Women experience manic episodes more frequently in men with depression.
In bipolar disorder, a mood disorder, the individual is unable to regulate his emotions or control the intensity and speed of his mood swings. Experts, noting that there is no gender distinction in bipolar disorder, said, “It occurs at an equal rate in both genders. However, within bipolar disorder, depressive episodes are more common in women, while manic episodes are more common in men.”
Bipolar disorder is a serious mental illness that can damage relationships and careers due to risky behaviors and, if left untreated, can lead to suicide. World Bipolar Day, observed on March 30, is commemorated worldwide on the birthday of the famous painter Vincent van Gogh, who may have had bipolar disorder himself. The goal is to raise awareness about bipolar disorder—which affects 2 to 5 out of every 100 people worldwide—to improve the lives of patients and their loved ones, and to combat stigma.
EMOTIONS CANNOT
BE REGULATED
Prof. Dr. Sermin Kesebir, a psychiatrist at Üsküdar University NPİSTANBUL Hospital, noted that bipolar disorder is a mood disorder, stating, “It is a disorder of the mood system. It can be defined as an inability to regulate emotions and to control the intensity and speed of those emotions.”
BIPOLAR DISORDER HAS
TWO EXTREMES Noting
that symptoms such as euphoria, irritability, or restlessness; accelerated thinking; increased goal-directed activity; and reduced need for sleep are experienced during the manic phase of the illness, Prof. Dr. Kesebir said, “In depression, however, the other end of the spectrum—that is, low mood, sadness, despondency, pessimism, loss of pleasure in previously enjoyable activities, lack of motivation, sleep problems, changes in appetite, changes in sexual desire, and changes in attention and cognitive function—may be experienced,” he said.
Noting that there is no gender difference in bipolar disorder, Prof. Dr. Kesebir said, “It occurs equally in both genders. However, within bipolar disorder, depressive episodes are more common in women, while manic episodes are more common in men.”
“The most important characteristic of bipolar disorder is that it is bipolar, but there is another very important feature: it is cyclical and rhythmic,” said Prof. Dr. Sermin Kesebir. “Seasonality is also important in that sense; regarding gender differences, factors such as the impact of the menstrual cycle on women, or the effects of pregnancy and the postpartum period, come into play. “It can overlap with seasonality in this way: if a life event or a stressor has triggered the illness, its anniversaries may appear to be seasonal in nature. Seasonality is observed in one in five bipolar patients, not in all of them,” he said.
PERSONALITY TRAITS PLAY
A ROLE
Noting that there are three factors in the development of bipolar disorder, Prof. Dr. Sermin Kesebir listed these as individual factors, factors related to the illness itself, and environmental factors. “Among individual factors, certain personality structures make individuals more susceptible to the illness. These include what we call a hyperthymic temperament—an outgoing, vibrant, and highly self-confident personality type. Another is the cyclothymic temperament. In this personality type, the person is more melancholic but is what we call a ‘sunny melancholic’—that is, someone who experiences elation followed immediately by that same proud, introverted style. We see bipolar disorder more frequently in these personality types,” he said.
A FAMILY HISTORY INCREASES
THE RISK
Noting that bipolar disorder—which has the highest genetic component among psychiatric illnesses—has a higher incidence in children if one parent has the condition, Kesebir said, “Family history is a very important external validity indicator; if it exists in the family, the likelihood of occurrence increases. If both parents have it, the risk increases even further. Bipolar disorder is one of the psychiatric disorders with the highest genetic risk, second only to autism,” he said.
Noting that life events play a significant role in triggering the onset of the disorder, Prof. Dr. Sermin Kesebir said, “Encountering a stressor—or, prior to that, childhood traumas—can be a factor; this can stem particularly from emotional abuse or emotional neglect.”
Noting that there are certain symptoms of bipolar disorder, Prof. Dr. Sermin Kesebir said, “If a person is acting differently than usual—that is, every person has a standard, well-known pattern of behavior—deviations from this pattern may emerge. Interpersonal relationships deteriorate; anger is followed by aggression, heightened sensitivity, and heightened suspicion. During this period, the person is more affected by things he would normally not care about. Risk-taking behavior increases. These individuals experience many situations—such as casual sexual encounters, uncontrolled shopping, or unnecessary spending—that they will later feel ashamed of or regret,” he said.
CREATIVITY DECREASES
AS THE DISEASE PROGRESSES
Kesebir also addressed the perception of bipolar disorder in society as an “artists’ disease,” stating the following on this topic: “We can say that intense emotions can stimulate certain creative processes. We see that many painters and writers produced their most important works during the depressive phase in the early stages of the illness. However, as the illness progresses, creativity declines.”
TREATMENT METHODS
Kesebir also discussed treatment methods for bipolar disorder, noting that outpatient treatment is possible for mild or moderate cases and stating, “In severe cases, inpatient treatment is necessary. Inpatient treatment is of great importance to prevent the person from doing things he might later regret or from harming himself or others. In inpatient treatment, pharmacotherapy is administered—that is, we provide the patient with medication. Additionally, if we are to perform somatic treatment, Transcranial Magnetic Stimulation (TMS) or Electroconvulsive Therapy (ECT) is applied,” he said.