Bipolar mood disorder is a serious and chronic condition that requires recognition, understanding and empathy. By coming to terms with and managing this mental illness the sufferer and their loved ones will enjoy a better quality of life.
Imagine spinning in and out of severe mood shifts, from the highs of mania to the extreme lows of depression, multiple times over a period of days to several weeks. These are not the normal up-and-down moods a mentally healthy person experiences.
The severity of the mood changes are so intense that they interfere with the ability to function normally. One thing to bear in mind is that this kind of mental illness has a pro- found effect not only on the person but also on those close to him or her.
Yvette Beneke, a 47-year-old artist from Cape Town, was, after a failed suicide attempt in 2015, wrongly diagnosed with depression. She says: ‘I accepted the diagnosis, but then one moment I would be very happy and the next very depressed. This happened to me many times a day. I felt hopeless and didn't want to carry on with life.’ In July 2016 she was diagnosed with bipolar disorder.
Yvette is not alone in suffering from bipolar disorder. According to the South African Depression and Anxiety Group (SADAG), bipolar affects 4 to 6% of the population in South Af- rica and is the sixth leading cause of disability in the world.
SYMPTOMS AND SIGNS
The main difference between bipolar types I and II is that those suffering from bipolar type I experience manic symptoms, and a person suffering from bipolar type II experiences hypomanic and depressive symptoms.
WHAT ARE MANIC SYMPTOMS?
Manic symptoms include increased physical and mental activity such as: speaking too fast and incoherently, excessive irritability, aggressive behaviour, inflated self-esteem to levels of grandiosity (for example, believing they have special powers to be the chosen leader of the world or universe), a decreased need for sleep, as well as reckless behaviour such as spending sprees, sexual indiscretions, and reckless driving.
In order for the mood to be considered manic, these symptoms must cause a ‘marked impairment in functioning’. The symptoms may necessitate hospitalisation to prevent harm to self or others.
WHAT ARE HYPOMANIC SYMPTOMS?
Hypomanic symptoms are the same as those for a person who experiences the manic symptoms but are not severe enough to cause marked impairment. In this phase, a person suffering from bipolar type II gets a break from the depressive episodes.
‘It is a common misconception that bipolar type II is “less severe” than bipolar type I – it is simply not true when considering the long-term course of both conditions. A person diagnosed with bipolar disorder type II experiences the same symptoms but less severely,’ explains Dr Mike West, a Cape Town psychiatrist whose fields of interest include addictions, anxiety, and psychotic and trauma-related disorders.
People in the hypomanic phase will buy five CDs and people in the manic phase will buy 50 CDs.
Although Yvette was relieved when she was diagnosed with bipolar disorder, because many things in her life and behaviour now made more sense, she still finds it difficult to handle the severe mood swings. These days, she is often quite anxious and she doesn't cope very well with big crowds. She says: ‘I become irritated and anxious so I try to avoid situations like this.’
HOW IS BIPOLAR DISORDER TREATED?
There is no cure for bipolar disorder but it is of utmost importance to see a psychiatrist in order to get the correct medication. A psychiatrist plays a critical role in assessing, diagnosing and treating the illness.
Mood stabilisers
The condition is treated with mood stabilisers and most people suffering from the disorder will need more than one medication through the course of the illness.
‘Finding the correct medication is quite often a trial-and-error process and may require adjustments at certain times, for example during pregnancy and breastfeeding. However, with the correct treatments, many patients with bipolar disorder are able to live a full and happy life,’ explains Dr West.
It is also common for a person with bipolar dis- order to experience bouts of anxiety. ‘In some patients, the medications prescribed for bipolar disorder may precipitate this as a side effect. Despite this, patients should not make rapid changes to their medications without consult- ing their doctor first,’ says Dr West.
Therapy
Many patients suffering from bipolar disorder have several therapeutic options for treatment.
Liane Lurie, a clinical psychologist from Johan- nesburg, explains: ‘An important aspect, which forms part of a patient's treatment option, is providing them with information about the dis- ease. Individual and group therapy are just as important.’
Friends and family
Cindy van Wyk, a clinical psychologist from Johannesburg, who specialises in neuropsychology, says: ‘It is always helpful to include family and close friends. Their support is of tremendous value.’
Yvette Hess, an artist, spends her time creating original paintings and writing biographies. She studied full-time and was a single parent struggling financially. ‘I took on part-time work. I was also a student leader of a number of organisations and I just couldn't stop taking on new projects,’ she says.
Yvette would jump from relationship to relationship. She drove recklessly – everything in her life was fast. ‘Somehow I managed to juggle it all. But soon, after bouts of low energy, constant negative thinking would overwhelm me. I would skip classes and switch my phone off for days,’ she confesses.
She says: “The bad days can be difficult to get through, especially when I can't read or write. When I'm well, I can trust myself to do anything.’
Yvette explains: ‘It took so long to accept my illness. I cannot do it alone; it is one of the big- gest lessons I've learnt. I need support from my family and friends to achieve my goals. I need regular sessions with my psychologist and psychiatrist. I am ill, just like someone with diabetes or cancer. It is important to remember there's always help. There's always hope.’
CONCLUSION
Running in circles around the severe mood shifts can leave a person suffering from bipolar disorder exhausted. Whether they want to pull their hair out or whether they want to hide in a dark closet, they must manage their illness. They have no choice but to gather their weapons and fight their moods.
SADAG's tips on self-help for bipolar disorder
- Keep a mood diary: It can help track your moods and things that happen to affect your mood.
- Don't use alcohol and drugs: It may be tempting to use alcohol and drugs to cope with your illness, but this almost always makes matters worse.
- Other medicine: Any other over-the-counter medications, such as for colds, allergies and pain, can interfere with your mood and prescribed medicines for bipolar disorder. It is best to discuss other medications with your psychiatrist before you decide to take them.
- Exercise: Take care not to be over-active or push yourself too hard. Maintain a regular pattern of activity.
- Sleep: Maintain a routine here. Go to bed every night at the same time and wake up at the same time every morning. If your sleep patterns are disturbed, it can affect your mood.
- Try to avoid too much stress.
- Find out if there are any support groups in your area.
SADAG'S fast facts and statistics on bipolar disorder
- 62.9% of those in the bipolar spectrum have an anxiety disorder.
- The average age of onset for bipolar disorder is 25 years.
- When one patient is affected, the risk to a child is 15 to 30%.
- 69% of patients with bipolar disorder reported an initial misdiagnosis.
- 30% of individuals with bipolar disorder will attempt suicide during their lives.
- Psychiatric care and medication reduce the risk of suicide to less than 3%.
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