Bipolar disorder: Not the same as moodswings

Life has its bundle of ups and downs. We fall, we rise and in no time, we move on, but some people stay down much longer and this undulation, is their every day life. VERA ONANA unveils with expert opinion the highs and lows of living with a serious mental condition that is largely under reported in Nigeria and how it may be managed.

AN average woman experiences mood swings that are associated with the menstrual cycle. For most women, when it is that time of the month, they act differently. However, mood swings are not attributed to only hormonal women. Every human being experiences a little bit of sadness and some happiness time after time.

In life, everyone has good days and bad days, ups and downs. School, jobs, parenting and relationships can be confusing and frustrating. Things can be great one minute, but in the next, they get awful. This can feel overwhelming.

Undulating between sadness and happiness is a normal part of living but when these feelings linger, it may be much more than just normal mood swings.

According to mental health experts, bipolar disorder, a serious mental condition, which is characterised by alternating periods of elation and depression is very prevalent but sadly highly under-reported especially in Africa, Nigeria inclusive. “It’s really as prevalent here as anywhere else in the world. Studies in Nigeria actually show a prevalence of about one in a thousand but this is very likely an underestimate,” says mental health specialist.

Consequently, it may be often erroneously considered to be the same as mood swings.

In a bid to set things straight, Dr Ayomide Adebayo, a mental health consultant, started by defining bipolar disorder. “The full name for bipolar is bipolar affective disorder — “bipolar” for “two poles” or “double extremes”; “affective” is an oldish word for “mood.” So another way to think of it is something like, “two-sided mood disorder.

“Bipolar disorder is not the same as mood swings. This is a very common misconception, but it’s easy to understand why it happens. The most striking thing about bipolar disorder is the extreme mood changes. Most people hearing this for the first time try to relate it to their own experience of mood swings. So, they assume they either have bipolar or that bipolar must be some kind of extreme mood swing, but it’s not.”

He added however that normal mood swings may be differentiated from bipolar disorder.

“The difference is like with most mental illnesses: the problem has to be serious enough to be causing the person or those who care about them significant distress and also enough to affect their ability to function in their usual day to day roles. If mood swings don’t prevent a person from getting out of bed, living a relatively normal life, or don’t cause too much distress to them, it may not be bipolar.

“Also, the duration of either the extremely high mood (mania) or low mood (depression) matters. A longer time frame spanning into days, weeks means more than just mood swings.”

According to mental health professionals, mania or depression is characterised by different symptoms. In a mania (high) episode, persons suffering from bipolar disorder tend to feel excited, impulsive, euphoric, and full of energy. During manic episodes, such people may engage in spending sprees, have unprotected sex, use drugs,  sleep less, make big plans, have big ideas and lots of projects, get aggressive, make spur-of-the-moment or bad decisions and drive fast.

On the other hand, depression is often characterised by deep sadness, hopelessness, loss of energy, lack of interest in activities that were once enjoyed, periods of too little or too much sleep and suicidal thoughts.

Dr Ayomide added that though bipolar disorder is genetic, it is not hereditary. “Bipolar has a very strong genetic basis. But is it hereditary? No. People often mix up the two: genetic simply means that genes are involved, that is, there’s some kind of transfer. But we use “hereditary” to describe transfer of traits from parent to child, the way you get, say your nose, from your parents. But the transfer of bipolar disorder isn’t that simple. One person might have it and the only other affected person in the family is some second cousin somewhere.”

Speaking on how best to handle the condition, the mental health expert stated that “cure and management are two words I don’t like. Cure sounds good, except it makes anything that’s not a “cure” look like one is settling for less, when in fact, people go on to live fulfilling lives while living with various health conditions.

“For bipolar and other mental health problems we don’t talk so much about cures. We focus more on what the person’s life is like and how much they’re able to live it in ways that are fulfilling. Some call that ‘management,’ we call it ‘recovery’. A person living with bipolar disorder if adequately empowered can live a full life.”

He added that for children, managing the condition is just like it is done in adults. Professional care must be sort and prescribed medications must be taken. There are the regular antidepressants for the depressive aspect and then there are also “mood stabilisers” for the manic side.