Bipolar disorder: the signs and effects to look out for

People diagnosed with bipolar disorder regularly suffer stigma. May 26 is Bipolar Awareness Day, which helps improve understanding of the chronic mood disorder. Stock photo.
People diagnosed with bipolar disorder regularly suffer stigma. May 26 is Bipolar Awareness Day, which helps improve understanding of the chronic mood disorder. Stock photo.
Image: 123RF/ostill

For many people diagnosed with bipolar disorder, the stigma isn't just felt in their homes but often at work and in broader society.

To help those who battle, the South African Depression and Anxiety Group (Sadag) has been driving education and awareness to ensure better general understanding of the condition.

Sadag on Wednesday hosted an online information day for interested people, offering information, resources and access to help.

Speaking at the event which will be followed by live online discussions on the Sadag Facebook page on Friday night psychiatrist Dr Antoinette Miric described bipolar as a chronic mood disorder where moods can be instable or erratic. It is sometimes equated with depression.

“It is characterised by sustained periods of low moods, shifting to an agitated high, and then back to low moods. These episodes can last days to weeks and even months, and so it’s not possible for the person to just pull out of it. This is a condition that mostly requires medication to be handled well,” she said.

While about 2% to 3% of the population has bipolar disorder, the figure is higher in families with sufferers, because it is hereditary. And those at highest risk are also more likely to be predisposed towards depression.

“It is not as severe as schizophrenia, but it is a severe illness and does need medication,” Miric said, adding that bipolar disorder was difficult to diagnose.

It is also a chronic condition, and could also change over time. It can become either better or worse, progressing in different ways for different individuals.

The illness is treated with three classes of medication, depending on the severity of symptoms. But it generally requires either mood stabilisers, antipsychotics or antidepressants, all of which have side effects ranging from sedation and lethargy to weight gain and loss of libido. The side effects, said Miric, sometimes prompted patients to reject medication.

It seems clear that people who suffer with mental health challenges are far more prone than the average person to contract Covid-19
Psychiatrist Dr Antoinette Miric

According to her, patients could relapse both on and off treatment. The best indication of a pending relapse was a change in sleep patterns that was consistent over several days.

“If the person suddenly starts sleeping for huge amounts of the day 12 or even 16 hours a day  or if they are getting by with only three or four hours, this means they are heading either for a depressive episode or a high,” she said.

She warned that there are dangers involved when patients decide to stop taking their medication, and that this should be done under supervision of a doctor or psychiatrist because of the high rates of suicide.

“The more a patient relapses, the worse the condition becomes and the more cognitive damage or harm to their thinking processes happens. We see a very high attempted suicide rate in these people about 50%, with a 20% suicide completion rate.”

Miric urged people with bipolar disorder, those who suspect they have a mental health issue, as well as those who live with someone who suffers with a mental health issue, to seek help and establish a support network something that can be sourced on the Sadag website.

“Bipolar is a very difficult disorder, but it is a reality that family members are living with. We don’t yet have clear information, it’s still coming in, but it seems clear that people who suffer with mental health challenges are far more prone than the average person to contract Covid-19.

“We are not sure why this is. It could be that many live in difficult conditions, but we also know that mental health is often accompanied by other comorbidities such as diabetes, high blood pressure and obesity.”

Her advice to sufferers was to adhere to their medication protocols, follow a healthy diet with regular exercise and to avoid alcohol and other toxic substances.

“It’s a hard place to be when you are suicidal, but if you know it is a possibility, have a standby list of people to call on if it happens. Understand that it is just part of the disorder and not part of you.”

Miric encouraged people to seek out the Sadag website for information, resources and help.

“By talking about it, sharing resources and encouraging others to share their stories, we can help people better understand their condition, and hopefully motivate them to reach out for help.”

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