Dr Ayesha Prout

MENTAL ILLNESS: Forensic psychologist Dr Ayesha Prout.

KANYE West may be one of the most polarising artistes of his generation but he is also one of the most high profile celebrities to publicly admit that he has bipolar disorder. Reactions to his bizarre campaign rally in South Carolina two weeks ago oscillated between shock, worry and anger. His speech made headlines and even sparked memes mocking his behaviour.

But not everyone thought it was a laughing matter.

“Based on what he said in those videos, it was very concerning. It could have been a big cry for help,” says counselling psychologist Jean-Luc Borel.

Characteristics

Much like any illness or disease, bipolar disorder doesn’t discriminate. And although there are no statistics concerning the percentage of our population that lives with bipolar disorder, based on his own experiences while working in the private and public health sectors, Borel says many people in T&T have been diagnosed with bipolar disorder.

Once known as manic depression, bipolar disorder may be more common in our society than we initially thought but it remains misunderstood and those who live with it are often stigmatised.

“Bipolar disorder is a mood disorder characterised by repeated periods of change in mood, activity levels, energy levels, sleep patterns, as well as changes in the way the person with the disorder thinks, speaks and makes decisions. It is called bipolar disorder because there are two extreme moods - mania and depression,” explains forensic psychologist Dr Ayesha Prout.

‘Mania’ is characterised by hyperactivity, elevated/irritable mood (which can lead to aggression though this does not mean that the person is a danger to others), euphoria (amplified happiness), impulsive and risky decisions, grandiosity (for the individual, nothing is impossible and no one is better qualified) racing thoughts/loosely associated subjects in their speech and the person can operate on little to no sleep, says Prout.

Depression is characterised by low mood, feelings of sadness, sleeping more/extremely tired all the time, difficulties making decisions and an increased level of rumination.

Bipolar disorder is typically diagnosed in late adolescence to early adulthood. Like Borel, Prout could not speak to the prevalence of bipolar disorder in T&T but she pointed to worldwide statistics which suggest that between 0.3 per cent to 1.2 per cent of a population per country across the world live with this condition.

The figures however may be much higher. Prout explained that there is a major issue regarding underdiagnosing or a delay in diagnosing, as well as misdiagnosing of bipolar disorder as unipolar depression as it is when the person is in this mood state (depression) that they may seek out help, leaving their manic state undetected or underreported.

Both mental health professionals stress that the stigma of mental health is prevalent and that there is a lack of understanding around the issue.

“There is the public belief that persons with mental illnesses pose a greater threat than persons without a mental illness, so they are viewed as much more dangerous and much more feared. This belief is inaccurate, and it is far more likely that a person with mental illness is a victim, rather than a perpetrator of violence, due to their increased vulnerabilities,” says Prout.

She added that as a result of living in a society which perpetuates stigmatising ideas regarding mental illness, persons with bipolar disorder may hold negative views of themselves, thus leading to low self-esteem and feelings of incompetence. They may also accept negative stereotypes regarding having a mental illness, and thus would not want to seek out assistance, as it may confirm negative ideas that are perpetuated, such as it is a weakness or they can control it without medical/therapeutic help from others.

Helping someone with bipolar disorder starts with reading up and understanding the disorder from reputable and trusted sources. Prout suggests reaching out to a qualified psychologist or psychiatrist or consulting websites like mayoclinic.org or nhs.uk.

According to Borel, one of the positives to come out of the incident with Kanye is that it may pique curiosity and start the long overdue conversation around bipolar disorder.

Being supportive

How can friends and family members help someone who is in the throes of a manic or depressive episode?

“When the individual is in either their manic or depressive state, it is important for others to understand that they are not their usual selves, and so they will require extra patience and attention. It may be important for persons close to the individual to learn how to identify the various mood changes in the individual, and gently point out to the person that they may not be well, without accusations, anger or negative language,” Prout advises.

“It is important not to tip-toe around the individual, which may increase their feelings of self-consciousness, or be overly critical or invasive of their space which can make the person feel like they do not have the capacity to care for themselves. Family and friends can support the individual in obtaining treatment from a qualified individual, as well as offer them support throughout their therapeutic journey, and ensure that they maintain a healthy lifestyle.”

The pandemic has brought with it new challenges for everyone, including those with bipolar disorder. Having to isolate from others may be a trigger for either mood state to arise, says Prout while adding that persons diagnosed with the disorder may not have been able to receive the required support during this period of staying at home and social distancing.

For some, their use of illegal substances to cope may have increased, due to not receiving the accurate medication. Those who are in in-patient units may have lost their social connections due to a reduction in visitors or changes in visiting policies, says the forensic psychologist.

She encourages persons with bipolar disorder to maintain the same routines which support their stable mood states. This includes:

—Getting sufficient sleep and exercise

—Eating nutritious foods.

“For persons who have received support, it is important to utilise the coping skills which they would have already learnt, and avoid what would exacerbate symptoms negatively. Finally, always feel encouraged to reach out to trusted persons,”says Prout.

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