Although many people suffer from the disorder, there are many stigmas still attached to it Photo Pexels
South Africa – What do comedian Russell Brand, actor Jean-Claude Van Damme and singer Mariah Carey all have in common? They all suffer from bipolar disorder, and they are not alone. Around 46 million people worldwide suffer from this misunderstood condition.
Even though many people suffer from bipolar disorder, there still exists dangerous and outlandish stigmas about it. According to Zakiyah Hoosen, a registered counsellor, bipolar disorder can be described as a mental health condition.
“It is primarily characterised by distinct episodes of manic, or hypomanic, and/or major depressive episodes, accompanied by other criteria including signs of grandiosity/inflated self-esteem, decreased need for sleep, more talkative than usual, fleeting ideas, distractibility, and excessive involvement in activities that have high consequences for pain.”
Symptoms and causes of bipolar disorder
Bipolar disorder causes significant changes in mood, behaviour, and energy levels. It is a difficult condition to diagnose. Its signs and symptoms can be subtle or assumed to indicate other disorders. Some symptoms are an inability to concentrate, changes in speech, suicidal thoughts, impulsivity, and abnormal sleep patterns. The causes of bipolar disorder are understood to be a combination of genetics, environment, and an altered brain structure and altered brain chemistry may play a role, explained Hoosen.
A bipolar disorder is only diagnosed by taking careful note of symptoms. The diagnosis hinges on having periods of unusual elevation or irritability in mood that are coupled with the various other symptoms. A doctor may order blood tests and urine tests to rule out other causes of the symptoms.
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Different types of bipolar disorders
Contrary to popular belief, there isn’t just one type of bipolar disorder. While there are several types of bipolar disorders, there are three main ones. Bipolar disorder I, bipolar disorder II and cyclothymic disorder. In order for any of these to be diagnosed, “an extensive criterion must be met to determine the type of bipolar disorder, and these usually constitute either a manic, or hypomanic, and/or major depressive episode.”
Bipolar disorder I is diagnosed when a person experiences a manic episode. During the episode, people with bipolar disorder I experience an extreme increase in energy and may feel on top of the world or they may experience the total opposite. They may be in an uncomfortable, irritable mood.
Bipolar disorder II is diagnosed when someone has at least one major depressive episode and at least one hypomanic episode. They return to their usual functioning between episodes. They often seek treatment as a result of their first depressive episode. This is because a hypomanic episode often produces feelings of pleasure and increases their performance or productivity at work or school.
Cyclothymic disorder is a milder form of bipolar disorder. People with it experience emotional ups and downs but with less severe symptoms than bipolar I or bipolar II. For at least two years one can experience many depressive or hypomanic episodes but the symptoms don’t meet the criteria for depressive or hypomanic episodes.
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Bipolar disorder is not just mood swings
People often associate mood swings to bipolar disorder. Just because one wakes up grumpy, then gets happy in the day and then ends up grumpy does not mean you have bipolar disorder. Everyday life is made up of ups and downs. This notion is absolutely false. It is much more complicated.
“Bipolar disorder is more complex than mood swings. It consists of manic, hypomanic and/or depressive episodes and each episode is expected to be present consecutively for most days from between 4 days up to 2 weeks, in order to reach a formal conclusion on diagnosis.”
Mania/manic episodes are not productive or good
Firstly, we have to understand what mania is. Hoosen describes mania as “an abnormally and persistently elevated or irritable mood, and abnormally persistently increased activity or energy”. Abnormal and persistent are key words here. While manic episodes can feel good at first, if left untreated, it can become very detrimental.
“Examples of mania that is uncontrollable could include a person suddenly spending large sums of money suddenly, on extravagant and lavish items that were otherwise unknown to them – this behaviour would be very uncharacteristic for the person, and it might be accompanied by extreme grandiosity such as believing that they are the richest person in the world.”
A manic person may lose control of their thoughts and actions. They may even lose touch with reality. A manic episode can last anywhere between four days to one to two weeks. However, there are certain criteria that define a manic episode apart from the symptoms that have been described.
“These other criteria include signs of grandiosity/inflated self-esteem, decreased need for sleep, more talkative than usual, fleeting ideas, distractibility, and excessive involvement in activities that have high consequences for pain. Additionally, the manic episode must have caused severe impairment in social or occupational functioning, and the episode cannot be attributed to the physiological effects of a substance.”
