For quite some time I have been involved with the German Society for Bipolar Disorders (DGBS) as this topic is of concern to me. All of the lyrics on my CD Songs from the Inside deal with different aspects of this mental illness.

Bipolar disorders have been called manic-depressive illnesses in the past. This term is still more familiar to most than the modern one. People with bipolar disorders suffer from extreme mood swings and sometimes they cannot control their actions by willpower. These mood swings cannot be compared to “normal” changes of affect everybody experiences: sometimes you just do not feel that good and sometimes you feel just great and at ease.

Bipolar disorders are much more than that. They encompass the entire scale of human emotions - from the euphoric and driven heights of a mania to the desperate hopelessness of a depression. The course of the illness is episodical. Between the periods of illness, be it mania or depression, are times of complete “normality” that can last for years.

The course of bipolar illness is different for every person and also the degrees of severity vary greatly. Some people experience severe manias with subsequent depressions (bipolar-I-type). Others are depressed most of the time and experience hypo-manias every now and then, this is a less intense form of mania (bipolar-II-type). However, this is just a rough classification. Timing differs as well. Some patients undergo only few episodes interspersed by long gaps, while others ride an emotional rollercoaster several times a year, some every other month or even daily. In view of those many different manifestations it can be said that there are as many different bipolar disorders as there are affected people.

The estimated number of unknown and untreated cases is at about 50 % - a fatal fact in view of the alarming suicide risk of these people. Frequently, the social consequences of the illness are devastating. People can no longer be part of the work-force; friendships and partnerships suffer or break off. These events may lead to a so-called social death. According to WHO the percentage of people with bipolar disorders in the entire population amounts to 1 to 2 %, which means that millions of people are afflicted. Add to this the relatives and friends of the patients who undergo agonizing moments due to the symptoms and the consequences of the illness. On average it still takes six to eight years until the correct diagnosis is made.


The good news is: once properly recognized bipolar disorders can be treated well in most of the cases. The most effective treatments for this condition are psychopharmacology, psychotherapy, psycho-education, and last but not least self-help groups. Therapies vary greatly: some patients get by with no or only small amounts of medication, others need to take their medications for life. Needless to say, they often have to cope with the side effects of these meds. In many cases it takes a long time to find a suitable combination of measures.

Some may say, “Such changes of mood cannot be that bad, not everything should be pathologized!” Psychiatry does not want to run things strictly by the guidelines, classifying everything as ill that does not fit into the norm. The crucial point is whether one suffers or not. If you jeopardize your education or career, ruin your social life or your secure existence it is good to know that psychiatry can be of help and support.

Bipolar disorders and creativity

The above-average ratio of people with bipolar disorder who work in artistic professions justifies the assumption that there is a link between bipolar disorder and creativity. However, this has not been scientifically proven. Still the list of well-known artists who are associated with this illness is impressive. It is tricky to make a solid diagnosis posthumously. However, the biographies of Vincent van Gogh, Michelangelo, Hermann Hesse, Edvard Munch or Robert Schumann suggest they suffered from bipolar disorder. This also holds true for Sylvia Plath, Virginia Woolf and Jackson Pollock. More recently musicians Jaco Pastorius, Kurt Cobain and Amy Winehouse should be added to the short list. More and more celebrities talk openly about their disposition, for example actors Catherine Zeta-Jones and Jean-Claude van Damme, British multi-talent Stephen Fry or singer Sinead O'Connor.

The rush of ideas, the increased self-esteem, and the enormous creative and physical energy of a (hypo)mania surely have contributed to the genesis of quite a few great works of art. Yet, we have to take into consideration that mania may lead to overestimating one's creative output. What is created in mania often cannot withstand a sober judgement when one's mood returns to normal.

Stigma

Stigma still rests strong on all mental illnesses although it has become socially acceptable to talk about depression or a burnout syndrome. However, other mental illnesses like schizophrenia, borderline or bipolar disorders still frighten and threaten most people. This despite the fact that studies have shown that mentally ill people do not commit more violent crimes than the average population. Rather, the mentally ill become more often the victims of violent crimes.

The image of the dangerous madman is still vivid, fired by Hollywood movies like “Shining” or “The Silence of the Lambs”. The reputation of the psychiatric system still suffers from movies like “One Flew over the Cocoo's Nest” although what is shown here has nothing to do with modern psychiatry.

I strongly believe we can only overcome stigma if we admit to these alleged flaws and speak out. Talking about a mental illness should be as normal as talking about diabetes, high blood pressure or allergies.