Mental Health

Bipolar disorder, previously known as manic depression, is a complex mental illness causing a person to experience drastic mood swings that is often misunderstood.

Dr Julia Lethole, a psychiatrist at Mediclinic Muelmed explains more about bipolar disorder.

What causes bipolar disorder?

Bipolar disorder impacts about 2-3% of South Africans, affecting men and women equally. While it’s not known exactly what causes it, there may be a genetic component because it’s more common in those who have a family history of bipolar disorder or major depression, says Dr Lethole. Bipolar disorder is a chronic illness, meaning it’s a condition you live with, not something that goes away after treatment.

Symptoms of bipolar disorder

The hallmark of the illness is that patients experience depressive episodes and manic episodes, not necessarily in a predictable cycle, says Dr Lethole. Some may also experience mixed episodes with symptoms of both type of episodes manifesting at the same time.

Possible symptoms during a depressive episode:

  • Trouble concentrating
  • Feelings of guilt
  • Lack of appetite
  • Thoughts of death
  • Long sadness
  • Slow speech and movement 
  • Poor cognitive functioning
  • Insomnia (difficulty sleeping) or hypersomnia (oversleeping)

Possible symptoms during a manic episode:

  • Increased irritability
  • Reduced need for sleep
  • Bouts of euphoria
  • Increased activity
  • Wastefulness
  • Provocative behaviour
  • Drug use

Being in a manic phase does not mean the person with bipolar disorder is happy, explains Dr Lethole. In fact, a person with bipolar disorder who’s experiencing a manic phase can actually be at risk. Having way too much energy may cause the person to act out of control, saying or doing things that they may later regret. This could be anything from making a rash comment to engaging in high-risk behaviour like using drugs or recklessly spending money.

Severity and sequence of bipolar disorder is personal

A common misconception is that manic and depressive episodes follow each other, one for one. However, this is not always the case, says Dr Lethole. While a person who has bipolar disorder will experience both manic and depressive episodes, how often they experience one or the other and how long those episodes last varies from person to person.

Getting help

As with other mood disorders, such as depression, a common belief exists that bipolar disorder is a state of mind and can be “cured” using willpower. This is not the case, says Dr Lethole. She explains that bipolar disorder is a complex illness of the brain that has many contributing factors, including psychological, neurological and environmental aspects. No matter how strong a person’s willpower, bipolar disorder is an illness that needs proper medical intervention.

A psychiatrist would diagnose bipolar disorder and prescribe one or more medications. It may take some time to get the dosages right, but once that’s established, there’s no reason why a person with bipolar disorder can’t enjoy a normal life – including a successful career, relationship or having children.

Treatment For life

However, it’s important that someone who has been diagnosed with bipolar disorder continues with their treatment, cautions Dr Lethole. That includes taking their medication and having regular check-ins with their psychiatrist and possibly a psychologist as well.

The problem is that when people are feeling good for a long period of time, they may be tempted to stop taking their medication because they believe they’re cured or are worried about becoming addicted, says Dr Lethole. However, there is no evidence that the medication used to treat bipolar disorder is addictive. What’s more, bipolar disorder is a chronic illness – it can be managed so that symptoms are kept at bay, but it won’t go away.

Even with medication, relapses can occur occasionally, particularly if the person is placed under stress. These can be dangerous as they affect the person’s quality of life. People living with bipolar disorder may even put themselves in danger through high-risk behaviour and are also at risk of suicide.

The important thing to remember is that bipolar disorder can be managed and the sooner you get diagnosed and start treatment, the sooner you can start leading a fulfilled life.

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