Considered within the group of invisible illnesses, it is estimated that between 2% and 4% of the world’s population suffer from this mental illness to some degree, although its true impact is inestimable due to the difficulty of its diagnosis.
The manic-depressive illness, more commonly known as bipolar disorder, causes suffers to experience cyclical periods of conflicting moods which can vary from phases of extreme euphoria or excitability (mania) to deep depressions.
Today, the scientific and medical community consider that the primary cause of bipolar disorder is genetic and that there is an electrochemical imbalance in the brain’s neurotransmitters.
However, the reason for and the trigger of this imbalance is not fully known.
The social environment, as well as the genetic component, may trigger the condition. People who have been the victim of differing degrees of violence or exposed to high levels of stress may show early symptoms or episodes, providing there is a genetic tendency to suffer from the disorder.
Backlog of work and pressure cause anxiety and stress, a small spark which induces the appearance of the disorder and it is estimated that in the more serious cases around 10% result in suicide.
The information which determines the risk of suffering a bipolar affective disorder is encoded in our genes.
For example, a person may live their entire life without the illness surfacing, but during a stressful period this information may decode, causing early symptoms.
The illness may surface in some people without the need for a hostile environment while for others, on the other hand, this may induce the development of the disorder.
There are people who may suffer several episodes of manic depression a year, while others suffer only a few throughout their lifetime. In this sense, experts indicate that it is important to bear in mind that this disorder has a cyclical nature.
It is not a condition which affects a patient’s behaviour permanently, which causes errors in the diagnosis, unconcern or lack of interest, leading to a misdiagnosis of temporary mood disturbance. The more serious cases may cause “psychotic symptoms” and hallucinations.
Depressive periods through mental disorders may manifest themselves in the person through feelings of extreme guilt, unusually low self-esteem or even the belief that they no longer exist.
On the other hand, during manic episodes, the person may convince themselves that they have an important mission to complete or that they possess special powers and abilities.
Symptoms and Types of Bipolar Disorder
The manic or euphoric episode is characterised by feelings of happiness, excitement, anxiety and irritability for no apparent reason and changes in judgement without weighing up the consequences of actions.
The sufferer may feel more important than usual, being more energetic and hyperactive, full of new and exciting ideas, starting many activities at the same time without finishing any of them. They also do not feel fatigued or the need to sleep. They may also talk very fast. The depressive episode, on the other hand, is identified by low self-esteem, fatigue and the need to sleep, loss of or increased appetite, isolation, fatalistic thoughts and even suicidal intentions. Furthermore, bipolar disorder is classed under four types, depending on how much a person is affected by the condition.
Bipolar I for example, presents itself in manic episodes lasting over a week, periods of euphoria mixed with depressive periods.
Bipolar II has severe periods of depression but only moderate manic episodes, known as hypomania. The third type, rapid cycling, has over four mood swings within a 12 month period.
This type affects 1 in 10 people with bipolar disorder. Finally, Cyclothymia causes less intense but longer lasting mood swings.
Bipolarity and public health
The impact of this disorder on sufferers and those around them, as well as the influence of stress in its development has caused it to be considered a public health issue, given that it affects many walks of life. According to the World Health Organisation (WHO) this condition is the sixth cause of work incapacity and causes more lost years due to disability than epilepsy, Alzheimer’s and all forms of cancer.
However, less than half of patients receive medical treatment. This information comes from the World Mental Health Survey carried out in 11 countries across America, Europe and Asia to gain a better understanding of the repercussions of psychiatric conditions across the globe.
The survey indicates that the United States has the highest rate of bipolar disorder (4.4% of its population are sufferers), followed by New Zealand (3.9%) and Columbia (2.6%).
Furthermore, according to this organisation, in the less developed countries, 75% of patients do not receive medical treatment, while in the under developed countries the figure reaches 66% and in the more industrialised nations the percentage of untreated patients is 49%.
Thanks to pharmacological advances, manic-depressive sufferers have three types of mood stabilisers which all take several months to work properly. One of the more common substances for sufferers of the condition is Lithium, a chemical element present in the body which regulates moods and in some cases is administered to patients with this type of condition.
Lithium can be harmful if the dose is too high. It is used to treat insomnia, muscular syndromes caused by tension, migraines, anxiety, and distress, decrease of intellectual faculties, nervousness, melancholia, phobias and obsessions.
However, in order to avoid developing the condition, experts suggest avoiding stressful situations and excessive anxiety which cause catastrophic thoughts and may result in developing some of the symptoms.
There are therapies for the symptoms which appear more commonly amongst 18 to 35 year olds which include psycho education which help patients and those close to them to understand the condition, share their experiences and support each other. In many cases the lack of family support may lead to the bipolar disorder not being detected and treatment is never started.
The Royal College of Psychiatrists in the United Kingdom offers some simple self-help advice for those who have already developed some symptoms such as uncontrolled changes in mood so that help can be given in time; avoid particularly stressful situations; have at least one supportive person and do exercise 3 times a week to improve mood.
(The Prisma’ memoirs. January, 2011)
(Translated by Louise Jefferson – E-mail: firstname.lastname@example.org) – Photos: Pixabay