Mental health has become as much of a concern as physical health in recent years. With the conversation around depression, anxiety and other so-called ‘invisible’ illnesses, we are seeing more due care and attention than ever. Not only has this helped broaden our understanding of these very real issues, but has also enabled people to feel more comfortable in being open about their own struggles.
This became even more evident this week when international singing superstar Mariah Carey revealed that she’d be struggling with bipolar disorder over the last two decades, having been first diagnosed in 2001. In an exclusive interview with PEOPLE magazine, Mariah revealed she’d recently sought treatment for “the hardest couple of years I’ve been through”. She added that “until recently I lived in denial and isolation and in constant fear someone would expose me”.
Thankfully, she’s now receiving the right treatment and is feeling better than ever. But her own rejection of the diagnosis caused her to suffer in silence for many years.
In the UK, around five per cent of people sit on the bipolar spectrum according to BipolarUK. But this takes an average of 10.5 years to correctly diagnose. Plus, if you have the mental illness, the risk of suicide increases by 20 percent, being one of the top causes of lost years of life in 15 to 44 year olds.
However, if you think you may be suffering from bipolar disorder or any other mental health issue, there is help available. We spoke to Dr Natasha Bijlani, a consultant psychiatrist at Priory Hospital Roehampton, to better understand the illness and what to do if you think you could be affected.
Hi, Dr Bijlani! First of all, what actually is bipolar disorder?
“Bipolar disorder used to be called ‘manic-depression’. People with bipolar disorder experience extreme mood swings that can last weeks or months. The severity of these mood swings are usually way beyond what most of us experience when our mood changes. The disorder is characterised by repeated – at least two – episodes in which the patient’s mood and activity levels are significantly disturbed. On some occasions there will be an elevation of mood and increased energy and activity, called mania and hypomania, and on others of a lowering of mood and decreased energy and activity – depression.”
Are there different levels of severity to it?
“Yes, there are different levels of severity to bipolar disorder. Mild symptoms of bipolar disorder manifest as hypomania with persistent mild elevation of mood, for at least several days on end, increased energy and activity, and usually marked feelings of wellbeing and both physical and mental efficiency. Patients usually experience increased sociability, talkativeness, overfamiliarity, increased sexual energy, and decreased need for sleep, but not to the extent that that it leads to severe disruption of work or results in social rejection.
“Severe symptoms are described as manic episodes. Elated mood will be accompanied by increased energy, resulting in overactivity, pressure of speech and decreased need for sleep. Normal social inhibitions are lost, attention cannot be sustained and there is often marked distractibility. Self-esteem is inflated and grandiose or over-optimistic ideas are freely expressed. In some cases patients may present with psychotic symptoms including delusions, irritability and suspiciousness.”
How would someone know if they had bipolar disorder? And what should they do if they think they do?
“All of us are prone to some changes in our mood, sometimes with obvious – usually stressful – triggers and sometimes without any external factors. If you find yourself regularly experiencing significant changes in mood which affects your daily functioning and relationships, you may find it helpful to seek a proper psychiatric assessment. You will be asked various questions about your symptoms and background, and may be asked to complete a questionnaire, which can help further in making a diagnosis.”
What options are available for managing bipolar disorder? Is it just medication?
“Appropriate treatment of bipolar disorder, as with any disorder, should usually start with educating the patient – and involved relatives/partners with the patient’s consent – about their condition. Medication is needed to treat a manic or depressive episode, but also as prophylaxis – to keep mood stable over a long period.
“No treatment can be complete without appropriate psychological input, which will include providing information about the condition, mood monitoring and learning to recognise when your mood is swinging, strategies to help you stop your mood swinging into a full blown manic or depressive episode, and help with developing general coping skills. Cognitive behaviour therapy techniques are very helpful in learning to manage negative thoughts and unhelpful behaviours that accompany mood swings.”
Does bipolar affect someone for life, or can you eventually be free of it?
“Bipolar disorder usually has a high rate of recurrence. Risk factors can vary from person to person. The rate of recurrence can be minimised if medication is used appropriately and for a sufficient length of time, as advised by your treating doctor, as well as by trying to minimise stresses as far as possible. Adopting sensible lifestyle measures such as balancing life and work, leisure and relationships with family and friends can be protective and minimise chances of relapse. Drinking excessive amounts of alcohol or taking recreational substances can also adversely affect mood and precipitate relapses in those vulnerable to bipolar disorder.”
What advice would you give to a young person coping with bipolar?
“I would advise anyone who has been diagnosed with bipolar disorder to consider all of my suggestions, but also to follow the advice of their doctor and to take medication as recommended. I often see patients relapse because they discontinue medication soon after they start to feel better. There is a strong body of research evidence to support the long-term use of mood stabiliser medication in bipolar disorder, and patients should always seek medical opinion before changing the dose or stopping prescribed medication.”
For more information on bipolar disorder and how to seek professional help, visit the Priory Group’s website.