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World Bipolar Day: Taking stock of a severe mental illness

Dr Sameer Jauhar

30 March 2022

Bipolar disorder is a life changing mental illness. Few who have seen someone in an episode of mania will forget the all-encompassing nature of this, with it usually being accompanied by psychosis, agitation and distress. The medical community has been familiar with the illness for decades, but as we acknowledge World Bipolar Disorder Day 2022, we also have to acknowledge that our approach to the treatment of bipolar disorder could improve.

In a poll of its members, Bipolar UK found that there are delays of up to 10 years in making a diagnosis of bipolar disorder (which replicates findings from research studies), which has devastating consequences for people with the disorder. Considering that symptoms first appear in adolescence, a person can lose their formative years, having knock on effects on their relationships and job.

The effects of this are stark. People with bipolar disorder are 50 times more likely to self-harm than others in the general population, as well as an increased risk of suicide .

What is challenging for people with bipolar disorder, and those close to them, is the lack of continuity of care, having first presented with mania. Again, in a poll of its members, Bipolar UK picked up that people’s care was fragmented, and this frequently led to relapses of illness, that could potentially be avoided; an episode of mania can last upwards of three months, and depression episodes for longer.

Unlike other areas of medicine, where a specialist may see people over the longer-term, e.g. Rheumatoid Arthritis, currently in the UK there is no clear pathway for people with Bipolar disorder, especially after their first episode.

What’s most frustrating about this is that treatments are both pharmacological and psychological, and have as good an evidence base as a number of treatments within medicine.

In essence, the treatments available are effective but not being delivered quickly enough. So, what’s to be done?

Well, for a start, increasing awareness of what it is and what it is not. Human emotions are not restricted to people with bipolar disorder, though the extremes of mood and pervasive nature of mania and bipolar depression are difficult to ignore. These are not just missed in society, they are missed in medicine, and psychiatry.

Within an NHS that has had to deal with direct and indirect effects of a pandemic, “mental health” will mean a lot of different things to different people, but acknowledging the needs of people with Bipolar Disorder (i.e. access to specialist care within psychiatry, involving doctors, nurses, social workers, occupational therapists and psychologists) is a good start.

What may also be a game-changer is focusing on care for young people who present for the first time with an episode of mania. One of the only targets in mental health is waiting times for people presenting for the first time with psychosis, and care for these people is embedded in the 10 year Mental Health Plan. Almost everyone with mania will present to these services, though in most cases the diagnosis of bipolar disorder is not made, and treatments such as lithium are not utilised. Personalised care for these young people has the potential to change their life trajectory, as treatments aim to prevent relapses, and encourage people to monitor for relapse with the help of friends and family.

Given the above, we would wholeheartedly back calls from Bipolar UK to improve existing services for people with Bipolar disorder, for careful research into improving care for people with Bipolar Disorder, and overall acknowledgement that doing so has the potential to transform the lives of a significant number of people and their families.


Further reading about Bipolar Disorder can be found on the NHS website.

For more information, please contact Patrick O’Brien (Senior Media Officer).

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