DO those with mental illness run Ultras??

  

 Do those with mental illness run Ultras?

   I have been researching online whether those with serious mental illness participate in Ultramarathons. I have found no mention beyond that exercise is good for depression (which it IS) but not about mental illness and ultrarunning combined. 

    Is this something that isn't done for some reason or another?? Or is there just no good documentation surrounding it? I would say with all my online research it seems as though there is no precedence for this. I would love to be proven wrong and have someone quote me some article or something but so far I have found zero about it. 
   I know that those with mental illness run endurance events. Yet how is there no research on how this affects their mental state especially in an endurance event such as a 100 mile run in which you are required to remain somewhat alert and functioning for sometimes over 26 hours at a time. This may be difficult for someone with a mental illness to complete. I say "difficult" and not "Impossible" because I know whether or not it is broadcast there are those who DO accomplish it. 
   The problems I can see with this are pretty basic to those with any kind of illness: Medication and side effects from medication making it difficult. Much of the medication prescribed to those with mental illness is sedating. That is done on purpose really to keep not only the symptoms but also the anxiety at a lower level plus help with sleep. The problem is that many of those with mental illness need sleep meds to feel restful or medications they take at night that are 24 hour lasting to see them through the next day of symptoms. So the issue is one of medication compliance in view of having to spend the night awake and alert the sleeping medication cannot be taken during the event. 
   That brings us to the medication that is extended release so it is taken at night but lasts throughout the next day to alleviate symptoms. If the meds are not taken the night before the person may be liable to be more symptomatic the day after on top of being exhausted from the exertion of the run. The timing of morning medication, should that be an issue, is also a factor. These things can be done. A night of missing medication usually is not going to ruin someone's mental health. The night following you can just pick up where you left off and go from there. The morning medication can be taken at the near end of the race that following morning. 
   Another thing to consider is fatigue and how that can play havoc with someone's mental state who is not diagnosed with anything and how that is multiplied in those with mental/emotional problems. When fatigued the mind is not able to stay as sharp even in healthy people and so can lead to strange thoughts, even hallucinations, during an all day and all night event. While this may not completely unhinge those who have not had these problems before it can be seriously worrisome to those that suffer from these problems already.        
       Fatigue can make the mind do funny things. And on top of not having the medication in their system to calm themselves it may lead to an episode. I believe the pacers must be made aware, especially those pacing at night, that the runner has a medical problem which may lead to an exaggerated affect different from those without those problems. That way the pacer can be prepared should the runner begin to suffer in some way different from the usual ultrarunner fatigue-related "events" during the night.
   That being said this doesn't mean those with mental illnesses cannot run these events but just need to be aware themselves, and make crew and pacers aware, that they may need extra help during the race. And pacers need not fear of any harm to themselves or that the person will go completely haywire on them. Obviously the runner has done much training and many long runs and know themselves and how they react to the circumstances and if they are able to handle any and all symptoms which may occur. 
    It is frustrating, though, not to find mention of it or any advice for the runner on if there are special things to be aware of on the long, long haul of a 100 miler. I guess the best thing is to be as prepared as any other runner, to remember that you have trained for this and to make sure you keep a positive mental attitude that even though this is by no means a common thing according to The Internet it is not an impossible thing. 
   To end on a good note: Those with mental health issues may be more suited to some of the extra hardships during the night. If you look at it from the perspective that they have been through worse times and have learned how to alleviate their symptoms they might be at an advantage when the mind gets tired and begins being "inventive". They may have tools that those who have not had this illness do not such as mental strategies, mindfulness training and experience "ignoring" the strangeness which might go on.