Living on the Edge

We’ve all been subject to mood swings at some point in our lives, but when the “highs” start to contrast very sharply with the “lows”; it’s time to suspect something might be very wrong.

When Hollywood actress Catherine Zeta Jones announced last month that she was checking into a mental health clinic to get treated for bipolar disorder, she made public a little understood mental condition that’s commonly confused with depression or other mood disorders.

Bipolar disorder can be misdiagnosed as anything from schizophrenia to Attention Deficit Hyperactivity Disorder (ADHD), given the similar symptoms as other mental ailments.
Yet, there are several distinguishing factors that can help you understand this condition, produce the right diagnosis and eventually, manage it for life.

What it means
Also known as manic depressive illness, bipolar disorder is a brain condition that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day work. It is characterised by periods of extreme emotional highs or “mania”, alternating with severe bouts of depression.

While Bipolar I symptoms are severe and can last for weeks, interfering with the sufferer’s day-to-day activities, the Bipolar II condition is less debilitating and people can cope with their daily routine. A third variation, Bipolar III, or Cyclothymia, is a mild form of bipolar disorder where episodes of hypomania shift back and forth with mild depression for at least two years.

“Symptoms of mania can include feeling overly happy, extremely agitated and nervy or irritable. In this state, the bipolar sufferer may feel they need little sleep and are more willing to take risks at work, in their relationships and with their assets,” observes Sharon Gorman, cognitive behavioural therapist and co-founder of Crisec Consultants.

On the other hand, when depression sets in, the person has feelings of low esteem and emptiness, loss of interest in the usual things, marked lack of concentration and dark thoughts of suicide. The symptoms are acute and can result in damaged relationships, poor job or school performance and even death through suicide.

Studying data collected from 11 countries, including the Americas, Europe, Asia, the Middle East and New Zealand, researchers from the National Institute of Mental Health (NIMH) in the US found that about 2.4 per cent of the world’ s population has bipolar disorder.

Who is at risk
While there is no single cause behind this condition, bipolar disorder tends to run in families. “Individuals with a family history of bipolar disorder are 70 per cent more likely to develop this condition compared to others,” notes psychotherapist Thoraiya Kanafani.

The condition is found to be more prevalent in women than men, with a ratio of approximately 3:2, as established by the National Co-morbidity Study in the US.

Low thyroid function, called hypothyroidism, has been associated with rapid cycling in some people with bipolar disorder, especially women.

Of the people studied worldwide who had bipolar symptoms, the NIMH team found that 75 per cent had at least one other disorder, the most common being anxiety disorders, especially panic disorder, followed by behaviour disorders and substance abuse disorders.

The triggers
Some of the common triggers for episodes of the illness are stress, money worries, relationship problems, difficulties at work, school or college, irregular sleep schedule, use of alcohol, drugs or caffeine, disrupted routine and missing medications.

In case of actress Zeta Jones, her condition was said to have been caused by the stress of watching her husband, actor Michael Douglas, battle cancer over the past year.
“It’s important to recognise distress or dysfunction in the family of a patient with bipolar disorder, since such ongoing stress may worsen the patient’s illness or interfere with treatment,” says Thoraiya.

Managing bipolar disorder
While there’s no cure for this chronic and lifelong illness, it’s possible for sufferers to live nearly normal lives with the correct medication, diet and support mechanisms in place.

The first step in managing this condition is getting the right diagnosis, which is not easy, given the NIMH findings that only about 25 per cent of people with this condition worldwide were being treated for bipolar disorder.

“This is not a straightforward condition, for which reason, there’s widespread misdiagnosis. It’s important that the physician considers the medical history alongside the family background, as the condition has a significant genetic component and often affects several members in the family,” says Sharon.

Bipolar disorder has been deemed the most expensive behavioural health care diagnosis, costing more than twice as much as depression for every affected individual, according to US-based Centres for Disease Control and Prevention (CDC).
“Treatment will usually include a programme of medication to reduce the manic feelings and ‘mood stabilisers’ to lift the depression of sufferers. Alongside that, therapeutic interventions with a qualified therapist, where sufferers can express their concerns and experiences in a non-judgemental environment, can prevent recurrences. Families are educated in ways to cope with and support the family member with bipolar disorder,” says Thoraiya.

People suffering from this condition will benefit in a big way from a disciplined lifestyle, experts opine. “The sufferers should ensure they get regular amounts of sleep, keep physically fit and eat a regular healthy diet rich in Omega-3 fatty acids as these can reduce mood swings,” advises Sharon.

Knowledge and support is key
Finally, bipolar disorder may be a very debilitating illness, but it can be effectively managed by sufferers, their families and loved ones if the sufferer takes ownership of the illness and shares his or her concerns with their family.

“A key element is to understand the illness and what triggers it in the sufferer.  Sometimes the sufferer will need to speak with his or her physician, other times with a therapist and at others with their loved ones. There are numerous self-help groups that sufferers can join to find out more about their condition, its management and to simply share their experiences with others,” says Sharon.

Also, making themselves knowledgeable about their condition can help them feel like they have some control over it instead of it controlling them. The best help for a sufferer of bipolar disorder is the team approach that can help him or her to feel that they’re not on their own and that they can hope for a constructive and happy life. For psychotherapy or counselling sessions, call Sharon at 66 344-470 and Thoraiya at 36 692-377.

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