The battle with bipolar
Why Bipolar Disorder is more than just a mood swing.
We all have mood changes; happy days and grumpy days; energetic days and couch-potato days; friendly and irritable days. Part of being human is the variability of our moods and behaviours. Previously known as Manic-
Depressive Disorder, Bipolar Disorder is a severe mood disorder that can be mistaken for normal, everyday mood
shifts. But Bipolar isn’t regular – it not only causes unusual shifts in mood, energy and activity levels, but also the
ability to carry out day-to-day tasks, to have relationships or perform at work or at school.
People with Bipolar Disorder experience unusually intense emotional states that occur in distinct, identifiable
periods. From the overjoyed highs or a manic episode to the crushing lows of depression, sufferers swing between
these two opposite moods. Extreme changes in energy, activity, the need for sleep and food, and behaviour are part of these mood changes and a chronic mental illness that affects about 2 percent of the population.
Symptoms can make it difficult for the sufferer to function at work, socially or at home.
The exact cause isn’t known however, it’s believed to be a combination of biochemical, genetic and psychological
factors. Research has shown that it’s associated with a chemical imbalance in the brain, which can be corrected with
Men and women are equally affected. Although an equal number of men and women develop the illness, men tend to
have more manic episodes while women experience more depressive episodes. Bipolar Disorder typically begins in
adolescence or early adulthood and continues throughout life, but it can start at any age. It can also affect children;
however, diagnosis is difficult as many symptoms mimic emotions and other behaviours such as ADHD.
Signs and symptoms to watch for
It isn’t always recognised as an illness, and people who have Bipolar Disorder may suffer needlessly for years.
‘It can be difficult to make a diagnosis of Bipolar Disorder,’ says The South African Depression and Anxiety Group’s (SADAG) Zane Wilson.
Symptoms wax and wane over time. At any one point in time, it can be hard to determine exactly what the diagnosis should be: Major depression? Bipolar? Attention Deficit Hyperactivity Disorder? Studies have shown that getting the right diagnosis can be challenging.
So how can you ensure that you or a loved one is getting proper diagnosis and treatment? Educate yourself and ask questions. ‘It’s very important that people take responsibility for their health by asking questions of their health professionals or seeking second opinions,’ says Wilson. Here are some of SADAG’s tips:
- Ask how the diagnosis was made.
- Make sure the doctor receives a full history – from family, colleagues, parents, teachers etc., or has written reports.
- Be sure you’re evaluated over a period of time – not just on one visit.
- Remember, there’s nothing wrong with getting a second opinion.
- Treatment and follow-ups need to be regular and scheduled – to check effectiveness, medication side effects and effectiveness, and monitor personal progress.
The dramatic and rapidly changing moods from high to low don’t follow a set pattern, and depression doesn’t always follow manic phases. A person may also experience the same mood several times before experiencing the opposite
mood. Mood swings can happen over a period of weeks or months. The severity of the depressive and manic phases can differ from person to person and even in the same person at different times.
Mania (the highs)
- Increased physical and mental activity and energy, like staying up all night and talking very quickly
- Heightened mood, exaggerated optimism and self-confidence
- Excessive irritability, aggressive behaviour
- Decreased need for sleep without experiencing fatigue
- Big delusions, inflated sense of self-importance
- Racing speech, racing thoughts, flight of ideas
- Impulsiveness, poor judgement, distractibility
- Reckless behaviour like having unprotected sex with strangers
- In the most severe cases, delusions and hallucinations
Depression (the lows)
- Prolonged sadness or unexplained crying spells
- Significant changes in appetite and sleep patterns
- Irritability, anger, worry, agitation and anxiety
- Pessimism, indifference
- Loss of energy, persistent tiredness
- Feelings of guilt, worthlessness
- Inability to take pleasure in former interests
- Lack of orientation, unexplained aches and pains
- Social withdrawal and recurring thoughts of death or suicide
Is it treatable?
Treatment in the form of medication and counselling can be effective for most people with Bipolar Disorder. It’s similar
to other lifelong illnesses – such as high blood pressure and diabetes – in that it can’t be cured. But it can be managed successfully through proper treatment, which allows most patients to return to productive lives. If not diagnosed and not treated, the impact of the illness can be devastating to the individual, significant others and society in general.
