Islamabad-Bipolar disorder is like a tempest blowing away your life violently in a very dark direction. Patients suffering from this disorder go through emotional transitions between severe depression and and mania (elevated or irritable mood) coupled with paranoia and anxiety. It causes severe mood swings which interfere with life, relationships and work. Unlike mood swings that occur due to hormonal changes such as those during PMS, such extreme mood swings tend to last for several weeks and can extend to several months, if left untreated. Formerly known as manic depression, it makes the patients mood jump from one extreme to another.

Bipolar I, Bipolar II and cyclothymic disorder are the three main types of Bipolar disorder. Bipolar disorder can also lead to substance abuse or vice versa, as those with a family history of mood disorders have a higher chance of developing Bipolar if they engage in substance abuse.

Like most mental health illnesses, the exact cause of this disorder is still unknown, but genetic and chemical factors, life altering problems/events and extreme stress are believed to contribute in triggering an episode. According to WHO, Bipolar disorder is the 6th leading cause of disability worldwide.

During a press conference at the National Press Club, Islamabad in 2017, Dr Ayesha Ali stated that around 80 million people in Pakistan are suffering from mental illnesses. Despite the high prevalence of these illnesses in Pakistan, such illnesses are looked down upon in the society due to lack of awareness because of which most patients are too afraid to seek professional help. A common misconception that exists in Pakistan is that mental illnesses like depression and bipolar, only affect the rich and supposedly these are western diseases that only affect those who are not in touch with religion, which is absolutely untrue, these illnesses are not confined to a specific social class, nationality or religion. In rural areas, it is very common for elders to tell a person suffering from such an illness to “pray more” as such diseases are believed to occur due to lack of faith, people also tend to believe that the delusions linked to psychosis and mania are actually caused by black magic, even though they would never tell people suffering from fever or diarrhoea to “pray more”, instead they’re told to get proper medication, because physical illnesses are taken more seriously in this part of the world. In 2015, PPP Chairperson Bilawal Bhutto was reported to be suffering from bipolar disorder, despite the authenticity of the news, people instantly labelled him as a ‘lunatic’, this is the dark reality of how people look at mental illnesses in Pakistan because of which people don’t want to be associated with such a disease and are afraid to seek medical help.

*Alizeh Ahmad a teacher and a patient suffering from Bipolar disorder said, “It is very important to work out a plan with your psychiatrist and it is even more important to stick to it and monitor it in case you decide to take medication. I am very forgetful, so I use plastic pill holders labelled with days of the week so I don’t miss a dose. You have to trust your doctor and therapist, otherwise treatment can be a very stressful process. Also if you know someone who is suffering from such an overwhelming disorder, please be kind to them and offer to accompany them to therapy if they’re too afraid to seek help, such illnesses can happen to anyone at any time, so it’s important not to trivialise the severity of the illness and make it worse for those suffering from it by telling them that it’s all in their head.” It is vital to keep an eye on loved ones suffering from this disorder as bipolar patients tend to get suicidal during episodes of depression due to the overwhelming feeling of helplessness and worthlessness.

Moreover, during episodes of mania they can end up spending large amounts of money, get involved in risky or promiscuous sexual activity, and could experience severe hallucinations and paranoia during psychosis. Medication can greatly improve the condition of such patients and can help in eliminating most symptoms so patients could lead a somewhat normal life. Depending on the severity and type of bipolar disorder, doctors tend to prescribe mood stabilizers, therapy or a combination of both. During a discussion about Bipolar disorder, Dr Osama Muslim said, “It is very important to consult a doctor if such a patient is considering getting pregnant, as this disorder can get worse during pregnancy and the medication can be harmful for the child. Bipolar patients are likely to reach out for help during an episode of depression than mania but it is important to establish a history of both depression and mania during diagnosis in order to avoid a misdiagnosis.” People suffering from Bipolar are often looked down upon as unreliable, so employers prefer not to hire them because of their extreme mood swings which can sometimes be violent, but a number of people suffering from this disorder have become quite successful and have created musical/literary masterpieces and have even served in senior political and military positions, a few famous names include Winston Churchill, Jimi Hendrix, Mel Gibson, Mariah Carey, Ludwig van Beethoven, Edgar Allen Poe, Frank Sinatra, Halsey and Nina Simone, among others. It is important not to judge those suffering from such an illness, in fact it is vital to appreciate them for whatever they achieve despite their mental illness. All those suffering from this disease deserve support, empathy and a pat on their back for fighting one of the hardest battles an individual can encounter. If you are suffering from such an illness, just know that your illness does not define you, it is your courage and strength to fight this battle that defines you.

*The name has been changed to protect the individual’s privacy.