Bipolar disorder: It’s not just about mood swings

Off late, several celebrities have come forward and admitted having diagnosed with bipolar disorder, which affects more than eight million Indians, but it’s still largely misunderstood. Vibha Singh speaks to experts to shed light on the disorder

Kanye West’s recent admission of being diagnosed with bipolar disorder sent netizens in a tizzy. And he is not alone in his fight with the disorder. Singer Demi Lovato, Camila Cabello, Emma Stone, Lady Gaga, Yo Yo have all bipolar disorder, they all have been diagnosed with it. No matter how progressive we claim to be, mental health disorders even today have a lot of social stigma attached to them. Assumptions made by people who do not fully understand the ramifications of a diagnosis owing to misinformation about these conditions, doesn’t help either. These celebrities were brave enough to admit to be suffering from bipolar disorder.

What is it exactly

Bipolar Disorder is a serious mental illness, which can cause extreme mood swings: From depression (lows) to mania (highs). Energy levels also dip and surge along with the moods. Typically, bipolar disorder needs to be treated for lifetime as it cannot be cured, but can only be managed. Vijay Nallawala, 56, personal branding coach was diagnosed with bipolar disorder in 2003. He fought a tough battle for 15 years and is now leading a normal life.

Sharing his ordeal Nallawala said, “It was on my sister’s insistence, I was taken to a psychologist at Jaslok hospital who immediately told us to see a psychiatrist. I was diagnosed with manic depression, as bipolar disorder was unknown then. As my mania was out of control, I was hospitalised for a week. Like most other patients, the actual onset of the illness was many years before the actual diagnosis. The first thought that hit me in hospital was that I was now mentally ill. I had a flourishing business of audio visual equipment rentals. The thought which disturbed me the most was about the reaction of my clients, colleagues and friends.”

How serious is the problem

According to the National Institute of Mental Health (NIMH) the prevalence rate for bipolar disorder is approximately 1.1 % of the population. H’vovi Bhagwagar, psychotherapist, is of the view that, “In the 90s, it was mainly due to the easy availability of mood stabilisers that bipolar became a catch-all term to promote sales for pharmaceuticals. Such is the case even today. However, psychiatrists are more cautious when offering mood stabilisers now. If the person has depression, mood stabilisers alone are ineffective.”

Kanye West
Kanye West

Around 9 million Indians have this disorder. An estimated 51% of individuals with this condition are untreated in any given year. Suicide is the number one cause of premature deaths among people with bipolar disorder, with 15%-17% taking their own lives. However, it is also over-diagnosed. Scientists have not yet discovered a single cause of bipolar disorder. Currently, they believe several factors like genetics, stress, brain structure and function can cause bipolar.

Share your problem

The biggest barrier to people opening up is the stigma associated with mental illness. In some cases even spouses are kept in the dark. Relationships are usually fragile when it comes to bipolar disorder patients and their family members or friends. Due to lack of awareness, people cannot fathom the challenges the patients have to face. As far as the work place is concerned, the atmosphere in India is not conducive for people with mental illness to share their challenges with their employers or colleagues. They either lose out on promotions, or worse lose their jobs.

“Anger outbursts are not uncommon. Marriage is one the first relationships that takes a toll. If the key earning member is ill, it has a potential to impact the financial stability of a family. Many of my tribe are either unemployed or cannot hold jobs with any consistency. During manic phases, there can be a tendency towards promiscuity as well. Addiction to alcohol, smoking and drugs is another common problem. So one can imagine the strain on marriages,” Nallawala explains.

Wide array of treatments available

One should consult only a qualified psychiatrist to prescribe medication for this condition. Mood stabilisers, antidepressants, tranquillisers and anti-psychotic drugs are usually give depending on patient’s symptoms and degree of severity. In addition to treatment, psychotherapy also helps manage this condition. Most patients are advised to avoid high-stress situations, maintain a healthy work-life balance, and try mindfulness-based meditation and yoga. Healthy eating and regular exercise are also encouraged to stabilise mood. Keeping a regular sleep schedule is particularly important.

“I usually encourage patients with bipolar and their families to learn as much as they can about the disorder. Also, keeping a track of symptoms and watching for signs indicating out-of-control mood swings  are essential to stop the problem before it starts. For those who may be reluctant to seek treatment because they like the “ups” of the manic swing, remember that the energy and euphoria come with a price. Mania and hypomania often turn destructive, hurting the victim and people around. So get the right help and soon,” Bhagwagar advices.

The website is a group which is bringing bipolar and depression affected people under one roof. Not only do they spread awareness about the disorders, but also inspire people. Many times, due to the intervention of group members, several people who were feeling suicidal, were motivated to live an active life.

A long way to go

Experts are of the view that awareness is very gradually spreading, but we still have a long way to go. The infrastructure in India for treating mental illness is in urgent need of an overhaul: For instance, we have merely 4500 psychiatrists for a population of 1.3 billion. Of these psychiatrists and psychologists, most practice in cities and semi-urban areas with very less facilities in rural India. Employers do not have a favourable policy when it comes to hiring the mentally ill. Medical Insurance does not cover mental illness either, though this is in for a change. The Mental Healthcare Act, which has recently come into force has some positive changes in store, such as decriminalising of suicide or attempt to suicide. Much more needs to be done on a war footing so that the millions of those ill can get succour at affordable rates.

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The different types of bipolar

Bipolar I Disorder

It is manic or mixed episodes that last at least seven days and by manic symptoms are so severe that the person needs immediate hospital care

Bipolar II Disorder

A pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.

Bipolar Disorder not otherwise specified (BP-NOS)

It is diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II. However, the symptoms are clearly out of the person’s normal range of behavior.

Cyclothymic disorder

A mild form of bipolar disorder. People with cyclothymia have episodes of hypomania as well as mild depression for at least two years.


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