/ 2 March 2012

The ups and downs of bipolar disorder

Gerry Dawson was an extremely talented computer engineer. Hard-working, diligent and energetic, he was also popular with his colleagues.

But people started to notice that Dawson’s considerable drive was going into overdrive. His wife worried that he was not getting enough sleep. He seemed forever restless and excitable.

At times he seemed euphoric. He believed he was “the chosen one” on some “special mission”.

With an almost nonexistent attention span, he could also quickly become irritable and impatient with colleagues who could not keep up with his punishing pace. He started adopting an inflated, grandiose view of himself and his abilities.

Of great worry to his family, he also went on spending sprees during which he splashed out on articles he did not need. His behaviour had become manic.

Dawson was on a downward spiral of bipolar disorder. It is a mental ­illness that has two distinct sides: the highest of the highs — the mania — and the lowest of lows — acute depression. The disorder has been described as causing people to have excessive mood swings that are out of proportion or unrelated to what is happening in their lives.

Clinically, the condition is regarded as a spectrum of mood disorders that are classified as either bipolar I, which presents one or more manic episodes with or without a depressive or hypomanic episode, or bipolar II, which presents with one or more hypomanic episodes and one or more major depressive episodes. There is also cyclothymia or bipolar disorder, which causes episodes of hypomania with periods of depression that do not meet the criteria for a major depressive episode.

Among the many symptoms of depression are feelings of intense sadness, a lack of energy or excessive fatigue, as well as a loss of interest in work, with pastimes or even with those family members and friends who are close to the sufferer. The patient also feels an inability to experience pleasure or return feelings of love and affection from others and, of course, low self-esteem and inexplicable guilt. These symptoms can lead to compulsive gambling and the excessive use of alcohol and recreational or prescription drugs. They can also lead to suicidal thoughts.

Bipolar disorder affects about 1% of the population and does not discriminate between gender or race. One peculiarity of the condition is that it tends to afflict people in the higher strata of society – the “upwardly mobile”. It usually manifests when sufferers are in their 20s or 30s, but this can vary.

The great tragedy of the disorder is that, because of the public’s ignorance, it often ruins the careers of talented professional people. It also damages their relationships with family and friends.

The cause of bipolar disorder is not known. In 2000, the American Journal of Psychiatry reported that, “in those with bipolar disorder, two major areas of the brain ­contain 30% more brain cells that send signals to other brain cells”. The article put forth a theory that “the extra signal-sending cells may lead to a kind of overstimulation, which makes sense considering the symptoms of bipolar disorder”.

The condition can be treated. Education, medication, psychiatry, psychotherapy and support groups are key ingredients in treating it.

Medication must be taken on an ongoing basis, because it is a chronic condition and the sufferer must continually monitor his or her emotional wellbeing. Patients must also learn to recognise their own stress triggers and develop strategies to deal with them.

Dawson was lucky. He had an excellent ­psychiatrist with whom he built a trusting relationship that helped him to learn to manage the condition. And his family, friends and work ­colleagues rallied around him with support and understanding.

Bipolar disorder will be the topic of Bonitas House Call on March 10 at 9am on SABC2