Filipino TV soaps share some common themes: twins separated at birth, the insatiable rich vs. the incorruptible poor, the evil antagonist kidnapping the protagonist's wife/daughter/priest/etc. leading up to the climax, the beautiful yet evil and bipolar concubine—you get the picture.
Perhaps it is this play in popular culture that has given bipolar disorder (once known as manic depression) a bad rep. Whatever it is, it hasn't stopped people from attributing their mood swings to the disorder as if it were a minor issue as common as a cold in June, likely to pass with a little chicken soup and a warm blanket.
President Rodrigo Duterte himself, in an interview during the campaign trail, attributed to the disorder his changes in mood when answering media-fielded questions. That he dropped the term so nonchalantly, however, is no medical or scientific proof that he had indeed been diagnosed with this often misunderstood ailment.
Lest you think bipolar disorder is more common among Filipinos than any other race, counseling psychologist Dr. Joy-Alvi R. Arañas does not believe it has anything to do with ethnicity or even country. Like most other illnesses, he says, nobody is exempted from bipolar disorder.
What is it really?
"Bipolar disorder," explains Dr. Arañas, "is a condition that affects an individual's moods." He adds that one who has the disorder typically experiences extreme shifts or sudden changes in mood, including emotional highs (very energetic, overactive) and lows (feelings of sadness or hopelessness).
It is not easy to diagnose bipolar, as mood swings do not happen at the flick of a button. In the U.S. the National Institute of Mental Health (NIMH) reports that the disorder afflicts as much as 2.6 percent of the population. Yet the first diagnosis is often incorrect for 40 percent of those who are indeed bipolar. As a result, a person may go a few years without being correctly diagnosed with the mental affliction.
Are there different types?
There are several types of bipolar disorder, according to the NIMH and Healthline.com:
1) Bipolar I Disorder
This is common in both men and women. For men, the first episode is typically mania; for women, it is major depression.
2) Bipolar II Disorder
This exhibits major depression similar to bipolar I, but the mania is replaced by “hypomania”, which is not as extreme as mania, though it is still responsible for high energy and excitability. Bipolar II does not cause hallucinations or delusions, however, and it is more common in women. When a male has bipolar II, his hypomanic episodes outnumber or equal that of the depressive's. The depressive episodes are more dominant in a female.
3) Rapid-Cycling Bipolar Disorder
This causes rapid mood changes, and it may cause four or more episodes of mixed symptoms, hypomania, mania, or a major depressive state within a single year. Episodes may shift within as little as one day. This happens to more women than men, and usually involves people who had their first episode when they were young.
4) Cyclothymic Disorder.
A.k.a. mild bipolar disorder. This is characterized by less severe mood changes of hypomania and mild depression.
How is it diagnosed?
While it may be tempting to base your opinion on these short explanations, Dr. Arañas says only a psychiatrist or a psychologist is qualified to make a diagnosis after a series of tests.
Dr. Arañas further explains: "Manic excitement (overconfidence, inflated sense of self-esteem, expressing bizarre ideas, irritability) or severe depression (a feeling of sadness, emptiness, hopelessness, crying) for most of the day may indicate a bipolar episode."
The NIMH adds that a person with this affliction is more likely to seek medical help when they are in a depressive rather than a manic state. This necessitates the need for the person’s medical history before a diagnosis can be made.
What causes it?
While the exact cause of bipolar disorder is still a mystery, Dr. Arañas says some factors may contribute to it:
1) It may be determined by genetic factors, so a parent may pass it on to their child.
2) Researchers have found physical changes in the brains of those diagnosed with the disorder.
3) Brain-chemical imbalance. Neurotransmitter irregularities have also been observed.
4) Substance abuse, mental stress, extreme sleep deprivation, a traumatic event such as a "significant loss" may all contribute to the development of bipolar disorder. In 2010, when Hollywood actor Michael Douglas was diagnosed with cancer, the stress affected his wife, actress Catherine Zeta-Jones, so much that it triggered her bipolar disorder, for which she receives therapy now and then.
Can it be treated?
Dr. Arañas says there is no known cure for bipolar disorder, but with treatment and management using psychotherapy, counseling, and medication, a diagnosed bipolar may still live a normal, productive, and otherwise healthy life. He believes the stigma of mental ailments like bipolar disorder is slowly lifting, particularly among Filipinos, so that more people are choosing to talk to medical professionals regarding such problems. This is a good start, considering how bipolar disorder can get worse over time without therapy and medicines.
Who do you know that has it?
"I don't like standing near the edge of a platform when an express train is passing through. I like to stand right back and if possible get a pillar between me and the train. I don't like to stand by the side of a ship and look down into the water. A second's action would end everything. A few drops of desperation."
These were the words of the great leader Winston Churchill to his doctor. Churchill was not the only famous person who has struggled with bipolar disorder. Here is a short list:
1) Ludwig van Beethoven
Some of Beethoven's best compositions were formed during great fits of mania. Self-medication and alcohol consumption led to his death by liver failure, as there were no known therapies or medicines for his mental condition during his lifetime.
2) Vincent van Gogh
Genius as he may have been with the brush, he also suffered from eccentricity and mood swings, and committed suicide at the age of 37. Even today, the causes of his illnesses are researched, studied, and debated, but the bipolar aspect has never been discounted.
3) Demi Lovato
The actress and singer admits she only found out that she was bipolar after going into treatment. Today she is living a more or less normal existence, thanks to therapy and treatment.
4) Scott Stapp
The Creed singer thought his family was taking millions of his money to fund the ISIS. That is the extent of his delusions that have affected his behavior and fueled his addiction to drugs and alcohol. Now he is under intensive therapy and going through a 12-step program.
5) Vivien Leigh
Unlike Stapp and Lovato, Gone With The Wind's Scarlett O'Hara lived during a time when bipolar disorder was not known, understood, or treated. This led to the destruction of her career and her marriage to Laurence Olivier.
6) Carrie Fisher
Princess Leia's childhood was anything but ideal, eventually pushing her towards drugs and alcohol. Motherhood changed her, however, and drove her to seek treatment for her bipolar disorder. She is now a best-selling author.
7) Jean-Claude Van Damme
He can kick anyone's ass, but he couldn't kick the problems that had besieged his personal life, which has been marred by four divorces, cocaine addiction, and charges of wife abuse. Today the Universal Soldier has found peace by taking a pill and going to therapy for rapid-cycling bipolar disorder.
If you suspect that you or a loved one may be suffering from bipolar disorder, it is prudent to visit a medical professional. Symptoms are unique to the individual, and only a doctor can diagnose and direct you to treatment. Unlike in the rehashed scripts behind our favorite drama series, bipolar doesn’t end when the director yells "Cut!"
Dr. Joy-Alvi R. Arañas is a clinical psychologist from Pathways Counseling and Assessment Center. For consultation, visit him at 718 Sunday Street St. Joseph Village, Panapaan, City of Bacoor, Cavite.