Most of the sharks are out attacking Mel Gibson’s shocking behavior.

Well, it’s better reading that the other stories in the news, such as the oil spill or that suffering Haitians still need help. And it allows lots of folks to wax self righteous.

Ironically, it is Whoopie Goldberg, a celebrity who also defended Roman Polanski, who came to his defense.

Drunks say stupid stuff to people all the time because they’re drunk. They’re out of control. They are not thinking they are idiotic. That’s why I don’t like alcohol. I can’t say anything about that because I know what people are like when they’re drunk.

Actually, I have a bit less sympathy for drunks, but in Mel’s case, his out of control behavior might have another origin: according to an Australian newspaper interview a few years ago, he admitted that he suffered from bipolar illness (what in the past was called “Manic depression”).

In bipolar illness, a person’s mood swings from being “high” to severe depression.

And it’s very nature makes it hard to treat.

When these people are mildly high, they feel great, and often are creative. They deny that anything is wrong, because they feel so well.

One of my professors said if you met a person writing a book, wearing loud clothing and several rings who talked fast and furious, think bipolar. In severe cases, these people get delusional or can hallucinate or get paranoid during the manic phase. Since they often drink/party/have sex/take drugs during the manic phase, often their behavior is seen as “bad”, not a manifestation of an illness.

We docs tend to see them during the “depression” phase, when they lose energy, feel depressed, and seek help (or have family members force them into your office).

One of the problems we docs face is that often the “high” episodes aren’t mentioned to us, so if we prescribe an anti depressent medicine, they may quickly swing back into acute mania. Many of the “horror stories” about Prozac are actually due to undiagnosed bipolar patients “flipping” from depression into an acute manic episode.

I usually try to refer these people to a psychiatrist, because one has to be careful with medicines in treating them for depression or mania.

However, if you persuade the person to take medicines, a daily dose of Lithium or some anti convulsant medicines will cut down or stop their mood swings.

Alas, the person often figures out they are okay, stops the medicine, and if he starts getting manic, is so happy he or she doesn’t have the insight that this is a sign of his or her illness getting out of control.

One of the ironies of Bipolar illness is that a lot of famous people have suffered from it. During the “hypo-manic” phase, they are often quite creative, but the real problem is that during the depressive stage, they might commit suicide because again they don’t see the terrible depression as the symptom of a mental illness.

It is the families who tend to suffer the most with this illness. Drug use and drinking, infidelity, spending money that leads to bankruptcy, and arrests for assault or DUI are common, and often family members may resort to divorce for the sake of the children.

One celebrity who is on the forefront of educating the public about bipolar illness is actor Sean Astin, better known for his roles as Rudy!, or as Sam in the Lord of the Rings trilogy.

His mother, the Academy award winning actress Patty Duke Astin, suffered from Bipolar illness, and like most people with the illness, suffered for years before it was properly diagnosed and treated. He became active in publicizing the disease to help other families who had to cope with a family member’s bouts of unexplained behavior:

(the family) called Duke’s manic episodes “freak-outs.” During these times, Astin said, his mother would scream, yell, throw and break things. Once, he remembered, she purposely drove her car into the front of the garage.

“What I know, from a family member’s experience: It was painful, it was excruciating, to watch her suffer.”

According to the National Alliance for the Mentally Ill, bipolar disorder affects 2.3 million adult Americans, about 1.2 percent of the nation’s population. Sheri Wittwer, executive director of NAMI UTAH, praised the work that Astin and Duke have done to raise the level of awareness about bipolar disorder, a brain disorder that causes extreme shifts in mood, energy and functioning.

Finally, unlike other “mental illnesses”, this one is best seen as an outside force acting on the person’s own personality.

It’s biochemical, and tends to run in families.

That is why there is no such thing as a “typical bipolar”personality.

And yes, “ordinary” people have mood swings, but like many illnesses, when the mood swings interfere with one’s daily life, medication is a blessing, even though, as I noted above, the patient’s refusal to take medicine and the problems of side effects in the medicines mean they are best prescribed by an experienced psychiatrist.

For more information, check out WebMD’s page HERE.

As for Mel: he needs help. You either love him or hate him, so this is nothing new. I have little compassion on those who abuse their partners, but even less for third parties who tape personal conversations and release them, an action that is illegal under California law, and inadmissible in court.

The best thing now is for his friends to intervene, and get him treated for his Bipolar illness and personal problems, while his lawyers quickly settle things with his girlfriend. She needs help in removing herself and her daughter from the situation, no matter what.

Will it ruin his career? No, because I can think of half a dozen other Hollywood stars who abused their wives or spouses or innocent third parties and still managed to work.

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Nancy Reyes is a retired physician living in the rural Philippines. She blogs at Finest Kind Clinic and Fishmarket, and writes about medical matters at HeyDoc Xanga blog.