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DR Chido Rwafa Madzvamutse
Mental Wellness

As discussed in previous articles, mental health is defined as a state of well-being in which an individual realises his or her potential, can cope with the normal stresses of life, can work productively and fruitfully, and can make a meaningful contribution to their community.

Bipolar disorder is a widely misunderstood mental health condition that affects millions of people globally. As we commemorate World Bipolar Day this week, let us reflect on what this condition is, what it is not, and how we can reduce stigma and improve access to appropriate care for those affected.

Common Myths about Bipolar Disorder

1. Bipolar Disorders are just mood swings: This is false, Bipolar Disorder is characterised by distinct episodes of mania or hypomania and depression, often with periods of stable mood in between. It is a serious often debilitating illness if left untreated. Myths that imply that Bipolar Disorders are mood swings undermine the severity of this condition and the effects on the individuals functionality as well as on their families, friends, and colleagues.
2. People with Bipolar Disorder can never lead normal lives: This also is false. When people with Bipolar Disorder are properly assessed, managed, and supported, they can live productive and fulfilling lives. Treatment includes counselling and psychotherapy as well as medications to stabilise mood and manage challenging symptoms.
3. Bipolar is a rare condition: This is not true. Bipolar Disorder has a worldwide prevalence of 1 percent, which means one in every 100 people could develop Bipolar Disorder in their lifetime.
4. Manic episodes are just bursts of extreme creativity: This is not true. The manic episodes seen in some types of Bipolar Disorder often result in agitation, impulsivity, irritability, and reckless behaviour, which can affect functionality and strain relationships
5. Bipolar disorder only affects someone’s mood: Bipolar Disorder affects more than just an individual’s mood. Bipolar Disorder will also cause disturbances in sleep patterns, appetite, energy levels, ability to focus and concentrate, and clarity of thought.

What is Bipolar Disorder and what causes it?

Bipolar Disorder is a mental health condition characterised by episodes of mania, hypomania, and depression. During an episode of mania, individuals experience an elevated mood or euphoria; inflated self-esteem; irritability, agitation, or anger; excessive energy; they may talk very fast about many things; may become disinhibited resulting in risky or inappropriate behaviour; a decreased need for sleep or feeling rested after very brief periods of sleep; being easily distracted.

Hypomania is a less severe form of mania. The episodes of depression in Bipolar Disorder resemble those of Major Depressive Disorder including sadness, loss of drive and motivation; changes in appetite; weight loss or weight gain; fatigue; insomnia; poor concentration; feelings of worthlessness, helplessness, hopelessness, and thoughts of suicide. Individuals with Bipolar Disorder may also experience psychotic symptoms like delusions or hallucinations often in line with their elevated or depressed mood, this could be a belief that one has special powers others don’t possess if one is in a manic episode or hearing voices belittling them if one is depressed.

Bipolar is thought to be caused by genetic and neurobiological causes. A family history of bipolar increases one’s risk of developing this condition. Abnormalities in brain chemicals that regulate mood, sleep, energy levels, and other brain functions also contribute. Abnormalities in brain circuitry have also been implicated. Excessive stress, poor sleep, alcohol and substance use can precipitate episodes in persons with Bipolar Disorder.

How can we improve the care of people with Bipolar Disorder?

1. Awareness about the condition, the symptoms, and the challenges faced by those affected to help reduce stigma and facilitate early diagnosis. Awareness in workplaces and schools to help facilitate reasonable accommodations for those affected.
2. Improve access to appropriate care and treatment as most patients will need psychological care and medication. This care is best integrated into primary care where possible.
3. Dignified, respectful care during acute episodes, this can also include setting up advance directives by the per-son affected on how they wish to be cared for during an acute episode when they may have diminished capacity to make decisions.
4. Improving access to affordable medications, medications such as mood stabilizers, antipsychotics and antidepressants for Bipolar Disorder are often costly to the patient and their family. In addition, there may be added costs of laboratory investigations often needed in monitoring this condition
5. Peer-led support groups to reduce the sense of isolation, particularly for those recently diagnosed.

If you think that you or someone that you know may be experiencing a mental health problem, please contact your nearest healthcare provider and get help.

l Dr Chido Rwafa Madzvamutse is a consultant psychiatrist. +263777727332) (www.ahfoz.org; [email protected])