World Bipolar Day

Every year “World  Bipolar  Day” is commemorated  globally  on 30th March in the  honour of a great Dutch Painter and an artist  Vincent Van Gogh who was posthumously diagnosed to have been suffering  from bipolar disorder. It is a Collaborative effort of the Asian Network of Bipolar Disorder (ANBD), the International Bipolar Foundation (IBPF) and the International  Society for Bipolar Disorders (ISBD) aimed at  enhancing  awareness about the disease and  removing  stigma associated with it so as to improve the acceptance and increase the stability  of  life among the affected individuals. Bipolar disorder is not a character flaw or persons weakness instead,it is a chronic mental health illness that demands early diagnosis and an appropriate treatment to mitigate the miseries  of an individual .

Globally around 40 million people are plagued by this disorder .Every one of us do experience mood swings in the form of ups and downs, Does that mean we are suffering from bipolar? No! Infact,  feeling sad , happy or angry is  quite a normal biochemical process.

It is actually the extreme forms of mood swings  impairing one’s socio occupational state that  qualifies for this disorder.

Bipolar disorder is the mental health illness in which extreme changes occur not only  in mood but thoughts, behaviour and energy . It ossicilates between Manic highs to depressive lows with an  intervening normal state of mood . It is a Chronic disease with episodic course that can’t be treated overnight by magic bullets rather it is a journey  that is to be  traversed with discipline, adherence  and endurance.

What happens  during Mania?

Overly energetic

High self-esteem ( Feeling all powerful)

Decreased need for sleep without fully tired

Talking more than usual

Racing thoughts , many ideas coming all at once

Getting  distracted easily, thoughts  jumping  from topic to topic

Excessive pursuit of pleasure ( eg. Financial or sexual ) without thought of consequences

Enhanced Goal directed activity , restlessness

What Happens during depression?

Sad ,empty, tearful mood nearly everyday

No interest in or pleasure  from activities once enjoyed.

Major changes In sleep or body weight

Insomnia or sleeping too much

Feeling of worthlessness and guilt

Difficulty in concentrating or making decisions

Thoughts of death or suicide

Bipolar disorder is of various types .To name a  few  we have Type I ,II , Cyclothymia and other types  .

Risk factors associated  are  Genetic as well as environmental .

Triggers for bipolar ?

Triggers are situations that can provoke either mania or depression in some one who has already had an episode of illness . Lack of sleep or feeling stressed, loosing loved ones , having financial problems  and relationship  issues.

Others are chemical that include antidepressants that “work too well” and result In Mania,  common medications like steroids , street drugs like cocaine  , amphetamines.

It  is indeed a challenge to live with Bipolar for individuals  but life can be made better with discipline and endurance. These individuals are artists in themselves possessing their own uniqueness  as is evident from the works of an  adept artist like Vincet .

What to do when person is experiencing Mania?

Keep conversation brief

Be firm , practical , realistic but not authoritative

Discourage  discussing feelings

Deal only with immediate issues don’t reason or argue

Reduce stimulation as people with Mania are overstimulated reduce activity and noise around your setting

Avoid jumping into persons demands

Do not try to convince that his or her plans are unrealistic

What to do when person is depressed?

• Speak quite calmly
• Focus on one subject at a time
• Be patient , just wait
• Be a good listener
• Have a very neutral approach while he or she is irritable
• Avoid enquiry as to what made them feel low ,don’t blame them
• Pace yourself

Bipolar is a disease as is diabetes & hypertension  in which lifestyle modifications too have role to decrease the the severity .It is manageable when treated effectively . Treatment modalities include   FDA approved antidepressants , mood stabilizers and antipsychotics.

Besides which psychotherapy  also known as talk therapy is one of the most effective treatments for bipolar disorder . By appropriate therapies , we aim to reduce the severity , improve the life quality , and prevent the relapses.

Right now yo might be dealing with symptoms that seem unbearable , and it can be tiring task to have patience  as you search for effective treatment . Important thing is to believe that there is a hope .Treatment does work and most people return to stable and productive lives . Most significant is to stick to the treatment plans, have discipline , avoid the avoidable Triggers , live a life of dignity,  fight  the stigma  with Grace as  stigma  always stems from ignorance and lack of knowledge. Affected individuals need to be embraced with gentle care and masses are to educated comprehensively about the disorder.

Be strong and fight till  you win.

As has been put by Mathew Polly “ Because it doesn’t take much courage to fight when you believe you can win .What takes real courage is to keep Fighting when all hope is gone”

Author is a PG Resident Doctor, Department of Psychiatry SKIMS