ACCORDING to the South African Depression and Anxiety Group (Sadag), between 3% and 4% of the population suffers from bipolar disorder. That’s about 2-million South Africans.
The National Institute of Mental Health in the US defines bipolar disorder, sometimes referred to as manic-depressive disorder, as "characterised by dramatic shifts in mood, energy, and activity levels that affect a person’s ability to carry out day-to-day tasks. These shifts in mood and energy levels are more severe than the normal ups and downs that are experienced by everyone."
US mental health organisation Mental Illness Policy Org says "Suicide is the number one cause of premature death among people with bipolar disorder, with 15%-17% taking their own lives, as a result of negative symptoms that come from untreated illness."
"The highest, biggest, quickest, can’t keep up with it all, can do it all, from can’t possibly fail to irritation to rage, and finally to the lowest, murky chamber of hell where the darkest of moods slowly strangles every hope … and, maybe, in between all is all right," a person with bipolar disorder says on the Sadag website.
"Depression: I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless. I am haunted with the total, the desperate, hopelessness of it all.
"Others say, ‘it will pass, you will get over it’, but they haven’t any idea of how I feel. If I can’t feel, move, think or care, then what on earth is the point?"
With the causes of bipolar disorder rooted in genetic inheritance and environmental factors, and despite mental illness still being grounded in stigma, experts say the illness can be managed and sufferers can regain productivity.
Mental Illness Policy Org says the most widely used mood stabilisers include lithium (Eskalith, Lithobid, Lithonate, and other brands), valproate (used as divalproex or Depakote), and carbamazepine (Tegretol). "About one in three people will be free of symptoms by taking mood-stabilising medications for life."
However, there are pharmacological side effects. Author of Breaking Bipolar Blog Natasha Tracy says that some of hers have been akathisia — "an inner and outer restlessness that typically causes distress because you can’t stay still.… About one in five people on one of my medications experiences akathisia"— as well as "hair loss, dizziness, nausea, fatigue, being cold, not being able to wake up, and so many others".
Haldol (or haloperidol), another drug used to treat the manic symptoms of bipolar, has a long list of side effects. Internet drug index RxList warns: "Common side effects are nausea, vomiting, diarrhoea, dry mouth, nervousness, headache, dizziness, spinning sensation, drowsiness, insomnia, restlessness, anxiety, and skin rash."
Tracy continues: "I try to remember that while bipolar medication side effects do suck, they suck less than untreated bipolar disorder. I take bipolar medications in spite of the side effects because they keep me alive. This feels like a small gain, but it’s a pretty big one if you ask my loved ones. I hate living with bipolar medications and I hate living with bipolar medication side effects. But they are the lesser of two evils."
Wits University clinical psychologist Antonio Lentoor says the disorder is treatable.
"This is a neurobiological imbalance, which will require lifelong medication."
READ THIS: EDITORIAL: Sustainable growth in doubt
He says the medications’ side-effects are "individual dependant — some people require mood stabilisers in conjunction with anti-anxieties, some in conjunction with anti-depressants, and some with anti-psychotics. They [the side effects] can be managed."
One looming issue preventing successful treatment is the stigma that surrounds mental illness. People with disorders are often depicted as crazy or unstable.
"This is a lifestyle disorder, a biological imbalance. People need to educate themselves around the issue of bipolar," Lentoor says. "I make families a part of the treatment, as the support system must be involved in management."
Psychotherapy or "talk therapy", where a patient discusses the thoughts, feelings and behaviours that cause stress, is the most successful form of therapy for people with bipolar.
Psychotherapy can be divided into behavioural therapy (focusing on stressful behaviours), cognitive therapy (identifying and changing patterns of thoughts that accompany shifts in mood), interpersonal therapy (deals with relationships and strain the illness can place on them), and social rhythm therapy (helps the patient develop a healthy sleep schedule and predictable daily routine).
The American Psychiatric Association says many with bipolar disorder run the risk of having or developing another psychiatric disorder, including an anxiety disorder, eating disorders, or personality disorders. It is estimated that 60% of people with bipolar disorder abuse drugs and/or alcohol. These can trigger episodes: drugs can mimic the symptoms of depression or mania, making it important to treat substance abuse to make an accurate diagnosis of bipolar disorder.
As the stigmas surrounding mental illness slowly melt in the face of understanding (or even glamour, as seemed to be the case in Warner Brothers’ recent Suicide Squad), mental health awareness is on the rise, and for the best.
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.