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Before Ian leaves to the army in Shameless, we see no sign that he has any mental illness. However, while he is there he seems to have a break. Tries to steal a helicopter, runs away and works in a strip club.
Is it normal that it is like a switch, in that you are fine all your life and then you are not or is it more gradual? In the show it just felt way too extreme.
The way the onset of Ian's bipolar and his subsequent symptomology was portrayed rather accurately. Comparing what we know about the onset and course of Ian's bipolar disorder with the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), clearly illustrates that Ian's bipolar disorder onset and symptomoloy is truly textbook.
"Mean age onset of the first manic, hypomanic, or major depressive episode is approximately 18 years for bipolar I disorder" (APA, 2013).
He also has many of the Risk and Prognostic Factors of bipolar I disorder including environmental, as well as genetic and physiological risk factors. The DSM 5 indicates what has been known for many years - that the genetic link is the strongest (and most consistent) of the BPD risk factors. According to the American Psychiatric Association, there is a 10x increased risk among adult relatives of individuals with bipolar I or II. The strength of predisposition is in direct correlation to degree of kinship.
So with Monica, Ian has the strongest possible risk of developing bipolar as due all of Monica's kids. The fact that none of the other kids have bipolar disorder is likely due to the fact that they will when they are adults. Frank meets many diagnostic criteria for many of the mental disorders recognized by the APA. That's a discussion for another time.
I could provide a great deal more to support why the onset of Ian's bipolar disorder is accurately portrayed, and let me know if you'd like me to. That said, using the DSM 5 was intentional since Ian's experience and life overall, especially when we see him untreated and in a manic state, are again truly textbook and would make a clinician evaluating him have a pretty easy time doing so.
Great show and the actor that plays Ian did a great job of portraying both Manic and Depressive Episodes. Any of the family members easily qualify for mental healthcare. I'm not sure I'd want to be the therapist for any of them though {^_^}.
Reference
American Psychiatric Association; Diagnostic Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
