Today (March 30) is World Bipolar Day – an occasion that many medical professionals like me and those suffering from this condition use to raise awareness, advocate available treatment options, offer support for those living with it and combat the social stigma associated with it by having open discussion and encouraging people to seek early interventions.
To say that even in the 21st century, raising awareness about any mental health condition – which is perceived as a stigma by society, by and large – is a cliche. Bipolar disorder is no exception to this social habit. It is generally dismissed as a ‘mood swing’ but it is way beyond that. It’s common to casually ‘label’ individuals experiencing mood swings as “Bipolar”.
However, it is crucial to understand that not all emotional fluctuations equate to bipolar disorder.
This misunderstanding often leads to stigmatisation and misrepresentation of this complex mental health illness. Bipolar disorder is a mental disorder and far more pronounced in its effects than just the perceived ‘mood swings’.
Mood swings are indeed a symptom but in bipolar disorder, they are more extreme, prolonged and dysfunctional compared to this state of mind – in general – which is normally momentary, transient, and mostly triggered by a particular external event. The mood swings in bipolar disorder are not at all momentary – to set the record straight.
Previously known as manic-depressive illness, bipolar disorder is a mental health condition that significantly affects a person’s mood, behaviour, and thoughts, and consequently, their very ability to function.
The global prevalence of bipolar disorder is estimated to be 1- 2%, with some studies suggesting it could be as high as 5%. Research suggests that a combination of genetic, environmental, and neurological factors may contribute to the development of bipolar disorder.
Symptoms of bipolar disorder are severe and differ from the typical ups and downs that people experience. It is characterised by mood episodes, ranging from manic episodes (full of extreme energy) to depressive episodes. They can last for days or weeks.
The symptoms can vary depending on the type of the episode, with manic episodes causing elevated or irritable moods, increased energy and activity levels, racing thoughts, and risky behaviours. Depressive episodes can cause feelings of sadness, hopelessness, and lethargy, as well as lead to changes in the appetite and sleep patterns. Therefore it is important to avoid casual and uninformed use of the term ‘Bipolar Affective Disorder or BPAD’ – as it is scientifically known.
Usually bipolar disorder is understood by people as one mental health condition only that comprises episodes of high energy and low energy. But it’s a myth because the disorder itself is of six types, as per the Akiskal classificatory system. Out of all the six types, type 1 and type 2 are the most common.
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Bipolar type 1 and 2
Bipolar 1 disorder typically involves manic episodes, in which people experience extreme levels of energy, which, on some occasions can be destructive too. This requires more, immediate attention and often gets diagnosed. Depressive episodes may also occur in it.
On the other hand, Bipolar 2 disorder is mostly characterised by a pattern of depressive episodes; what also occurs alongside are ‘hypomanic episodes’ – something which are less severe or full-blown than the ‘manic episodes’ that people suffering from Bipolar type 1 experience. (Both hypomania and mania are characterised by high energy but the former is less intense than the latter).
In other words, people living with type 1 experience rather extreme levels of energy as part of ‘fluctuations’ as compared to those with type 2. And, therefore the former requires immediate attention.
What also differentiates Bipolar type 2 disorder from type 1 is the fact that hypomanic episodes – the ones with relatively more energy – are often missing or lesser in number. In the type 2 form of this disorder, there are more depressive episodes than type 1 and often they are prolonged as well. This tendency in type 2, at times, leads to a misdiagnosis of the disorder as ‘depression’ which is a different condition.
The prolonged depressive episodes in type 2 bipolar disorder can disrupt the daily functioning of the individual experiencing them. They do come out of these depressive episodes and function with relatively better energy levels as part of their ‘energy swings’. However, such ‘better’ episodes may be shorter in duration as well as lesser in the number, as compared to the respective depressive ones. This can significantly affect people’s ability to work besides causing a roller coaster of emotions in them.
It is impossible to predict or draw a pattern as to when a better episode would ‘flip’ to a depressive one; and vice versa. This also holds true for the duration of such episodes. In other words, every day, week or month, can be unpredictable for people suffering from type 2 as well as type 1 bipolar disorder.
Often, it can remain undiagnosed for years before the individual finally feels the need; and seeks professional help. In these scenarios, corroborative information from family members or caregivers often supports in reaching a diagnosis. Once it’s diagnosed, the role of everyone surrounding the person becomes important ranging from friends to family members and colleagues at the workplace.
However, supporting a loved one with bipolar disorder can sometimes lead to burnout and depression for the caregiver also. Therefore it’s always suggested to educate yourself, and understand the triggers for the individual and the treatment options.
The change is episodes are beyond the caregiver’s control also, and not just that of the individuals going through them. Therefore, rather than feeling frustrated or being critical, caregivers should offer open communication and receptivity to feelings of such people. Being more empathetic and listening without judgement often helps in better caregiving of patients with bipolar illness.
Diagnosis of bipolar disorder typically involves a comprehensive evaluation by a mental health professional, including a review of the person’s symptoms and medical history. Treatment often involves a combination of medication and psychotherapy, such as mood stabilisers, antipsychotics, and antidepressants, and cognitive-behavioural therapy or interpersonal therapy.
With proper treatment and support, individuals with bipolar disorder can lead fulfilling lives.
The success stories
It is not without reason that March 30 is observed as ‘World Bipolar Day’. It is the birthday of Vincent Van Gogh, a famous artist believed to have had bipolar disorder. He performed to the best of his potential despite this condition. However, this is not the only ‘success story’.
In 2021, rapper Honey Singh (also known as Yo Yo Honey Singh) shared in an interview that he had been diagnosed with bipolar disorder and had been receiving treatment for the past 18 months. He spoke about his struggles with depression and alcoholism, which he attributed in part to his bipolar disorder.
His openness about his experience also helped to reduce stigma surrounding bipolar disorder and encouraged others to seek help when they needed it. These success stories are a reminder that with the right treatment, support, and determination, people with bipolar disorder can thrive and accomplish their goals.
This World Bipolar Day, we encourage people to connect and remind others that they are not alone. By sharing their stories online using the hashtags #BipolarTogether and #WorldBipolarDay, we can unite to educate, empathise, and empower others. There are many successful people who have lived with bipolar disorder and have found ways to manage their symptoms and lead fulfilling lives .
Sharing success stories can normalise the existence of people suffering from any type of bipolar disorder. When people realise that bipolar disorder can happen to anyone, they may be more likely to empathise with those who are struggling with the condition and less likely to judge or discriminate against them.
The success stories also help dispel myths. They provide hope, and inspiration. They also encourage people to seek help who might have been dodging this one most important move of their lives for years, otherwise. And, of course, it increases empathy and compassion, in society as a whole towards people suffering.
Ensuring social equity by providing accessible mental health services and intervention to every individual in this country should be a joint responsibility of the State and mental health professionals. Access to mental health care is a fundamental human right and the government should have a moral obligation to uphold and protect the mental health of its citizens.
Dr Jitender Jakhar is a consultant psychiatrist at the Sitaram Bhartia Institute of Science and Research, New Delhi. He can be reached at jitender.jak@gmail.com
