Taking on the world the highs and lows of bipolar disorder

Recently, many people have been asking me about bipolar disorder. This is so because there is a growing awareness of the condition.

Bipolar disorder is also referred to as a manic depressive illness. As the name suggests, it has two poles or phases - mania and depression. The manic phase is often referred to as the high phase of the illness in which the person may have an elevated mood and racing thoughts.

The high phase is associated with high levels of self-confidence and the person may begin to believe that they have special powers and abilities. The affected individual's energy level also becomes extremely high and he or she becomes very busy or very engaged in activities such as home renovation, organising events, writing books and/or producing songs.

Risky sexual behaviour

Unfortunately, some people in the high phase also get involved in activities that have a tendency for harmful consequences such as spending sprees, sexual activities and drug use.

Engagement in these high-risk behaviours can impact negatively on relationships, as persons with the disorder may cheat on partners or become sexually involved with people with whom they are incompatible. Spending sprees may lead persons to wiping out their savings or bankruptcy.

Extreme sadness

During the low phase of the illness, affected individuals become depressed. They feel extremely sad, their thought processes and energy level slow down, self confidence decreases and the feeling of hopelessness is pervasive. In severe cases, they may become suicidal.

People with the condition move from a period of elevated mood, to normal and then to a sad mood. Bipolar disorder exists from mild to moderate and severe. Many people with the mild form of the condition experience mood swings. They are able to function normally and, by and large, have good interpersonal relationships. In the severe form, individuals move from highs to lows and often have turbulent relationships with family members and friends.

Grandiose and impractical

People with bipolar disorder are often very creative and visionary. Some people with this disorder are able to come up with great ideas, but are never able to implement them because they are either too grandiose or impractical. Some of these individuals often end up in bankruptcy because of their tendency to be grandiose or to engage in foolish business ventures or pet projects. Drug use, fast driving and inappropriate sexual behaviour may lead them to problems with the law.

Approximately one in 100 persons gets bipolar disorder, and it is more common in men than women. We know that the disorder is due to a chemical imbalance in the brain, but diagnosis is difficult, often taking doctors five to 15 years to pin down the diagnosis. Effective treatment exists, combining medication and therapy. The problem with many people with bipolar disorder is that they do not readily accept that they have a problem and may not comply with the treatment.

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept. Of Community Health and Psychiatry, University of the West Indies, 977-1108; email: yourhealth@gleanerjm.com.