Growing up I saw many different moods of my mother. Most of the time she was depressed. Some of the time she would get aggressive and at others euphoric or highly energetic. From dealing with diabetes and smoking a pack in a day, to changes in her eating habits. Restless sleep, problems with handling money, withdrawal from friends and family. Lack of activity, fatigue, to taking pills whenever she felt guilty or nervous. After she tried to kill herself when I was in the 12th standard did we realize she suffered from Bipolar disorder. It changed the dynamics of my family altogether. I saw it take refuge in the dark and empty spaces inside her. This led to a lot of bad decisions on her part.
In those 17 years we had never once noticed possible symptoms because we were unaware. This lack of awareness is what afflicts majority of the Indian population. In this case ignorance is not bliss. It is deadly. We don’t understand the depth of a tragedy until it happens to us. Every day is a battle, not just for the afflicted individual but for the family as well
What is BD? (Bipolar disorder)
A mood disorder, it is characterized by extreme swings of mood from manic highs plunging to lows (depression) with periods of normalcy in between.
- Mood: Anger, anxiety, apathy, apprehension, euphoria, general discontent, guilt, hopelessness, inability to feel pleasure, loss of interest, mood swings, sadness, or elevated mood
- Behavioral: Aggression, agitation, crying, excess desire for sex, hyperactivity, impulsivity, irritability, risky behavior, or self-harm.
- Cognitive: Delusion, lack of concentration, racing thoughts, slowness inactivity and thought, unwanted thoughts, or false belief of superiority.
- Psychological: Agitated depression, depression, manic episode, or paranoia.
- Sleep: Difficulty falling asleep or excess sleepiness.
- Whole body: Fatigue or restlessness.
- Weight: Weight gain or weight loss.
- Also common: Rapid and frenzied speaking.
Why Is It So Serious?
Bipolar Disorder is a serious and very common mental illness, which has no known cure. It requires lifelong treatment. Not only is this taxing on the individual but financially on the family as well. The social stigma that follows is the worst consequence of the disorder. It can mean loss of jobs, loss of family and social support, dysfunction in major areas of life (work, interpersonal and intrapersonal levels).
Treatments can help reduce symptoms. Medications include valproic acid, lithium, lamotrigine, quetiapine, among others. Other treatments include Cognitive Behavioural Therapy (CBT) or psychotherapy. Combining psychopharmacology and CBT or psychotherapy is the best approach. The medications act on the neurotransmitter levels by “sedating” them or “calming” them. CBT is a type of talking therapy which changes or restructures the client’s thought process. This is done to help them understand the nature of their disorder, importance of medication and appropriate ways of behaving.
Prevalence in India
Times of India reported that mental illness was carved out as a separate category for Census 2011. The findings released recently, however, estimate that only 7.2 lakh people across India suffer from mental illness, a figure suspected to be grossly underestimated. Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370/1000 population in India. More than 10 million cases of BD per year (India), but majority of the population lack awareness of such psychological disorders. India has a mere 7000 practicing psychiatrists! Going by the more realistic global rate, we are talking about 13 million Bipolar disorder afflicted in India!
What is the Mindset?
People and their families don’t come forward for treatment or talk about it as they fear of getting judged.“log kya kahenge? Log kya sochenge?” This sort of mindset, which comes with living in a collectivist society, is a barrier to openly communicating about certain topics. Genetic and environmental factors can influence the onset of the disorder, the important thing is to focus on “what next?”, “how to treat?” than the “why?” as such. Bipolar Disorder is heritable and risk factors need to be discussed to be prepared for the future.
What Is The Need Of The Hour?
The need in India is to educate and create awareness of psychological disorders. There is a need for counseling and support groups, proper rehabilitation centers and mobilizing investment in the health sector towards mental health. What needs to be emphasized is that there is nothing shameful in having a disorder. The myths associated with disorders in general need to be dispelled. Family support is very essential in such cases. Yes the treatment is expensive; the emotional and mental burden is distressing. But it’s important to understand that they are “human”, they are “individuals”, and they are not just a disorder.