Yesterday in my OPD, I saw a youngster Nikhil aged 19, a 1st year Computer science engineering college student brought by his parents. On presentation Nikhil came across as being extremely happy and super confident. As he spoke it became evident he was in his own world, communicating with Martians who were helping him write a code which would alleviate poverty from the world once and for all.
The idea though noble - Did not come across as practical and feasible and downright science fiction. On further enquiry his parents informed Nikhil over the past few weeks had changed. Initially, he came across as being more friendly, open, engaging in conversations with which his parents were pleasantly happy for good as Nikhil had always been a shy individual. They were taken back a little when the iphone and other stuff was delivered for which he had paid with his credit card. Things took a turn for the worst when his mother discovered weed in his room and spiralled out of control for the last two days as Nikhil had not slept for the last two days, was constantly blabbering and was constantly on his laptop engaged in his coding.
Welcome to the world of bipolar disorder. It is a serious mental illness that affects approximately 1 out of a 100 individuals. So, it's not that uncommon. A lot of famous personalities have had it especially in the creative world, including Sinead O’Conner, Maria Carey, Jean Claude van Damme, Catherine Zeta Jones, Winston Churchill to our own Yo Yo Honey Singh.
So what are the symptoms of Bipolar disorder?
There are different types of this disorder depending on how severe the symptoms are or how long they last. The mood changes can sometimes happen very rapidly within hours or days. For some people, the mood symptoms are less severe. In between the highs and lows, there are usually ‘normal’ periods that can last for weeks or months. However, for some people, especially when they have had the disorder from some time, these periods of ‘normalcy’ can be shorter or difficult to see.
Below is a list of the sort of symptoms that can occur in each type of episode. One needs to have several symptoms at the same time for at least several days.
Symptoms that can occur during a ‘high’ or manic episode
- Feeling incredibly happy or ‘high’ in mood
- Very excited feeling
- Irritable talking too much
- Racing thoughts
- Increased activity and restlessness
- Difficulty in concentrating
- Constant changes in plans
- Over confidence and inflated ideas about yourself or your abilities
- Decreased need for sleep
- Not looking after yourself
- Increased sociability or over-familiarity
- Increased sexual energy
- Overspending of money or other types of reckless or extreme behaviour
Hypomania is a milder form of mania (less severe and for shorter periods). During these periods people can feel very productive and creative and so see these experiences as very positive and valuable. However, hypomania, if left untreated, can become more severe, and may be followed by an episode of depression. At the extreme end, some people also develop ‘psychosis’.
Symptoms that can occur during a depressive episode
- Feeling very sad most of the time
- Decreased energy and activity
- Not being able to enjoy things you normally like doing
- Lack of appetite
- Disturbed sleep
- Thoughts of self-harm or suicide
On the milder end, one may just feel sad and gloomy all the time. Here too, at the extreme end, some people can develop psychosis where one loses touch with reality and starts experiencing and believing in things which are not real.
Symptoms that can occur during a mixed episode
A mixture of both manic and depressive symptoms at the same time.
So, what can one do about it?
The first and foremost thing is to recognise that things are not alright either at your end or at someones whom you know. Seeking appropriate treatment is extremely important as well as keeping the individuals and others safe during the illness. Then comes “psychoeducation” where the individual and family learn to recognise early warning signs of the illness and are able to seek help at the appropriate time before things spiral out of control.
Making appropriate changes to one's lifestyle is very important as for eg lack of sleep,increased exposure to stress - personal, professional, financial are known precipitating factors. Am sure with time Nikhil will be able to not only get better and get along with his normal life, stay away from harmful things eg weed but also contribute gainfully to himself, his family and the society at large.