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The highs and lows of Bipolar Disorder

60 million people globally1 including over 4 million South Africans2 are affected by Bipolar Disorder. Bipolar Disorder is not restricted to any social or educational class, race, gender, or nationality. First episodes occur for no apparent reason with no external stressors precipitating them.


Bipolar Mood Disorder typically causes mood and behavioural changes which will, if left untreated, severely affect a person’s ability to function effectively. The chronic illness is often referred to as manic-depressive as it typically begins in adolescence or early adulthood and continues throughout life.


Dr Leverne Mountany, specialist psychiatrist at Life Riverfield Lodge explains, “Bipolar Mood Disorder is a mental illness during which patients experience episodes characterised by either severe depression or excessive energy and extreme elation”.


“The condition falls on a mood spectrum with the major ‘highs’ and ’lows’ on the far ends of the poles but a variety of combinations can also occur,” says Dr Mountany.


A manic episode is not always euphoric but can also present dysphoria which may result in excessive aggression, irritability and argumentativeness or even suicide.


While the primary cause of the disorder remains unknown, experts believe that family history of the condition is a strong risk factor with this connection being due to certain genes, 3specific maladapted brain circuits as well as the malfunctioning of neurotransmitters in the brain also have a significant role to play in the disorder.


Local research shows that between 3 to 4 percent2 of those affected by the disorder believe that Bipolar Mood Disorder is a condition that will not affect them. Bipolar Disorder is heavily stigmatised and society portrays and refer to those suffering from the condition as crazy, unstable, and dangerous.


“Public education and awareness of the disorder can assist in de-stigmatising the condition to ensure that family and friends of those diagnosed can better understand the treatments available for an individual to be able to live a fully functional life,” says Dr Mountany.


Treatment for Bipolar Disorder ranges from a combination of evidence-based medication therapy, individual psychiatric consultations, psychotherapy, group therapy and, where needed, physical therapy. ECT is often included in this combination as a treatment option. The onset of a bipolar episode should be an indicator that treatment needs to be started as the earlier diagnosis and treatment with prevent future episodes.


Various treatment options are available for patients suffering from Bipolar Mood Disorder. A treatment that is often included in a patient’s treatment plan and also carries its own stigma is Electroconvulsive Therapy (ECT). ECT is one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal patients4.


In speaking to a former patient at Life Riverfield Lodge (who prefers to remain anonymous), ECT is a treatment option not to be feared, “I first heard about ECT from a specialist who treated my disorder when it was at its worst. The benefit of ECT for me was that it immediately took away the intensity of my bipolar episodes. Patients who are suffering from Bipolar Mood Disorder should not fear ECT as it is painless and the only symptom may be a headache which is easily treated with a headache tablet once you have awoken from the anesthetic”.


“Today the outlook for people with Bipolar Disorder is optimistic, given the effectiveness of the range of treatments available that assist patients in leading fulfilled and meaningful lives,” concludes Dr Mountany.


Symptoms of Bipolar Disorder:

The symptoms of Bipolar Mood Disorder can vary widely in their pattern, severity and frequency. There are four types of mood episodes in bipolar disorder: mania, hypomania, depression and mixed episodes. Each type of bipolar disorder mood episode has a unique set of symptoms. However, although the condition is treatable, many people don’t recognise the warning signs and therefore cannot get the help they need.


Below are seven common symptoms of bipolar disorder:

  • Feeling unusually “high” and optimistic or extremely irritable
  • Unrealistic, grandiose beliefs about one’s abilities or powers
  • Sleeping very little, but feeling extremely energetic
  • Racing thoughts, jumping quickly from one idea to the next
  • Impaired judgment and impulsiveness
  • Pressure of speech
  • Risk taking behavior like excessive spending or sexual promiscuity


Common symptoms of depression include:


  • Feeling hopeless, sad, or empty
  • Fatigue or loss of energy
  • Feelings of worthlessness or guilt
  • Thoughts of death or suicide
  • Poor memory and planning ability
  • Poor appetite
  • Loss of pleasure or joy


If you suspect you or a loved one is suffering from Bipolar Disorder, it’s important to consult a mental health professional. This can be done directly or through you family physician, or your nearest Life Mental Health facility.

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