Shining a light on bipolar disorder
BIPOLAR disorder – previously referred to as manic depressive disorder – is a serious mental condition whereby sufferers undergo intense mood changes with extreme highs and lows.
The symptoms are very different from normal mood changes. Bipolar disorder is also difficult to diagnose, especially when the condition sets in.
Often it is diagnosed only when a sufferer reaches adolescence or in early adulthood.
However, it may slip under the radar and proper diagnosis may emerge only after a hyper-manic episode occurs later in life.
In some cultures, mental illness is not spoken about, so sufferers rarely seek help and support, which delays diagnosis.
Most sufferers are known to be highly gifted, intelligent and creative.
Many talented actors, artists and writers have spoken about their condition, which is usually elevated to the status of a “celebrity disorder”.
To an ordinary sufferer, this means little when they are in the grip of an episode.
The fact that mental illness is still a “closet” disease, where family, cultural groups and sections of society view it as a taboo subject not to be discussed, also made it a “lonely” disease.
By contrast, people are at ease when speaking about other conditions like “sugar” (diabetes) and “pressure” (hypertension).
Medical schemes don’t provide bipolar sufferers with the same benefits as other chronic diseases, which adds stress to a family’s financial resources.
During the build-up to the hyper-manic episode, if untreated, a sufferer will go through the hypo-manic or elevated mood stage, which may last a long or short time.
The person will exhibit changes in personality, become energised and experience bouts of increased creativity and production.
Student sufferers might be able to study for longer and produce better results. A usually reserved person may become more sociable, outgoing, optimistic and enthusiastic about everything.
During the hyper-manic phase, mood changes are common, and while the sufferer might have energy to burn, sleep deprivation and abnormal behaviour, including fasting, paranoia, delusional thoughts and risky behaviour is common, depending on whether psychosis is present.
A person only needs one hypermanic episode to be diagnosed with bipolar disorder. Most sufferers are put in hospital and treated during this phase.
Often they are put in hospital without their consent as they are not in a position to clearly determine how irrational their behaviour appears.
While high-risk behaviour may lead to tragic consequences for some, suicide and para-suicide is most common during a depressed state, which typically follows the manic state, if untreated.
It is during this low state that feelings of worthlessness, general apathy and hollowness are described, leaving the person with unexplained exhaustion, lack of concentration and no zest for life.
It is an emotionally dark and lonely phase where sufferers may not seek help from others for various reasons, including trying to balance work, home and family.
This chronic cycling from manic to depressive state may disrupt home life, work and relationships, anyway.
While some have periods of normality between episodes, others require medical treatment, which carries unpleasant side effects. So sufferers often tend to skip medication, which results in relapses.
Support groups are helpful for sufferers. Some hold the view that support groups are all fun and laughter, as depicted in the series Anger Management.
This is actually not the case. People usually become emotional when sharing about their despair, fears and pain as sufferers because group sessions highlight the harsh realities of the condition.
So what is it like living with bipolar disorder, diagnosed late, at age 50, like myself ? While it is thought that women have more support from others, and ask for it quicker than men, this is dependent on culture, upbringing and social conditioning.
It is common for Indian women not to impose themselves on family or children, even if their concerns are genuine and ongoing.
I put my family’s well-being ahead of my own emotional needs, which made dealing with my mental illness a lonely road.
Having children doing stressful jobs, and studying at university, I was not prepared to constantly trouble my children, family and friends with my trials. I only shared my triumphs.
Medication made me emotionally flat and I was left with virtually no social life. I avoided being involved in romantic relationships to protect others and myself from what I perceived as unnecessary drama. So my state of loneliness deepened, which set me up for further relapse.
My circle of friends whittled down to a tight-knit group of understanding and supporting people who I could trust.
A burglary at my home, and the resulting post-traumatic stress from the incident, together with my bipolar disorder, made me more guarded against making new acquaintances.
I learnt to survive by eliminating all stress and living one day at a time.
A crucial reason for becoming an activist for any disease is to create awareness and demystify it, not to gain sympathy.
With regard to bipolar disorder, my mission is to lobby medical schemes to recognise that this is a chronic condition that should be treated as such and not with indifference.
They impose restrictions on consultations with health practitioners and medication which make it difficult for sufferers and their families to manage the condition effectively.
By law, medical schemes are required to offer a person with serious mental health problems access to specialists and/or GP consultations up to 15 times a year. But they tend to limit patients to two visits and 21 days in hospital when required, which is not the case for other conditions, and grossly unfair.
They use terms like “nondisclosure of the condition” as an excuse to deny a person benefits, yet, as I explained, it is not easy to diagnose until, for instance, the first manic episode.
With diagnosis and treatment, some normality can be achieved even with other social factors taken into account.
The number of people seeking help for the condition is probably just the tip of the iceberg. There are far more sufferers out there.
Shaik is a bipolar disorder sufferer who taught at the Durban University of Technology and now manages a hospitality business in Gauteng.