Interview: Everything you need to know about Bipolar Disorder

Mental health issues can be a tricky subject to discuss in Singapore, especially with the stigma that surrounds such conditions. For many, it is easier to skirt around such uncomfortable issues or brush them off as unimportant. As such, we have a long way to go in raising awareness of mental illnesses and its place in our community.

With World Bipolar Day falling today, we reached out to Dr Daniel Fung, Chairman of Research Committee for the Singapore Association for Mental Health (SAMH), to answer some important questions regarding the condition to help readers understand the complexities that it can bring to the lives of those suffering from it.

Marie France Asia: How do you recognise the onset of bipolar disorder? Are there obvious signs to look out for?

Dr Daniel Fung: The most obvious and critical feature of bipolar disorder lies in the emotion or the mood of the person, most often being dependent on the feelings that the person experiences. From the highs of mania (euphoria) on one extreme to the lows of depression on the other, these serious shifts in mood, energy, thinking, and behaviour is very symptomatic of bipolar disorder. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder can be intense that they interfere with one’s ability to function.

However, bipolar disorder can look very different in different people. The symptoms vary widely in their pattern, severity, and frequency. Some people are more prone to either mania or depression, while others alternate equally between the two types of episodes. Some have frequent mood disruptions, while others experience only a few over a lifetime. In children, the onset may be a bit more disruptive as it can be masked as behavioural problems – like anger issues and destroying things.

Some classic symptoms can include:

• Unusually high or irritable mood for an extended period of time
• Inflated self-esteem or grandiosity; thinking that one is more important than he really is
• More talkative than usual
• Feeling that the mind is racing
• Increase activity to make grand and unattainable plans
• Reckless behaviours such as spending sprees, delusional thoughts that they can fly and impulsive sexual indiscretions

MFA: What makes a person more susceptible to bipolar disorder?

DD: It appears that certain people are genetically predisposed to bipolar disorder, yet not everyone with an inherited vulnerability (for example: a sibling or parent with the illness) develops the illness, indicating that genes are not the only cause.

External environmental and psychological factors are also believed to be involved in the development of bipolar disorder. These external factors are called triggers. Triggers such as stress, alcohol or substance abuse, and lack of sleep can set off new episodes of mania or depression or make existing symptoms worse. However, many bipolar disorder episodes occur without an obvious trigger.

MFA: Is there a cure? How can it be prevented?

DD: Bipolar disorder is a chronic or what we call a lifelong condition that may include the risk of relapses. The biggest of these risks would be suicide as often times it is hard to predict and may go unnoticed in individuals especially those displaying euphoria. It can be managed with medication being the main treatment option. Mood stabilisers, antidepressants, anti-psychotics and sedatives can be used in different combinations, depending on individual presentations, to treat acute episodes and to help prevent a relapse.

Psychological therapy such as counselling and other rehabilitative services offered by organisations such as Singapore Association for Mental Health is an option for patients who are more stable, to help them with symptom recognition, management and reintegration into society. Ultimately, the treatment and management of this disorder is to help stabilise the mood so that it doesn’t go into extreme peaks and troughs but rather a regulated pattern.

In order to get the most out of treatment, it’s important to educate oneself about the illness, communicate with doctors and therapists, have a strong support system, and help oneself by making healthy lifestyle choices that may reduce the need for medication. Stick to the treatment plan, reassessing with the doctor as changes in one’s life occur.

MFA: What can people around someone with this condition/illness do to give practical help?

DD: Be supportive and understanding towards them by acknowledging that it is a condition that they can’t easily snap out from. Instead, help them if possible in terms of ensuring that they take their medication or steer them away from stressful situations that you think would trigger an episode.

Provide a listening ear and if possible, try to help them regulate their moods so as to ensure that it doesn’t go towards the extreme ends. Ultimately, we all one way or another benefit from those who look out for us.

MFA: What can we do to diminish the stigma that surrounds mental illnesses in general?

DD: Most often, stigma is the result of fear and ignorance by those who may not fully understand what mental illnesses is all about. Many may just draw upon from negative examples of those people suffering from such conditions in being violent, dangerous or unstable. This forms perceptions and may inadvertently lead to discrimination. For those suffering from mental health conditions, it may cause them to feel ashamed for something that is out of their control and prevents many from seeking the help they need and speaking out.

That is why it is important for us to strive towards becoming a more inclusive society by seeing the person beyond their mental illness; as they have many other personal attributes that do not disappear just because they also have a mental health condition. We see many people in society, even celebrities, who suffer from bipolar disorders and yet are leading mostly normal lives.

Stigma is not something that will go away on its own, but if we work together as a community, we can change the way we perceive mental illness in our society. Together, we can create robust systems, services and efforts all along the path of recovery and encourage early intervention and access to treatments without fear of labels or diminished opportunities. When that is achieved, we will know that our tireless efforts to diminish stigma have been successful.

Angela Goh

Photos: Getty Images, Singapore Association for Mental Health

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