Many common conceptions of bipolar disorder are misleading, stigmatising, or just inaccurate.
Here are three common misconceptions about bipolar disorder:
1. Bipolar Disorder is rare
It is estimated that 1 in 50 Australians develops this illness, with more prevalence among males than females. Most of those diagnosed are in their 20s, around the same time schizophrenia is often diagnosed. By the late 90s with the inclusion of hypomania in the symptom profile of bipolar disorder, some researchers estimate the prevalence to be as high as 5-7%
2. Bipolar sufferers are always in manic or depressive episodes, or some mix of the two.
While individuals with bipolar disorder do experience periods of extreme changes in mood and energy levels, this isn’t happening all of the time. In fact, over a given lifetime of someone suffering from bipolar disorder, about 8-10 episodes can be expected, but this figure varies from person to person. It’s important to define “episodes”, as there are a few different types:
A manic episode is characterised by abnormally high energy and activity levels, a reduced need for sleep, feelings of confidence and euphoria. People in manic episodes generally have poor insight into their state and find it difficult to accept that they are ill. They may start ambitious work projects only to drop them later, or dress colourfully and haphazardly. Occasionally, mania can present itself with psychotic features, involving delusions of grandeur with a special purpose or special abilities. Left untreated, manic episodes last for an average of about four months. A single episode of mania suffices to meet the DSM criteria for bipolar I disorder. More on the different types of bipolar here.
This is a version of the manic episode but with reduced intensity. It is characterised by feelings of high energy and activity and a reduced need for sleep. One common misconception about both the manic and hypomanic phase is that individuals in the grips of these episodes are very happy. On the contrary, irritability and aggression are common experiences during manic and hypomanic episodes, oftentimes leading to interpersonal and work difficulties.
In a depressive episode, the person may feel intensely sad or down, fatigued, or they may have difficulty concentrating or have thoughts of death or suicide. Approximately half of the bipolar sufferers attempt suicide at least once in their lifetime, so therapeutic intervention in these episodes is especially important. Left untreated, depressive episodes last for an average of about six months.
In mixed episodes, the person is experiencing symptoms of either a manic or depressive episode with some features of the opposite mood state at the same time. According to a 23-year old bipolar sufferer named Anna, “…mixed episodes scare me the most. That’s when I feel like I completely lose myself”
3. Bipolar is difficult to treat
While the average life expectancy of bipolar disorder sufferers is estimated to be eight or nine years less than average, that gap is rapidly shrinking due to better management, including effective psychological and pharmacological treatments. While responses to pharmacological treatments are very individual, most patients respond well to some form of mood-stabilising, antidepressant, or antipsychotic medication, depending on the type and severity of the episode. The prognosis for the illness is hopeful, especially with proper self-care, sleep hygiene, strong social support, and an efficient and supportive medical triage.