Commentary: Living with bipolar disorder, trudging through life's highs and lows
A complex illness, bipolar disorder affects 1.2 per cent of Singaporeans but those who live with the disease have reason for optimism, says one expert from the Institute of Mental Health.
SINGAPORE: World Bipolar Day falls on Mar 30 each year – the birthday of Vincent Van Gogh.
A Dutch painter in the 1800s and one of the most famous and influential figures in the history of Western art, Van Gogh suffered from several mental breakdowns in his life.
He often neglected his physical health.
His friendship with a close friend and fellow painter, Paul Gauguin ended after a purported mental episode in which Van Gogh severed part of his own left ear and offered it to a prostitute.
As a result of his mental breakdowns, he spent extended periods of time in several psychiatric hospitals in the last few years of his life. After his last discharge, he moved to a place near Paris.
But his depression persisted and on Jul 27, 1890, Van Gogh shot himself in the chest with a revolver. He died from his injuries two days later.
Although it is difficult to say with certainty, Van Gogh may have well suffered from bipolar disorder. He had episodes of extreme elevated moods and episodes of severe depression.
It is not an uncommon illness. In a Singapore Mental Health Study conducted in 2010, we found that 1.2 per cent of Singaporeans suffered from this condition in their lifetime.
INVINCIBLE AND POWERFUL, THEN DEPRESSIVE AND WITHDRAWN
Bipolar disorder is a very complex illness. Like many mental disorders, there are no obvious external signs. Rather, a person is susceptible to episodes of extreme moods.
They could have periods of extreme euphoria. During these episodes, they may feel invincible and powerful. They may feel rich or have the belief that they have special powers.
Sufferers have grandiose ideas or may perform irrational acts such as starting up several companies or buying 10 bedframes to give away.
During this state of extreme euphoria, they may also experience other symptoms including feeling like they have unlimited energy, their mind racing from idea to idea, or feel that they don’t need sleep. In milder cases, they may have spells of extreme creativity or productivity.
Then the pendulum swings, giving way to depressive episodes. Those who suffer from bipolar disorder would be thrown into extremely low moods. Many become socially withdrawn and in severe cases, feel keenly that life is not worth living.
Studies have shown that even between episodes, those who suffer from the illness have a greater degree of mood swings compared to the general population. Understandably, this paints a rather grim prognosis for anyone with the illness.
Stigma, dealing with the day-to-day challenges of a chronic illness, caregiver burden, its effects on the various facets of a person’s life (including career and family), all make it difficult to live with the illness.
LIVING WITH THE ILLNESS, FEELING LIFE MORE DEEPLY
However, while it is a complex illness, those who suffer from it should not feel like they have to go through it alone in the same way Van Gogh did.
Indeed, World Bipolar Day is not meant to be a day of grimness and negativity but a celebration of uniqueness and strength.
Author and psychologist Kay Redfield Jamison wrote in her autobiography An Unquiet Mind about her struggles living with the illness and how difficult it was to accept that she needed medication. However, she ended with a rhetorical question. If given a choice, would she still choose to have the illness?
She said that she would not if she had not received treatment. But with medication, her answer was different. She said the illness had enabled her to feel things more deeply, to experience both life and death intimately, and to experience loyalty and care.
Although her autobiography was written in the 1980s, much of this still holds true today. There are more medication available to treat bipolar disorder today than in the 1980s. While they do not offer a cure, the medication help stabilise severe mood episodes.
OVERCOME THE STIGMA OF MEDICATION
A common fallacy is that once the mood episodes have been treated, medicines are no longer required.
However, it is recommended that such medication or mood stabilisers be taken on a regular basis. Doing so has been shown to help those who suffer from bipolar disorder manage mood swings in between episodes.
Many see medication as a reminder of their illness and a crutch. Some even see it as causing harm.
Indeed, many may feel like they need to stop their medication, in order to show they have recovered and can move on with life. It may be encouraged by friends and family.
There is also the fear that employers would discriminate against them if they learn about their illness and that it would render them uninsurable by healthcare insurance providers.
Yet, the goal of treatment is to enable a person to live a normal and full life, free from the severe mood episodes and mood swings. There is no reason why a person living with bipolar disorder should not be able to complete school, find a job, advance in their career and find love.
A CELEBRATION OF THE HUMAN SPIRIT
Today, beyond medication, there are resources and support groups available to help the person on their journey.
Specific therapies have been shown to help a person remain stable and well. Support groups and online information are available to help both the sufferer and caregivers learn to cope with such an illness.
Kay Redfield Jamison eventually became a professor of psychiatry at the John Hopkins University School of Medicine.
Many famous and successful people similarly struggled with and overcame bipolar disorder to achieve success in their fields.
Among them count Winston Churchill, the British prime minister during World War II, Carrie Fisher who starred as Princess Leia in Star Wars and famed singers like Demi Lovato and Sinead O’Connor.
So let’s celebrate World Bipolar Day. It’s a celebration of how far we have come in the management of this illness.
It’s a celebration of every struggle that those who suffer the illness had to face and overcome.
It’s a celebration of those who fell down and picked themselves up again and ultimately, a celebration of the human spirit.
Dr Mok Yee Ming is senior consultant and chief of department of mood and anxiety at the Institute of Mental Health (IMH).
READ: Channel NewsAsia’s commentary series with IMH on mental health which includes:
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A commentary on the prevalence of depression in Korean pop stars.
A commentary on the dark underbelly of youth binge-drinking.