Last week, Mumbai Commissioner of Police Param Bir Singh had addressed the media following the suicide of Bollywood actor Sushant Singh Rajput in July, saying, 'It has come to the surface that he had bipolar disorder; he was undergoing treatment.' This was followed by the recent suicide of television actor Sameer Sharma. This has led mental health experts to highlight the importance of awareness and action.
Bipolar disorder, specifically, is a mood disorder characterised by episodes of emotional swings ranging from depressive lows to manic highs, and can be of different types: Bipolar I, where the individual may suffer severe episodes of mania and depression; Bipolar II where they experience hypomania (mild mania) with severe depression, and Cyclothymia, where hypomania and depression last for years, but show no specific pattern nor matching the severity of the symptoms. The last type sees individuals experience loss of grip over reality, where they see and hear what doesn't exist.
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Sushant Singh Rajput
"Because of its complex nature, the condition is hard to diagnose and can turn severe if left untreated for years. While many individuals first experience the symptoms in their early 20s, the repercussions on health start showing in their 40s," says Delhi-based Dr Roma Kumar, a senior consultant psychologist. City-based psychologist, Sailee Rupani, adds how her colleague treated for depression, found out 15 years later that he had been misdiagnosed and was suffering from Bipolar II.
Speaking about underlying causes that trigger the disorder, Rupani shares, "Studies indicate that imbalance in the brain chemicals can cause it and in many cases, it could be genetically passed down, or caused by severe trauma, childhood or drug abuse."
Shilpi Singh
Why seek help?
The intervention of bothÌu00c2u009b — a psychiatrist who can diagnose the condition and administer medication, alongside psychotherapy by a clinical psychologist or therapist can help, says, Dr Kumar. "When a practitioner is not trained, they may misdiagnose bipolar as borderline personality disorder due to the similarity of symptoms. So thorough testing is required before labelling someone," quips Rupani.
Words matter
"Yeh thodi excited hai. It's just a mood swing. We are all a bit bipolar, no?"
Sailee Rupani
We hear these terms being used loosely in our daily interactions, without considering the gravity of what living with the disorder is like, and how they could trigger a person with the condition. "Words are important," emphasises Rupani. "When a person is experiencing a depressive phase and says 'I am feeling low,' listen to them. Ask how you can help. Stop using labels loosely at home like, 'Don't act bipolar,' or when you see them struggling with even getting up or getting through simple tasks in a day, don't say, 'Stop giving me an excuse for your laziness, you just don't want to work.' In a manic high, it is common for the person to pick fights. Mute yourself," she adds. Often, the disorder can go undiagnosed in women (especially with PCOS) because the mood instability is generally associated with PMS, rather than investigating the real cause.
Create a mood chart
To normalise the talk around bipolar disorder, family and friends must be active in the recovery process. One way to do this, suggests Rupani, is creating a mood chart. This should be treated as a calendar where every family member marks their moods two to three times a day. This routine not only helps break stigma but when everyone including the person is going through the disorder, it helps them sense highs and lows compared to the other members and try to calm their behaviour or excessive thoughts.
Roma Kumar
Always around
"Work out pre-decided moves with the person on how you could help them in a manic episode. So, when you approach them at their most vulnerable moment, they do not feel distressed about a violation of privacy or become aggressive," says Rupani.
Delhi-based leadership coach, Shilpi Singh adds how developing an ecosystem of people in the professional workspace for those with bipolar disorder is critical for their wellbeing. "People with mental health disorders need work cultures that put people first. So if it means sitting with the person and carving out a role that works with their strengths, then why not?"
Signs and symptoms
1 Experiencing extreme highs to extreme lows
2 Heightened energy or creativity
3 A sense of euphoria or invincibility over time
4 Talking a lot without getting tired
5 Impulsive behaviour like excessive spending, gambling, risk-taking
6 Feeling low on energy, sense of worthlessness, exhaustion, helplessness, negativity, restlessness, irritability
7 Disturbance in sleep patterns — may sleep too long or not sleep for days
8 Suicidal thoughts
9 Loss of reality in extreme episodes
Caregivers are key
Rupani, who has a perspective, also reminds about the caregiving burden, where the caregivers are experiencing turmoil themselves:
"It is a tough job taking care of people experiencing mood disorders at home. Many families may not be financially equipped to deal with impulsive spending, and that leads to conflict. There comes a point where you get emotionally exhausted."
Joining a support group might help.
Meeting others experiencing similar situations builds solidarity and gives hope that you are not alone.
Individual therapy for caregivers is a good starting point.
"A safe space to allow you to vent is ideal because when you are a caregiver, you are on a rollercoaster with your loved ones' moods too."
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