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Former congressman Patrick J. Kennedy, who also suffers from bipolar disorder, visits Jackson at the Mayo Clinic on August 16, 2012. For more photos, launch the gallery »
Bipolar disorder is typically characterized by prolonged periods of depression alternating with episodes of mania—a seesawing combination that affects roughly 2 to 3 percent of Americans, according to Robin Nusslock, the director of the mood disorders laboratory at Northwestern University. Depression periods can last for weeks, usually months. But when the mania hits, he says, people get overcome by a rush of energy, more than they can typically handle. “It’s like putting a Ferrari engine in a Ford Taurus; the Ford doesn’t know how to handle so much horsepower,” he says.
Nusslock says common signs of bipolar disorders—particularly in the manic periods—include inflated self-esteem, poor judgment, irritability, aggressive behavior, spending sprees, and an increased sex drive. Or some combination of these. Sources interviewed for this article point to some of Jackson’s behavior in recent years—the affair, the dogged pursuit of the Senate seat, among other things—that fits the latter description.
As for depression, there was the “darkness” that Jackson spoke of experiencing after Blagojevich’s indictment undercut his Senate seat hopes. Jackson’s mother, Jacqueline, alluded to it in July, right after her son’s disappearance became known. “He thought he was going to be a senator,” she told a friendly crowd at an Operation PUSH luncheon. “He thought he was going to have a chance to run for mayor. And young people don’t bounce back from disappointment like me and my husband.”
Could the bipolar depression that Jackson was diagnosed with in August have been triggered by the weight-loss surgery he had eight years ago? New areas of science are finding some intriguing connections between the gut and the brain—particularly in cases of bariatric surgery patients.
Vivek Prachand, an associate professor of surgery at the University of Chicago, says that gastric surgery can indeed result in nutritional deficiencies if protocols—vitamin supplements, for example—aren’t followed. That, in turn, can affect mood and well-being. “There’s just so much complexity in terms of the psychology of eating,” he says.
John Alverdy, the chief of the surgical obesity program at the University of Chicago—and the only doctor in the Chicago area besides Prachand who performs duodenal switch procedures—adds: “There’s a growing body of knowledge that the surgery dramatically changes the composition and function of gut bacteria so much it can actually affect brain activity and brain chemistry.”
But no direct connection between duodenal switch surgery and depression has yet been proved, say Prachand and Alverdy, neither of whom treated Jackson. Some patients who undergo the procedure are already suffering from depression, they say; the surgery could exacerbate a preexisting condition. And still another body of research shows that mood disorders and depression can actually decrease after such surgeries, at least in the short term.
The Jackson camp clearly wants the public to see a connection between the bipolar diagnosis and the earlier surgery, perhaps to bolster sympathy. The mid-August statement issued by the Mayo Clinic said in separate paragraphs that (a) its doctors were treating Jackson for bipolar disorder and (b) he had previously undergone the weight-loss surgery. Asked for more details about the statement—including who actually wrote it—Traci Klein, a Mayo spokeswoman, said: “We don’t give out information unless they [patients] want us to. The wording is sent out on their behalf. [Statements] are approved by the patient, and they are what they are.”
Regardless of how Jackson’s illness is being spun by his family and handlers, he faces a potentially long and tough road to recovery. Treatment for bipolar disorder generally consists of a combination of medication—antidepressants and mood stabilizers, lithium being one of the most commonly prescribed—along with psychotherapy and the maintenance of a healthy lifestyle. It can take weeks for the drugs to begin to work, and months to return to feeling fully well. Bipolar sufferers, adds Nusslock, may also take additional medications to manage the possible side effects (which include sleep loss and tremors) of the antidepressants and mood stabilizers. “It’s not just something that goes away,” he says. “The risk of relapse is very high. It’s a lifelong illness that involves lifelong treatment.” Still, it’s quite possible for bipolar patients to live a fully functioning life.
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On August 16, Jackson was seen for the first time in months in a photograph taken at the Mayo Clinic. He was sitting with a visitor, Patrick Kennedy, the former Rhode Island congressman who himself battled bipolar disorder—and remained in office. (After resigning last year, Kennedy founded One Mind for Research, an initiative to find new treatments for brain disorders.) Jackson looked drawn and a bit dazed and was suffering from what Kennedy described as a “deep, deep depression.”
A few days later, Ohio congressman Dennis Kucinich paid a visit and said that his friend was in “a fragile state.”
Both comments stood in stark contrast to the string of assurances in August from Team Jackson that their man was getting ready to hit the campaign trail. But truth be told, political experts say, it doesn’t much matter whether Jackson hits the campaign trail or not. Even with redistricting, the 2nd District remains overwhelmingly Democratic. And his opponents in November are little known: Brian Woodworth (Republican) and Anthony Williams (Green Party). Jackson could likely win this race from a hospital bed—or from a jail cell. After all, this is Illinois. “He can be congressman for however long he wants,” says one top Illinois Democrat. “But that’s all he’s ever going to be.”
What if Jackson were to pull out of the race? The Cook County Democratic Party chairman, Joe Berrios—the kind of old-school machine pol Jackson has spent much of his career castigating—would select his replacement (with his counterparts in Will and Kankakee counties.)
Worry over that scenario may be partly why, in mid-August, after weeks of silence, Sandi and some others in the Jackson camp began talking. In a carefully calibrated series of interviews, they assured the public that Jackson was on the mend and would be back soon. Even though the message remained unclear from day to day—“back soon,” to “back whenever the doctors say it’s OK”—the steady drumbeat seemed designed to send a larger message: Don’t get any ideas. This is Jesse Jackson Jr.’s seat. If not his, then, ideally, Sandi’s.
But if Jackson’s short-term political future seems secure, it’s less clear that in the long term he’ll have much room to advance. His illness is probably the least of his problems. The shadows of Blagogate and his affair still hangs over him. The total package is no longer as shiny as it once was. Politicians have come back from worse—Ted Kennedy is Exhibit A. But it’s a steep hill to climb. “When will he be back? Well, we don’t know,” the elder Jackson told the online journal Politico in August. “We wish he never would have gone.”
Photograph: Courtesy Of Former Congressman Patrick J. Kennedy