Bipolar - the cerebral civil war

© Elnur Amikishiyev – 123RF.com

An estimated 2-5% of the South African population suffer from bipolar mood disorder (bipolar disorder), therefore it is only fitting that Tuesday, 26 May 2015 is set aside not only to raise awareness of the devastating effect this illness can have on both sufferers and their families, but also to bring hope that this debilitating disorder can be tamed.

Dr Antoinette Miric, Gauteng psychiatrist in private practice explains, "Bipolar disorder I is diagnosed when an individual has had at least one manic episode which has lasted one week or required hospitalisation and may have had depressive episodes. During a manic episode an individual has an elevated mood, rapid speech, and little need for sleep, racing thoughts, continuous high energy, and overconfidence and may experience irrational thoughts."

"Bipolar disorder II is diagnosed after a patient has had a hypomanic episode (which shows similar symptoms to a manic episode, but is less intense) and has had depressive episodes.

Patients with bipolar disorder can experience a range of symptoms. They are also more predisposed to develop other conditions including substance abuse disorders, anxiety disorders, attention deficit disorder (ADHD) and personality disorders.

Depression # bipolar disorder

A common question asked of clinicians is, "What's the difference between bipolar disorder (also known as manic depression) and plain old depression?"

"It's a simple question to answer, because depression can either be a stand-alone diagnosis, or a part of another disorder, like bipolar. Therefore a mental health professional is going to examine whether there are other symptoms present (or have occurred in the past), to see if the depression is just depression, or whether it is a part of a larger disorder.

"If bipolar disorder includes a depressed mood, what else does bipolar include? We can find the answer to this question by looking at the old name for bipolar disorder, manic depression. The old name is pretty descriptive, bipolar is a combination of mania and depression, alternating in cycles," says John M. Grohol (Psy.D.)

Diagnosis

Only a comprehensive psychiatric assessment and diagnosis by a psychiatrist or a doctor will determine whether a person has bipolar disorder. Family history, past mood episodes, response to medications and current symptoms all need to be explored in detail, Dr Miric advises.

"In its early years bipolar disorder may look similar to major depression. Likewise, certain endocrine and neurological conditions could look like bipolar disorder. This is why it is most important to get suitable medical advice, since the doctor can advise if you need further testing for these conditions."

Medication

Bipolar disorder is often treated with a combination of medication strategies, primarily mood stabilisers and antipsychotic medication. Often multiple medications are needed in order to stabilise mood swings. As bipolar disorder is a chronic disease requiring long-term medication, it is hard to predict the future. "Medication and situations might change as the disease progresses. It is generally necessary to stay on medication for a long time, in order to stabilise the mood cycles which commonly have been going on for years, undiagnosed," she says.

Non-medication strategies

"Practical steps include developing a daily structure of the day to day activities including regular exercise and regular sufficient sleep. All substances of abuse including alcohol, recreational drugs and prescribed/non-prescribed (such as codeine, diet tablets) should be avoided.

"Therapy (individual, group, family and interpersonal) is also used in the treatment of bipolar disorder and the prevention of relapses. Educating yourself about the illness and its treatment is key. These different therapies can help you and your families accept and understand the illness and go a long way in removing the stigma around bipolar disorder," she concluded.

Akeso Psychiatric Clinic's general psychiatry units are specifically equipped to help bipolar patients and their loved ones cope with the difficulties of bipolar disorder. Not only by providing patients with an integrated treatment programme designed to help stabilise mood swings, but also equipping patients and their loved ones with the necessary tools to help them manage their lives going forward.

For more information, go to www.akeso.co.za.