delivery varies with each individual, a pregnant woman can become very dehydrated. When a woman gets dehydrated, the serum medication concentrations will increase (Llewellyn et al., 1998). This is the opposite effect of the increase in glomerulus filtration. Nonetheless, both situations are dangerous and can be very toxic to the woman and indirectly to the fetus.  As varying as the symptoms of bipolar disorder, per individual, so are the treatments. It is very important that bipolar pregnant women get the appropriate care and treatment that they need, in order to properly care for themselves as well as for the child that they are carrying.

It is disturbing to know that women with bipolar disorder are more susceptible to misdiagnosis.   recent study estimated that the odds that a woman with bipolar disorder will fail to be correctly diagnosed are roughly three times the odds for a man. This disparity may be explained in part by the fact that bipolar disorder tends to look different in women than it does in men—in the same way that physicians sometimes fail to catch heart disease in women because they are effectively looking for the male version of the disease, mental health professionals may not always be aware of the distinctive signs of bipolar disorder in women.  According to Vivien Burt, MD, PhD, director of the Women’s Life Center at UCLA’s Resnick Neuropsychiatric Hospital, “Women are more demonstrative—they have more of what’s known as ‘affective loading’—so it’s not surprising that bipolar disorder might be underdiagnosed in women compared to men.”

Another article stated that a woman is likely to have more symptoms of depression than mania.  And female hormones and reproductive factors may influence the condition and its treatment.  Research suggests that in women, hormones may play a role in the development and severity of bipolar disorder. One study suggests that late-onset bipolar disorder may be associated with menopause. Among women who have the disorder, almost one in five reported severe emotional disturbances during the transition into menopause.  Studies have looked at the association between bipolar disorder and premenstrual symptoms. These studies suggest that women with mood disorders, including bipolar disorder, experience more severe symptoms of premenstrual syndrome (PMS).

My sister had the disorder since she was in her thirties.  She is unmarried and doesn’t have any children.  If she had children would they be at risk?  Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is estimated to be 15-30%.  Bipolar symptoms may appear in a variety of behaviors. According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children with depression in the United States may actually be experiencing the early onset of bipolar disorder.

If you notice mood swings in yourself or someone else, don’t write them off as hormonal changes.  Seek medical help.  And if you are diagnosed with bipolar disorder, consult a psychiatrist or a general practitioner with experience in treating this illness.

My sister is currently on disability.  A bipolar diagnosis can have a great effect on your job and career.  In a survey of people with depression and bipolar disorder conducted by the Depression and Bipolar Support Alliance, 88% said their condition affected their ability to work.  Don’t be discouraged, though.  Being diagnosed with bipolar disorder doesn’t necessarily mean that you can’t keep your job. Plenty of people with bipolar disorder work and live normal lives.  If you are currently unemployed and are seeking employment, find a job that is a good fit for you–one that is not stressful and has a flexible schedule.  If you are currently in a job that is not working for you–is affecting your health, not letting you get enough sleep, maybe it’s time to make some changes.  Here are some things you should consider:

• Decide what you really need from your job. Do you need to reduce your responsibilities? Do you need extra breaks during the day to reduce stress? Would you rather work independently or in a group? Do you need to work shorter hours or take time off? Or do you need a different job altogether?
• Make decisions carefully. People with bipolar disorder are prone to acting impulsively. Think through the effects of quitting your job — both for yourself and possibly for your family. Talk over your feelings with your family, therapist, or health care provider.
• Look into financial assistance. If you do need to take time off because of your bipolar disorder, see if your employer has disability insurance, or look into Social Security Disability Insurance, which will provide some income while you recover. You can also look into the Family and Medical Leave Act. Ask your doctor or therapist for advice.
• Go slowly. Returning to work after you’ve taken time off can be stressful. Think about starting in a part-time position, at least until you’re confident that your bipolar disorder has stabilized. Some people find that volunteer work is a good way to get back into the swing of things.

Unfortunately you may encounter stigma at work.  Some people might treat you unfairly because of your disorder.  If you feel that you are being passed over for promotion or are being treated unfairly, there are things you can do.  Find out what policies are in place at your company that will protect you from this kind of discrimination which is illegal.    The Americans with Disabilities Act can protect some people who are discriminated against because of a health condition.  Before you do anything, research the law and talk things over with family, friends and therapist.  Mitzi Waltz, author of “Adult Bipolar Disorders,” advises bipolar employees to call a counselor or local support group to help them with workplace problems.

Bipolar disorder is tough on families and spouses.  They have to cope with behavioral problems.  Family members often experience feelings of extreme guilt after the individual is diagnosed. They are concerned about having had angry or hateful thoughts, and many wonder whether they somehow caused the illness by being un-supportive or short-tempered, although this is not the case.  There are times when I feel guilty because I didn’t touch base with my sister as often as I should have.  There are times when I am frustrated with her for coming off her medication because she is aware of what happens when she does.  I feel that she should take more responsibility for keeping the disease under control by taking her medication.  I see how her relapses affect my mother who has Parkinson’s.

I realize that although it is difficult to cope, families of patients with bipolar disorder need to be more supportive.  It is in the best interest of the person to be hospitalized for his or her own protection and for much needed treatment if he or she is in the middle of a severe episode.  And it is important for the patient to  to understand that bipolar disorder will not go away, and that continued treatment is needed to keep the disease under control. It is important that they understand that proper therapy will enable them to have a good quality of life and enable them to have a productive life.

The following tips are for families who want to help their loved ones to cope with the illness:

1. Educate Yourself
2. Learn How–and When–to Talk
3. Make Some Rules
4. Plan Even More
5. Listen
6. Go Gentle
7. Laugh Together
8. Support Yourself

I encourage families of people with bipolar disorder to educate themselves and then see how they can help their loved ones to cope.

Sources:  http://bbrfoundation.org/frequently-asked-questions-about-bipolar-disorder; http://psychcentral.com/lib/2007/women-and-bipolar-disorder/all/1/; http://www.health.com/health/condition-article/0,,20274376,00.html; http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-women; http://www.bphope.com/BipolarIndepth.aspx; http://www.ehow.com/about_5032842_signs-bipolar-disorder-women.html; http://www.webmd.com/bipolar-disorder/going-to-work-bipolar; http://www.livestrong.com/article/23014-good-career-those-bipolar-disorder/; http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=bipolar_family; http://www.beliefnet.com/Health/Emotional-Health/Bipolar/8-Ways-to-Help-Your-Bipolar-Loved-One-Cope.aspx