The sudden loss on Tuesday of Carrie Fisher, best known for her role as Princess Leia in the original Star Wars trilogy, made us pause. She touched many lives. Carrie, and Leia, as role models, were feisty, courageous, formidable women and Carrie carried that banner bravely in her long struggle with bipolar disorder and recovering substance abuse. She has been a real-life advocate for mental illness and approached it with a wry sense of humor, something that clearly comes through in her media interviews and writing (Postcards From the Edge, among many other works). In speaking openly about her illness she has reduced the stigma and helped many people. We will always be grateful to her for that.

According to media reports, Ms. Fisher died at the age of 60 several days after experiencing a massive heart attack while on a plane from London to LA. Attempts to resuscitate her were made on the airplane, yet the damage to her heart and organs were too great to sustain life. That is the great tragedy of her life and this illness. Many accounts of this event and her accomplishments have been published in the past two days, but none have addressed what I am about to tell you now. While I do not pretend to know the details of Ms. Fisher’s life and general health, there are some points of universal nature that we can learn from her premature loss.

Scientific reports on the physical health of those who have bipolar disorder (bipolar depression and mania/hypomania) have appeared in the recent medical literature. (Young AH, 2014; Laursen TM, 2014). These findings describe risk factors that contribute to cardiovascular (heart) disease and early or premature death in those who have bipolar disorder. Some of these risk factors are modifiable, which means you can change or control them yourself. These risk factors include weight gain and obesity from lack of exercise, poor diet, or certain medications; tobacco smoking; diabetes or pre-diabetes; alcohol abuse; and the metabolic syndrome. The metabolic syndrome is when you have at least three of the following: obesity; insulin resistance; high blood pressure; elevated triglycerides in the blood; or decreased HDL-cholesterol in the blood. It happens more frequently in those who have bipolar disorder. The reports show that those who have bipolar disorder die approximately 20 years earlier than those in the general population from all causes, including those listed above as well as suicide. This is a great tragedy. The good news is that if you have any of these risk factors and can work to modify them, you have a good chance of decreasing your likelihood of getting heart disease and other medical conditions.

I am not saying that this applied to Ms. Fisher, although she is said to have died of cardiovascular causes. Final reports are pending. And I am not placing blame on her or anyone else who has this illness. I know what it’s like — I have personally been in this struggle. My point is to emphasize the importance of a healthy lifestyle and self-care in managing your illness. It is more than just your family members or physician “bugging” you to do this or that. I am suggesting that you pay attention to the modifiable cardiac risk factors that can be more common in a person who has this illness. These are the things you have control over, the things you can change. There are real consequences behind your lifestyle choices, and it’s never too late to start on a healthy path now. What do I mean?

Aim to follow a healthy, balanced, low fat diet with a variety of fruits and vegetables and avoid junk food. A good example is the Mediterranean Diet, which you can find online. No smoking. No street drugs or alcohol. Daily physical exercise. Try to sleep regular hours each night. Yes, it’s hard to do these things when you don’t feel well, but it is possible. Ask your family doctor for help to get started on this, and don’t try to do it all at once. It’s not a guarantee, but it will make a difference.

A version of this article previously appeared in View From the Mist on Psychology Today

Originally published at on December 29, 2016.

Originally published at