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People with bipolar disorder have neutral days
Although manic episodes can last for quite some time, people with bipolar disorder can experience long periods of even and balanced moods. They are not always manic or depressed as one may believe. Describing it in this way can be likened to a stereotype called ‘black and white mentality’ (when we describe things as only ‘this’ or ‘that’), said Hoosen.
“Persons affected by bipolar disorder also experience complex and nuanced emotions and experiences on a daily basis, similar to any other individual who is not experiencing mental health disorders. When a person with bipolar disorder is not experiencing highs (mania or hypomania) and lows (major depression), they experience euthymia – a calm state.”
A diet and exercise cannot cure it
Bipolar disorder is understood to arise genetically or could stem from an altered brain chemistry. This therefore means one cannot cure it with a change in diet or the introduction of a different type of exercise. It is a lifelong disease and currently there is no cure for it.. Having a healthy diet and exercising is key to managing it but it is not a cure.
“Having a healthy diet and exercise is simply one aspect of managing bipolar disorder, and this should exist holistically in your treatment plan. Currently, research indicates that bipolar disorder is a chronic and lifelong condition, and no cures are known as yet. Treatment for bipolar disorder can include a combination of medication, psychotherapies, adjustment to diets, exercises and lifestyle changes, and a strong emotional support network.”
Just like there different bipolar disorders, there are also different treatments
Stemming from the notion that there is only one type of bipolar disorder, many believe there is only one treatment. This is false. There are many ways to treat bipolar I, bipolar II and cyclothymic disorder. Treatment for cyclothymic disorder can involve medication and talk therapy.
“To the best of my knowledge, I believe that the combination of medication might be different depending on the type of bipolar disorder (I or II). Common types of medication may include anti-depressants, antipsychotics, and anticonvulsants.”
In some cases, an effective treatment known as electroconvulsive therapy (ECT) may be used should medication and psychotherapy not help a patient. This is used as a last resort. ECT involves several rounds of a brief electrical current applied to the scalp while the patient is under anaesthesia. This leads to a short, controlled seizure which is believed could remodel brain signalling pathways.
Managing your bipolar disorder won’t take make you lose your creativity
As mentioned at the start, many brilliant and famous people have bipolar disorder. Ernest Hemmingway, the famous author, also had the disorder. Those with the creative spark may feel they will lose it after getting treatment, but this is not the case, assured Hoosen.
“While this is one of the widely spread myths about bipolar disorder, other studies have indicated that individuals are even able to tap into their creativity better when they are receiving treatment.”
Pulitzer Prize-nominated author, Marya Hornbacher discovered this first hand. In her book Madness: A Bipolar Life, she talks about how getting treatment actually improved her focus and creativity. She was able to channel her creativity effectively and released a book 10 months after being diagnosed.
It has nothing to do with split personality disorder
The word ‘bi’ is a combining form used like a prefix which means two or twice. It is probably because of this combining form that people believe bipolar disorder is the same as split personality disorder. This is extremely far from the truth, said Hoosen.
“Briefly, personality can be described as a set of enduring traits that an individual possesses that is lasting in most contexts and captures a set of characteristics unique to persons. Bipolar disorder is a mental health condition that consists of a specific set of symptoms that capture the episodes experienced by an individual. A person with bipolar disorder does not display a different personality altogether, rather they display altered and elevated states of mood.”
Another dangerous stereotype that exists is, People with bipolar are crazy. This is a dangerous and damaging stereotype.
“Due to the elevated mood and energy, plus other signs such as decreased need for sleep, grandiosity, excessive talking or pressure to keep talking, pop media has displayed bipolar disorder in a negative light. Managing bipolar disorder can be tricky, and it is important to always place an episode or an event within context before labelling an individual.”
Overcoming the stigmas of bipolar disorder
Bipolar disorder impacts the young and the old. Oftentimes the dangerous stereotypes and stigmas attached to bipolar disorder force one to not get help. Fearing they might be ostracised or treated differently. A person with such a condition can lead a normal life, have friendships and relationships but that requires them to get help. This will provide them with the tools to manage their disorder better and help live the life they want. By not having open and honest discussions, continuing the stereotypes and stigmas that the media produces, we are effectively harming those who may have the disorder. It is only by talking about it and educating oneself will people be open to speaking about their condition and getting help.
