More threads by David Baxter PhD

David Baxter PhD

Late Founder
Stigmatizing bipolar disorder
September 18, 2006
By Mindelle Jacobs, Edmonton Sun

The recent high-profile case of a Grande Prairie nurse with bipolar disorder who drugged her co-workers has the unfortunate potential to stigmatize the mentally ill.

Combine a crime that terrorized hospital staff with a mental ailment that isn't well understood, and you risk undermining efforts to educate the public about mental illness.

So let's be crystal clear right off the bat: there is no systematic cause-and-effect relationship between mental illness and crime. All kinds of people commit offences, including those with mental problems.

But just because you're mentally ill doesn't mean you're criminally inclined.

Unfortunately, Sarah Bowes committed a series of bizarre and disturbing crimes while she was suffering from then-undiagnosed bipolar disorder.

Mental illness sometimes leads to aberrant behaviour. When such activity is criminal, however, it gets media coverage and becomes fodder for conversation around the water cooler.

And experts worry that the Bowes case will fuel myths about mental illness.

"We work with hundreds of people who are dealing with bipolar and they are not doing this crime," says Jan Neumann, supervisor of the outreach program of the Edmonton branch of the Canadian Mental Health Association.

"This (incident) does have some potential to cause that stigma," she adds.

Over the course of about a year, between 2004 and 2005, Bowes' behaviour at the Queen Elizabeth II Hospital escalated from practical jokes - sending food and flowers to co-workers with anonymous notes - to the theft of ID used to obtain credit cards to spiking colleagues' food with a tranquillizer.

The 28-year-old licensed practical nurse was arrested in March and pleaded guilty a week ago to 12 charges, including four of administering a noxious substance.

She was given a two-year conditional sentence and three years' probation.

The sentence was immediately denounced by some of Bowes' co-workers. Readers, too, vented about the case.

"I'm very disappointed in the justice system," said one of Bowes' colleagues. "She showed no mental illness to me." But mental illness isn't necessarily glaringly obvious.

One Sun reader wrote a letter to the editor saying she was "bewildered and appalled" at the conditional sentence.

"This verdict has set our cause of education and removing the stigma back about 20 years," wrote the woman, who says she has bipolar disorder.

Bowes should have gotten help for her mental illness instead of using it as an excuse for her crimes, the woman suggested.

"I live with (depression), knowing that I am always responsible for my own feelings and actions. As should Sarah Bowes," she wrote.

While she's right to point out that the mentally ill are no more prone to criminal activity than anyone else, she mistakenly assumed that Bowes knew she had bipolar disorder.

In fact, Bowes wasn't diagnosed until after her arrest. And, as her lawyer D'Arcy Depoe points out, it can be terribly difficult to get the mentally ill to acknowledge they're sick.

"Mentally ill people engage in strange behaviours," says Depoe. "Some of them happen to be criminal but that doesn't stigmatize everybody who has mental illness."

Bowes began exhibiting symptoms of bipolar disorder - alternating periods of depression and hyper behaviour - at age 21 and started taking a sedative, benzodiazepine, to control her mood swings. She eventually became addicted to the medication.

While she wasn't completely unaware of the nature of her actions, her mental state affected her judgment, according to the forensic psychologist who assessed her.

Bowes is now off the benzodiazepine and has been stabilized under the care of a psychiatrist - precisely the right outcome.

Jail would have derailed her.

Danny Boy

I find the stigmataization (is that even a word?) of any disease or illness disturbing. Bipolar just happens to hit home for me because my sister is affected by it. Stereotypes also "get my goat".

Jennifer, my sister ordinarily a peace loving girl. She's honestly the best sister a brother could ask for. I love her dearly and it hurts me to see her ostracized by society for something that isn't her fault.

The stigma around her having a mental illness has compounded her illness. On more than one occasion her manic episodes have gotten so out of control that the police/ambulance has had to remove her. We live right in the center of a very small town many people here have scanners to "see whats going on".

At any rate the grocery store across the street from us is always hiring new people. At said grocery store, Jen has applied many times and never gets called back. Yet every time I go in there I see new faces. I believe this only because people more specifically the manager has witnessed the scene of her being "dragged" out of the house.

My sister being 32 years old, having no job, virtually no friends, or driver's license makes her more depressed. I've witnessed Jen "talk herself" into depression many time. She suddenly has this realization that: "Look at me, I'm 32 no job, friends, husband, kids etc. As much I try and cheer her up her illness takes over and she starts playing around with her meds almost guaranteeing a visit to the hospital for a "leveling out".

At the core stigmas and stereotypes are only ignorance doing it's work. I've found once people are educated and things explained compassion takes over and the stereotypes disappears.

Danny Boy

Danny, is Jennifer in therapy? Is she on any medications to manage her illness?

