The Faces of Bipolar
Recognising these faces on Bipolar Awareness Day
"Depressed, I have crawled on my hands and knees in order to get across a room and have done it for month after month. Manic, I have run faster, thought faster, and loved faster than most I know". (Kay Jamison, professor of psychiatry at Johns Hopkins Medicine.)
Bipolar Disorder (previously known as manic depression) affects about 1% of South Africans yet remains misunderstood and stigmatised. While many people claim to know what it's like to be depressed, because they have gone through a divorce, lost a job or a loved one, Bipolar Disorder is entirely different and has two faces – severe depression and mania.
"The fast ideas are too fast, and there are far too many, overwhelming confusion replaces reality.... you are irritable, angry, frightened, uncontrollable." (Kay Jamison) People in a manic phase, often act bizarrely –stay up all night, max out credit cards, talk at high speed, work for 20 hours straight, go on expensive shopping sprees, drink excessively, pick up strangers in shady nightclubs and bars. But as these 'highs' feel fantastic and people feel invincible. "I felt like I could do anything, be anything", says 40-year-old Claire*from Johannesburg "I wasn't shy anymore, I could talk to people and they found me interesting. I felt powerful, then it all changed". Mania is a 'high' and many people don't want treatment for fear of losing this great feeling. "One of the biggest obstacles to treatment and taking the medication is that people liking the mania and don't t want to be 'boring'", says psychiatrist Dr Frans Korb from Sandton. . "What they don't understand, or don't want to understand, is the highs are temporary, there is the inevitable drop into the depths of despair that follows mania."
The depression of Bipolar, is often made worse by hazy memories, of credit cards being declined, excuses and apologies to friends. . "You start to wonder who of your friends knows what? What are they too polite to say? Too tactful to tell you?", says Claire. People can't get out of bed in the morning, can't go to work, don't want to socialise and consider suicide. "People have vague memories of what they did when manic, are ashamed with themselves and this fuels their depression," says Dr. Korb.
The South African Depression and Anxiety Group (SADAG) and GSK have a Bipolar Support Helpline that is a vital lifeline for patients and their families. The line is open seven days a week from 8am to 8pm and can be reached on 0800 078 377 Patients can also access information on the website at www.sadag.co.za or contact SADAG on sms 31393.
Bipolar is a difficult disorder to understand – both for the patient and their loved ones. It is essential that you consult someone who is knowledgeable about Bipolar Disorder and that you learn as much as possible about the disorder, through reading books, attending lectures and talking to specialists. "You and your loved ones need to be prepared and armed against this illness so you can treat it correctly and learn the importance of sticking to treatment", urges Dr Korb. The more you know, the more control you have over the illness. In the words of Prof Redfield Jamison: 'Knowledge is marvelous, but wisdom is even better'.
Common signs and symptoms of mania include:
Feeling unusually "high" and optimistic or extremely irritable
Unrealistic beliefs about one's abilities or powers
Sleeping very little, but feeling extremely energetic
Talking so rapidly that others can't keep up
Racing thoughts; jumping quickly from one idea to the next
Easily distracted and unable to concentrate
Impaired judgment and impulsiveness
Acting recklessly without thinking about the consequences
Delusions and hallucinations (in severe cases)
Common symptoms of bipolar depression include:
Feeling hopeless, sad, or empty.
Loss of interest in things you used to enjoy
Fatigue or loss of energy
Physical and mentally slowed down
Appetite or weight changes
Sleeping too much or too little
Concentration and memory problems
Feelings of self-loathing, shame, or guilt
Thoughts of death or suicide
A family member or close friend should work with the suffer to spot any mood changes and get help at the onset of an episode to prevent the episode from being more severe.
The following behaviors can lead to depressive or manic recurrence:
Discontinuing or lowering one's dose of medication without consulting a doctor
An inconsistent sleep schedule can destabilize the illness. Too much sleep (possibly caused by medication) can lead to depression, while too little sleep can lead to mixed states or mania.
Caffeine can cause destabilization of mood toward irritability, and mania.
Excessive stress can cause the individual to relapse.
For further information, please contact
Janine Shamos 082 338 9666 / 011 262 6396
Cassey Amoore 011 262 6396
1% of the South African population suffer from Bipolar Disorder
Typically begins in adolescence or early adulthood
Men and women are affected equally
Bipolar does not affect any race more than another
Bipolar does not discriminate
Here are some possible Bipolar questions:
1. What is Bipolar Disorder?
Bipolar disorder, formerly known as manic depressive illness, is a physical illness marked by extreme changes in mood, energy and behaviour, it is a mental illness involving episodes of serious mania and depression. A person’s mood usually swings from overly “high” to irritable to sad and hopeless, and then back again, with periods of normal mood in between.
2. Who gets it?
Bipolar disorder is common – affecting about 1% of the population. Men and women are affected equally. The usual age of onset is late adolescence and early adulthood. Although the disorder has been seen in children.
3. What causes Bipolar and is it genetic?
The exact cause of Bipolar Disorder is not known, but it is believed to be a combination of biochemical, genetic and psychological factors. So yes, Bipolar disorder tends to run in families. However, if you have bipolar disorder and your spouse does not, there is only a 1 in 7 chance that your child will develop it.
4. What are the symptoms of Bipolar Disorder?
In the course of bipolar disorder, 3 different kinds of mood episodes can occur:
1. Mania (Manic Episode)
- very irritable, too much energy
- thoughts race
- speech is rapid
- energy level is high
- self-esteem inflated
- little need for sleep
2. Mixed Episode
- symptoms of both depression and mania occurring at the same time
3. Depression (major depressive episode)
- symptoms present for atleast 2 weeks and makes ir difficult to function
- feeling sad, blue or down in the dumps
- losing interest in things you normally enjoy
- trouble sleeping / eating / concentrating
5. How is Bipolar diagnosed and is it treatable?
If you suspect that you or a loved one suffers from bipolar disorder, you need to speak to a mental health professional (such as GP, psychologist, psychiatrist or community mental health centre). You can also phone The South African Depression Anxiety Group where we have an extensive referral guide with contact details for top psychologist, psychiatrists in your area as well as over 200 support groups that can help you. SADAG also provides telephonic counseling and we can send you information on Bipolar Disorder for you to learn about. Treatment in the form of medication and counseling can be very effective for most people with bipolar disorder.
6. Medication is very important, what about counselling?
The most important medicines used to manage bipolar disorder are mood disorder. Your doctor will discuss the need for additional medication to treat depression or mania. Counselling can be very beneficial for someone suffering from Bipolar disorder. Therapy issues include dealing with the psychosocial stressors, dealing with the individual, interpersonal, social and occupational consequences of the disorder itself. Counselling provides support and education.
7. How can families help a loved one with Bipolar?
If you are a family member or friend of someone with bipolar disorder, become informed about the patient’s illness, its causes, and its treatments. Learn the particular warning signs for how that person acts when he or she is getting manic or depressed. Encourage the patient to stick with his or her treatment. You can call SADAG on 0800 567 567 or 011 262 6396 for more information about the illness and we can also send you a brochure on Bipolar Disorder that you can learn more about.