Self-help for sufferers
The first thing that you can do to help yourself live with Bipolar Disorder is to become an expert on the condition. Since Bipolar is a lifetime condition, it’s essential that you and your family learn as much as you can about the disorder and its treatment. Read books, attend lectures, talk to your therapist or doctor, and consider joining a support group to learn from others how to manage daily life and your medications.
You can help manage the minor mood swings and stresses that sometimes lead to more severe episodes by paying attention to the following…
- Maintain a stable sleep pattern by going to bed around the same time every night and getting up about the same time each morning. Disturbed sleep patterns appear to cause chemical changes in your body that trigger mood episodes. If you have trouble sleeping, or are sleeping too much, be sure to tell your doctor.
- Maintain a regular pattern of activity and exercise. Take care not to be over-active or push yourself too hard.
- Keeping track of your daily moods and ‘triggers’ that can affect your mood is easier with a daily mood diary. It can help track your mood, medications, and things that happened to affect your mood and will help you and your doctor better understand your condition.
- Don’t use alcohol and drugs, as these are chemicals that can cause an imbalance in your brain. This often triggers mood episodes and interferes with your medications. It may be tempting to use alcohol or drugs to cope with your mood or sleep problems, but this usually makes matters worse. If you do have a problem with substances, ask your doctor for help.
- Over-the-counter medications for colds, allergies and pain in even small amounts can interfere with sleep, mood or your medication. Be careful about ‘everyday’ use of small amounts of alcohol as well as caffeine (in Cola and stimulant drinks as well as tea and coffee).
- Support from family and friends helps a lot. However, it’s important to understand that living with somebody with mood swings isn’t easy. By learning as much as possible about Bipolar Disorder, you can help reduce the inevitable stress that the condition can cause, both for the person who has it and for the family. Even the ‘calmest’ family will sometimes need outside help in dealing with the stress of a loved one with the disorder. Family therapy and joining a support group can be very helpful.
- Try to reduce stress at work. We all want to perform well and do our best at work, but avoiding a relapse must be your first priority. Try to keep regular hours that will allow you to get to sleep at a reasonable time.
If mood symptoms interfere with your work, discuss with your doctor whether to take some time off from
work or not. What to tell employers and co-workers is ultimately up to you. If you feel unable to work, it
might help to have a family member to tell your employer that you aren’t feeling well, are under a doctor’s
care, and will return to work as soon as possible.
Helping someone with bipolar
Don’t force them to cheer up. People with bipolar disorder and depression have real feelings. They can’t just ‘feel better’. They aren’t weak or lazy, and do want to feel well again.
- Help the person to find out what their mental illness is and get treatment. Go with your loved one to a psychiatrist, psychologist, clinic, doctor or counsellor to find out what’s wrong.
- Find out if there are any support groups in your area. Sharing fears, worries and feelings with other people who are in the same situation helps hugely.
- Depression is a disease. Learn about the illness. The more you know, the more you can help your loved one. See Sadag.org for all the info you need.
- Care and support your loved one. Being with family and friends is very important for the person to feel supported. Always tell the person that you care and love them.
- Let the person be part of your life and events. Invite your loved one to come with you and the rest of the family for walks, church and other activities you would normally do. Encourage your loved one to join in fun activities – both new events and things that the person enjoyed before they got depression or bipolar disorder.
- Don’t force them to cheer up. People with bipolar disorder and depression have real feelings. They can’t just ‘feel better’. They aren’t weak or lazy, and do want to feel well again.
- Listen to what your loved one says. Most people with mental health problems want someone to listen to them. Don’t leave the person out of family discussions because you think it might be less stressful for them if they’re not involved. Treat the person as normally as possibly. Ask them what they hope, fear, feel and need.
- Support is very important – tell the person that asking for help is a sign of strength. Remind your loved one that they can always get treatment for their illness, and they’ll recover in time.
- Don’t treat your loved one like a child – remember that they aren’t feeling their best and try to help where you can. Don’t try to do everything for them – it’s good for them to do some things for themselves if they feel they can cope.
- If your loved one or friend talks about having thoughts of suicide, take it seriously and get them help straight away.
Mental illness is still highly stigmatised and misunderstood, and many people fear admitting there’s a problem or don’t know there’s a problem at all. Bipolar Disorder is treatable and very effective treatments are available. If you suspect you, a family member, or a friend has possible Bipolar Disorder, you should contact SADAG on 011 234 4870, 8am to 8pm, 7 days a week, or visit Sadag.org for more info.
COMPILED BY LAUREN FISCHER PHOTOS: DOLLAR PHOTO CLUB