No therapy but she's recently started a day program called RSS. Rehabilitative Support Services. Basically she's goes six hours a day and they teach job skills and stuff like that. I'm really not sure if group therapy is a part of that.

As for medication you name it she's been on it. Every time the doctor finds the right combination a month or two later something goes haywire and she's back at square one again. She came home from the hospital yesterday; The doctor upped her Seroquel, Haldol, and Lamical prescriptions. I know she's on a few other meds but those are only ones I know for sure.

Her best combination was Lithium and Thorazine but a few years back it just stopped working for her finding the next "ultimate combination" has been a tough road for her.

David Baxter PhD

Late Founder
Oh, I'm sorry to hear that. Some patients just have a great deal of difficulty finding the right combination of medications and others, like your sister, find that something will work for a while and then stop working - psychiatrists and psychopharmacologists call such patients "non-responders".

At least she is still trying. In time, with patience and luck, I hope she finds something that works.


There might be more of a general stigma around bipolar disorder than I'd previously supposed. When I began to cop fairly openly to my diagnosis, I was assuming that there would be less of a stigma regarding it than, say, had I been a drug addict or an alcoholic. I think I was wrong.

When I began to realize that I was having a depressive episode, pretty much costing me my last job, I sent an e-mail to my client here in which, for some reason, I opened up about the episode. She told me that the e-mail bewildered her, that she didn't know what I was talking about, and that she had always found me to be perfectly responsible and always kind and gentle and reliable, and a good piano teacher.

When I came back, I mentioned it a second time when we were conversing, and she looked confused again. Her husband sort of smiled and said: "Stigma!" I wasn't exactly sure what he meant, but he led me to the door at around that time, and I decided not to bring it up anymore.


I can understand the stigma not necessarily with bipolar but with depression as my parents are still stuck in that. They consistently deny that I suffer (anything). According to them it is all stress. The other day they were having a conversation with someone and referred to me as being on medication for stress when the person referred to me as being on medication for depression. My mother was like no, it is stressss. It is almost like they accept it within themselves but don't want others to know...God forbid :eek: It is still a huge stigma with them. I am not going to fight them on it. I have tried and it is really just not worth it. A waste of energy as far as I am concerned. I to be honest wish that it wasn't in my own family that is all. From other people I guess I could handle it better than my own family.
i think people don't understand what bipolar disorder is. i think 'manic-depressive' may be better understood, although i realize that this term is no longer supposed to be used. i'm not really sure what the stigma/association would be with 'manic-depressive' these days.

i've just been suffering from "mere" depression, but even at that i still hesitate to tell people. it's not something i want to broadcast to the world, even though i would like for there to be no stigma. i think i will only feel comfortable mentioning it to those that seem like sympathetic people anyway.

i think the trouble is people aren't educated enough on these topics, and i'm not sure how to go about changing that. i was thinking the same thing too, if i just talk about it like a fact of life, then that would remove the stigma. i'm not sure though that it can work that way, as shown by your story.


There are a couple of things that come into play here, I think. One is that people, in general, have little understanding of mental illness of any kind. They just don't want to think about it. I think that's slowly getting to be less true, but the improvement is very, very gradual.

Secondly, most people don't want to hear about our problems. When they do hear about them, the almost feel an obligation to offer to help in some way, but they don't know how. It's also got something to do with the general tendency of people to be a bit egocentric. They want to talk about themselves, their families, their interests. They really don't want to talk about ours, in most cases. It just isn't conducive to good relationships amongst acquaintances; although, it can be very helpful and encouraging to talk to very close friends about highly personal matters. You just have to be careful about to whom you speak about what. :)


TL, I think that you bring up a really good point. There are many people that I know that I just don't speak to about my depression and my struggles for many different reasons and one big is because they just don't understand and because I just don't feel like care. Well they care but not to extent that I know others care. I can come on here and know that you people care more than they do and that is okay. I am good with that. I would rather open up to people that understand me and do not judge me than open up and bear my heart and my thoughts (as distorted as they may be) and have and open ear to hear me like on here than to have someone who is just half hearing me and not really wanting to listen to me and not knowing what to say.


Hi Danny,

Salicylate intolerance really upped the stakes for my bipolar stuff.
Omega 3s have been essential (2000mg), calcium-magnesium 1,500mg, glutamine 2000mg. I'm also GF/CF and on a small amount of Seroquel for what's left. If Jen hasn't explored dietary impacts on bipolar one of the first stops may be to look at a short trial on a low salicylate diet. I'm feral on high salicylates. Re friendships, Jen may like to visit and list in the 'autie friendly' section. It's all free. We have a number of people at our dinner clubs who have an autism spectrum condition and either depression or bipolar. If there's none in her area she could think of starting one. I'm glad she's got such a supportive brother who is obviously also a valued friend.
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