Bipolar disorder - shining a light on bipolar

What do Winston Churchill, Isaac Newton and Vincent Van Gogh have in common besides their fame and genius? They were mental illness sufferers – today the sixth leading cause of disability in the world is bipolar disorder, which also affects 1% of South Africans. Mental illnesses like bipolar are hard to understand and even harder to live with. That’s why the first step of treatment is learning more about the condition and the resources available to sufferers and their loved ones.

What is Bipolar disorder?

Bipolar disorder is an illness characterised by extreme changes in mood, energy, thinking and behaviour. These extreme mood swings take sufferers from grave depression to extreme mania in a matter of weeks. The length of these extreme highs and lows vary from person to person. While men and women are equally affected by the condition, men tend to have more manic episodes while women experience more depressive episodes.

What causes Bipolar disorder?

Doctors don’t know exactly what causes bipolar disorder. It is believed to be caused by a combination of biochemical, genetic and psychological factors. The truth is that bipolar disorder is not always recognised as an illness, which means many people suffer needlessly for years before a proper diagnosis is made and treatment starts.

Types of bipolar disorder

Bipolar I is diagnosed when a person has at least one episode of extreme mania or mixed mania (both mania and depression occur on the same day and an episode lasts at least a week), and one or more episodes of major depression.

Bipolar II typically involves a milder form of mania, called hypomania, in which the person may feel energetic and productive and not even realise they are acting abnormally. In these cases, most people only recognise and complain about their depression.

BP-NOS usually refers to people who experience only a few of the typical bipolar symptoms or when their symptoms don’t last as long.

Cyclothymic disorder is a milder form, in which a person has numerous episodes of hypomania and mild depression during a period of two years or longer.

Symptoms: from dark and depressive to upbeat and manic

In the depressive phase a person may experience episodes of intense depression and express feelings of debilitating sadness, anxiety, loss of energy, hopelessness, and difficulties concentrating.

During a manic phase people usually feel euphoric and believe they can accomplish anything. This can result in inflated self-esteem, a reduced need for sleep, being more talkative and a sense of racing thoughts. Some display reckless behaviours like going on spending sprees, fast driving or substance abuse. If more than three of these symptoms are experienced nearly every day for a week, this may indicate a manic episode. 

Diagnosing bipolar disorder

Bipolar cannot be diagnosed in a lab or with a test. The first step is to rule out other possible causes of extreme mood swings, which could include a brain infection or other neurological disorders, substance abuse, thyroid problems, ADHD, etc. A psychiatrist will make the diagnosis based on a history and careful evaluation of the patient's mood and other symptoms.

Taking control

Bipolar can be successfully treated through a holistic combination of medicine, education, lifestyle changes and support.

Medicines such as mood stabilisers, as well as antipsychotic and anticonvulsant drugs, are usually prescribed to smooth out the highs and lows. Between acute states of mania or depression, patients will typically stay on maintenance medicine to avoid relapsing.

Support remains a key part of treatment and can come in various forms. Cognitive behavioural therapy helps patients change any thought patterns and behaviours that accompany their mood swings, while interpersonal therapy helps ease the strain added to personal relationships.

Lifestyle changes, like establishing firm routines around sleep, meals and exercise, help manage the disorder better. Alcohol and recreational drugs can worsen the symptoms and need to be avoided. It also helps patients to identify their personal early warning signs of mania and depression so they can get help before an episode gets out of control.

Educating friends and family is key to helping loved ones understand and better manage their feelings and actions in the various phases. Having a solid support system can also help motivate patients to manage their condition and make them feel less isolated and alone.

Getting help at home

You are not alone. South Africa has over 15 support groups around the country. To access the resources and support you need, start by contacting: South African Depression and Anxiety group (SADAG) South African Bipolar Site

Further resources

This article contains opinions and facts and references to other information sources. You should always consult a registered healthcare professional for any personal advice.