Anxiety is part of bipolar disorder

On the trail of bipolar disorders

NEW ISENBURG. Around two million people in Germany are said to suffer from bipolar disorder. The first point of contact for them is usually the family doctor's practice. But it can be a rocky road until the correct diagnosis is made. Those affected notice that something is wrong with them and are definitely looking for help.

At the same time, however, they try to hide their illness. Or downplaying them because they don't want to be considered mentally ill. "Manic-depressive patients are good at hiding their feelings and illness, or at finding alternative explanations for their breakdown," says Dr. Kay Redfield Jamison, professor of mood disorders and psychiatry at the Johns Hopkins University School of Medicine in Baltimore.

Take insomnia seriously

Jamison not only works and researches as a doctor in this area, but has also suffered from a manic-depressive disorder herself for over 30 years. She knows which symptoms, inconspicuous at first glance, should make doctors sit up and take notice. And how important it is to know the family history and include it in the anamnesis.

"Has there been a family history of bipolar disorder, depression, attempted suicide, or cases of alcohol dependence?" The attending physician should answer such questions first. "But insomnia, restlessness or mood swings can also be the first signs."

According to Jamison, it is also helpful to involve family members directly - because they often have an objective view of drinking behavior, irritability, increased spending or changed sleep behavior. However, it is not always easy to obtain such information. Medical confidentiality applies, which means that the doctor must ask the patient beforehand whether he is allowed to speak to family members.

According to the American psychology professor, it is important that the doctor includes family members or good friends in the treatment from the start and informs them about the disease.

Jamison has put her own experiences into a personal book that describes the disease and its symptoms in great detail - from the point of view of a person affected and that of a doctor. After each bout of unrestrained mania, life seemed to threaten her. The illness drove her into a ruinous shopping frenzy, sometimes into violent phases and finally into a suicide attempt.

But Jamison is also very open about the fact that mental illnesses still cause fear and prejudice in many people. Because they know too little about the disease and the therapy options. "That's why it's important to explain that bipolar disorder is treatable," she says.

"That is the most important fact. Lithium works for me." For many patients, the combination of psychotherapy and medication is the right treatment method.

Many sufferers are also very afraid of disadvantages in their private or professional life if they make the disease public. You don't want to be stigmatized. This is also mostly due to a lack of information - but unfortunately also due to insufficient medical advice, says Jamison.

Fear of side effects

According to Jamison, a greater risk than experiencing professional disadvantages through becoming aware of the disease is that those affected are too hesitant to consult a doctor and start treatment late.

However, it is important to treat the disease because it is treatable. "I am the best example that one can be manic-depressive and successful at work."

Another problem for patients with bipolar disorder is that they do not take their medication, for example out of fear of side effects or that the medication might not help, as Jamison writes in her book.

But for many, the refusal to really understand and recognize one's own condition as a disease also plays a role here. "This is a very widespread reaction that - contrary to our own intuitive knowledge - follows the first episodes of manic-depressive disorders.

Moods are such an important part of the substance of life, of self-image, that even psychotic extremes in mood and behavior can somehow still be viewed as temporary, even understandable reactions to what life does to you, "she continues.

"My restless soul - The story of a bipolar disorder" by Kay Redfield Jamison, published by mvgverlag, Munich 2014, ISBN 978-3-86882-504-6