A serious mental health condition, bipolar disorder that can be treated with medicines and psychotherapy. 

By Dr Debanjan Banerjee and Snehasree Neogy

World Bipolar Day is observed on March 30 every year, on the birthday of Dutch painter Vincent van Gogh — one of the most influential artists in the history of Western art. His creativity was paralleled with his mental illness and he was posthumously diagnosed with bipolar disorder.

Formerly known as manic-depressive illness, bipolar disorder is characterised by significant shifts in the mood, irrespective of life situations. All of us face mood swings — feelings of ecstasy and sudden bouts of sadness. But when it is in extremes and strains our daily life and relationships, it is termed as an illness. Typically, bipolar disorder occurs episodically with either a manic (high state) or a depressed state (low state). Many return to a well state from these two extremes and function normally at times.

Two states 

A person in the manic state is usually overwhelmed with feelings of euphoria, excessive energy, inflated self-esteem, and a tendency to talk excessively. Many in this state also feel differently, with sudden bursts of uncontrollable anger, irritability and aggressive behaviour replacing the euphoria. There may even be a reduced need for sleep, with the person being easily distractible. 

A person in the depressed state exhibits a continuous low mood, loss of interest or pleasure. This is similar to clinical depression, which is an illness in itself. An individual with depression may experience weight loss or loss of appetite, sleep difficulty or excessive sleepiness, restlessness and anxiety, fatigue, inability to focus, and recurrent thoughts of death. 

Both manic and depressive states can occur either in isolation, or an episode may have mixed symptoms. The most diagnosable symptom is the abnormal elevation or depression of mood. 

Decoding the condition 

Bipolar disorder affects nearly one per cent of the population worldwide, commonly occurring between 20-25 years of age. The exact cause is not yet known. 

Imbalance in neurotransmitter levels in the brain areas responsible for mood, energy, sleep and functioning as well as impaired nerve-to-nerve signaling in these areas can all lead to this illness. Lack of proper sleep, irregular routine, long-term stress and addiction behaviours are common risk factors for bipolar disorder. Genetics also play a role.

The risk of suicide is high. Over a period of 20 years, six per cent of those with bipolar disorder died by suicide, while 30-40 per cent engaged in self-harm behaviours.

It’s important to note that bipolar disorder is a serious mental health condition that can be treated — with medicines (such as mood stabilisers and antipsychotics) and psychotherapy (like cognitive behavioural therapy, interpersonal psychotherapy, interpersonal and social rhythm therapy). Family education about the illness is vital, as is frank discussion with the treating psychiatrist about the dose of medicines and duration of the treatment. 

Let’s spread awareness and abolish the stigma — so that prompt professional help can be taken when needed. Also, healthy lifestyle patterns, including adequate nutrition, exercises, yoga and regular sleep-wake schedule can be of immense help.

(Dr Debanjan Banerjee is a consultant neuropsychiatrist, Apollo Multispecialty Hospitals, Kolkata, India; Snehasree Neogy is a clinical psychologist, Apollo Multispecialty Hospitals, Kolkata, India)