Bipolar Disorder: A life of extremes

The South African Depression and Anxiety Group (SADAG) says some people still believe common misconceptions and hurtful stereotypes, including that individuals with Bipolar Disorder are not like everyone else – that they are “pyscho” or “crazy” and that they cannot live normal lives.

The Depression and Bipolar Support Alliance of South Africa explains: “Asking someone to think positive is like asking someone with diabetes to change his or her blood sugar level by thinking about it.”

Previously called manic depression, Bipolar Disorder is a serious mental illness that wrecks lives and affects at least 2% of the population. It is characterised by mood fluctuations that sway from depressed moods – such as loss of interest in normal activities, loss of energy and inability to concentrate, to extremely elevated moods such as feeling invincible, having an inflated self-esteem and decreased need for sleep.

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Everyone experiences mood changes. We all have happy days, sad days, friendly days and irritable days. But in Bipolar patients, these symptoms are severe and can cause the person to act entirely out of character. And contrary to popular belief, they occur over long periods of time. The episodes are separated by periods of stability and people can go for months, sometimes even years, without an episode. Many sufferers and observers don’t even recognise there is a problem.

Because it is such a complex disorder and there are so many different types, it is also difficult to diagnose Bipolar Disorder. The process is further complicated because there are no detection blood tests or scans. Symptoms wax and wane over time, and it is difficult to distinguish between symptoms and personality characteristics. Some research suggests that 50% of individuals with the disorder were first incorrectly diagnosed with depression or ADHD.

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So how can you or a loved one ensure you are getting a proper diagnosis or treatment? SADAG’s Zane Wilson suggests you educate yourself and ask questions. Make sure the doctor receives a full history from family, colleagues, parents, teachers, as well as ensuring you are evaluated over a period of time, not just during one visit. There is also nothing wrong with getting a second opinion.

An accurate diagnosis of Bipolar Disorder can be made by using psychiatric tools, such as the patient’s medical and psychiatric history, self-reported symptoms, observable behaviour, input from friends and family and family medical history.

It is possible for someone to talk themselves into a diagnosis or out of it, which is why it is important to be diagnosed over a period of time.

Once diagnosed, it is important to maintain treatment and have regular follow-ups to check the effectiveness of the medication. An incorrect diagnosis can lead to worsening of symptoms.

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Another misconception is that medications that treat mood disorders are habit-forming and that they change a person’s personality. This is not true. When properly prescribed and used, medications are not addictive and do not change a person’s character. These merely help to keep the person’s moods in the middle range.

Bipolar Disorder is a life-long ailment and cannot be cured, but only controlled through appropriate treatments. One of the biggest mistakes patients make is going off medications because they feel they no longer need them.

“Even a balanced mood can, without treatment, spiral into mania or crash into depression without warning,” says SADAG spokesperson Janine Shamos.

Shamos suggests that you keep a schedule, taking your medication at the same time every day.

“Make your medication part of your daily life and know when you’ll be more likely to remember them, even if it means setting an alarm on your phone,” she advises.

Think you or a loved one could be suffering from Bipolar Disorder? Find help here.