The actual cause of bipolar disorder is not yet clear. Some people have a family history of such conditions which also includes depression. Stressful events in life including those in the childhood, deprivation of sleep can trigger these disorders. Making things worse, most lab tests have not been found useful in diagnosing bipolar disorder. An important diagnostic tool is still an open and candid talk with the doctor about the underlying symptoms.
The date 30th March is mostly remembered in the modern world as the birth date of Vincent Van Gogh, one of the most influential artists in the history of Western art, and the date to spread awareness about a complex disease that this great artist was posthumously diagnosed with as well.
Initiated by the International Society for Bipolar Disorders (ISBD) in partnership with the International Bipolar Foundation (IBPF) and the Asian Network of Bipolar Disorders (ANBD) in 1999, Word Bipolar Day was created with a vision to bring world awareness to this disease, educate the public on this disorder and eliminate social stigma around this condition.
Bipolar Disorder, a mental health condition in which a person’s mood alternates between periods of extreme highs(mania) and deep lows(depression), is still a complex disease in the world despite many treatment options that have been developed over the period.
Effective treatment still a challenge
Correct diagnosis and timely detection is a major challenge for treating bipolar disorder (BPD) as any other mental health issues. While, BPD is also often mistaken for other mental issues leading to a cost burden and futile treatments.
The key issue that affects the diagnosis here is that the alternation between depression and elevation does not follow a same set pattern and may vary with individuals. In between the two phases, the patient by and large feels normal.
While the importance of mental health has been prioritised and recognised, a lot more needs to be addressed. Research and data have shown that delays in diagnosis are common amongst people with bipolar disorders. It can take as long as 10 to 15 years for people with this condition to be properly diagnosed, according to a study published in February 2020 in BMC Psychiatry.
Early onset
In a large percentage of adults with bipolar disorder, onset of mood symptoms occurred before the age of 20. Paediatric bipolar disorder is not prioritised and many are treated for other conditions instead of bipolar disorder.
Delay in diagnosis can cause serious problems is not addressed urgently. An untreated bipolar disorder can often lead to great disability and higher health care costs, according to the authors of the study.
Unfortunately, bipolar patients suffer from their symptoms for more than a decade before they get a proper diagnosis. Sometimes they go through several clinicians, change treatments before finally being diagnosed. But by then damage is already done.
Depressed individuals may find it difficult to recall their episodes of mania making the diagnosis even more tricky. Most of the patients spend more time in the depressed phase than they do in the manic or the hypomanic phase. And if the clinician is not an expert, they get treated for depression. So, the most common misdiagnosis is major depressive disorder. Besides AAD or attention to deficit disorder can also be misdiagnosed in the bipolar disorder patients.
An untreated bipolar disorder can cause severe impairment, loss of ability to work, inability to focus and strain on interpersonal relationships.
Psychosis (delusions and hallucinations) can occur not only in bipolar disorder but other conditions such as schizophrenia or schizoaffective disorder. In addition, people with bipolar disorder often have other psychiatric problems such as anxiety disorders, generalised anxiety disorder (GAD), substance use disorders or personality disorders that may complicate an illness presentation and require independent treatment.
Some non-psychiatric illnesses such as thyroid disease, lupus, HIV, syphilis and other infections may have signs and symptoms that mimic those of bipolar disorder. This can make the diagnosis and treatment even more challenging.
Tricky task
Most lab tests have not been found useful in diagnosing bipolar disorder. An important diagnostic tool is an open and candid talk with the doctor about the underlying symptoms.
There are several types of prescription drugs for bipolar disorder. They include mood stabilisers that prevent episodes of ups and downs as well as antidepressants and antipsychotic drugs. When not in a manic or depressive phase, people usually take the maintenance medications to prevent a relapse.
A large percentage of people who seek treatment for bipolar disorder are overweight or have obesity. Weight gain is a side effect of many medications that treat the disease. Some people with bipolar disorder also have attention deficit hyperactivity disorder and anxiety disorders.
Memory loss is an overwhelming challenge for as many as 40 to 60 percent of people with bipolar disorder, according to a 2017 research article published in the International Journal of Neuropsychopharmacology
The actual cause of bipolar disorder is not yet clear. Some people have a family history of such conditions which also includes depression. Stressful events in life including those in the childhood, deprivation of sleep can trigger these disorders.
The key to overcoming this medical challenge is a correct diagnosis. The earlier, the better the chances of recovery.
—The author, Dr Vanita Srivastava, is an independent science and health writer. The views expressed are personal.
Read her previous articles here
(Edited by : C H Unnikrishnan)
First Published: Mar 30, 2023 1:07 AM IST
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