Fighting the Stigma Associated with Bipolar Disorder

HOUSTON (April 27, 2011) – With the spotlight on bipolar disorder, in part, because of news of actress Catherine Zeta-Jones receiving treatment for the condition, Dr. Asim Shah, deputy chief, Psychiatry, Harris County Hospital District, wants to clear up the misunderstood disorder and its associated stigma.

"When you tell patients they’re depressed or suffer from attention deficit disorder, they accept that diagnosis quite easily," Shah says of his practice as medical director of the Psychiatric Intensive Outpatient Program at Ben Taub General Hospital. "But when you tell them they have bipolar disorder, about half will fight and argue with you about the diagnosis."

With Mental Health Awareness Month in May, Shah wants to educate the public and reassure people with bipolar disorder that they can control and manage their condition and lead healthy, productive lives.

"People should know that a diagnosis of bipolar is something that can be treated if they follow their medication regimen," Shah says. "The disorder can lead to tragic consequences such as suicide or other life-threatening actions, if left untreated or if patients stop taking medicines."

A bipolar diagnosis is defined as a combination of a single manic episode and one or multiple bouts of depression that are disruptive to home, work and personal relationships.

"Some people have described mania as having their mind going faster than their bodies, or 'I feel like I’m driving 90 miles an hour all the time,'" Shah says. "On the other hand, patients describe depression as a total lack of energy, desire or interest."

To be considered manic, a person must suffer an episode of mania lasting at least seven days. During these episodes, people may go on out-of-control spending sprees, engage in indiscriminate sexual exploits or have thoughts of fame or "god-like" abilities. During these euphoric periods some patients decide to stop taking their bipolar medicines. The results are stronger episodes of depression and mania and more instability.

"They feel they’re cured or don’t want anything to stop their feelings of being top of the world," Shah says.

To properly diagnose the condition, psychiatrists often will want a complete history from a patient’s perspective, as well as from family members.

"Some patients may not remember having a manic episode, but usually can recall bouts of depression," Shah says. "Family members may remember manic bouts, because that’s when they couldn’t cope with their loved one’s actions."

Ensuring a proper diagnosis is important because prescribed medications have counterproductive effects if not administered correctly. For instance, certain anti-depression drugs can trigger manic episodes in patients who previously suffered manic episodes, but were not properly diagnosed.

Signs that someone may have bipolar disorder are:

• Family history of diagnosis or mood disorders
• Disruptive behavior at home or work
• Unable to sleep
• Mood fluctuates for long stretches of time (days)
• Grandiose thoughts
• Changes jobs often
• Is the life of the party, but can overwhelm others quickly

It can take up to 2-8 years to accurately diagnose a patient with bipolar disorder. One reason is that people who are bipolar often hide their condition. Clinicians commonly diagnose bipolar during various phases of the disorder:

• 4 percent during mania
• 8 percent during hypomania (a less intense mania)
• 50 percent during depression

To properly diagnose a mood disorder or any psychiatric ailment, Shah recommends people consult a medical provider.

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