- People with bipolar disorder experience emotional swings between depression and manic euphoria ‘like a line of cocaine’, as one sufferer describes it
- Sadie Kaye, who founded non-profits in Hong Kong to help fellow sufferers, pairs medication with creativity and a healthy lifestyle to manage her condition
When you think about depression, you imagine a sufferer’s mental state goes in one direction: down. They are unipolar. In the condition once known as manic depression, a patient swings between high and low, up and down, between two poles: in other words, bipolar. The treatment for this strives to find a balance, a steadying of that pendulum, a finger to still it.
Teresa Chan, clinical adviser at Mind Hong Kong, a charity, gives the textbook definition of bipolar versus unipolar depression: unipolar depression symptoms include lethargy and loss of interest. Bipolar comes with an additional set of symptoms – mania – which are opposites to the low mood and apathy of depression as we know it. People with bipolar disorder present with confidence, euphoria, racing thoughts and restlessness. Sadie Kaye, a Hong Kong-based TV and radio performer who lives with bipolar disorder and founded Bipolar Hong Kong, a non-profit community group, and Mental Ideas, a film and media platform supporting mental health awareness, describes what the condition feels like to her.
“Mania is like your first sugar rush or line of cocaine,” she says. “The effects can last weeks, months, even years. During this time, our factory default setting is bold, impassioned, inspired, intuitive, seductive, magnetically charming and charismatic. We have no fear of failure.”
Sadie Kaye is founder of Bipolar Hong Kong and Mental Ideas. Photo: Antony Dickson
At first it sounds almost attractive – to be ignited by such energy, inflamed with can-do. But, as Kaye warns, there are huge downsides: “Life is generally about a degree of predictability, so if your mood suddenly goes up or down, for no apparent reason, it’s very hard for you and it’s very hard for those close to you. As mania builds, imagination and reality can easily blur. We might hallucinate or experience delusions, typically of grandeur.”
People with bipolar disorder can disconnect from their lives, and become unhinged in a way that those who battle with unipolar depression don’t; they are grounded by their illness, mired by its deadweight.
Kaye was diagnosed with bipolar disorder in 2011 after a battle with Graves disease – an autoimmune condition that causes the thyroid gland to become overactive, and triggers meningitis, an inflammation of the membranes surrounding the brain. This health scare exacerbated her previously mild and undetected bipolar symptoms.
“Immediately prior to my diagnosis, I experienced a self-destructive ‘mixed episode’ (acute mania and depression simultaneously), in which I nearly succeeded in taking my own life, and had to be treated at a psychiatric hospital in the UK,” Kaye recounts.
Chan says bipolar disorder is particularly difficult to diagnose, because of the similarities and overlap in symptoms during the ‘low mood’ phase. Anyone who suspects that they may have symptoms of bipolar disorder, she says, should first see a family doctor and press for a referral to a psychiatrist. “You can normally only be diagnosed with bipolar [disorder] by a mental health professional,” she says.
Frank Sinatra spoke about his bipolar disorder. Photo: Getty Images
It may be difficult to diagnose, but it is more common than one might think. According to the World Health Organisation, it affects about 45 million people worldwide. Singers Mariah Carey and Demi Lovato, martial arts actor Jean-Claude Van Damme, comedian Russell Brand, Sting, Stranger Things actor David Harbour, American astronaut Buzz Aldrin, actress Catherine Zeta Jones and Frank Sinatra were all diagnosed with the disorder.
Sinatra summed up his experience in this way: “Being an 18-karat manic-depressive and having lived a life of violent emotional contradictions, I have an over-acute capacity for sadness as well as elation.”
How do you treat such a wildly vacillating illness, so mercurial a condition as bipolar disorder? Chan says it takes a combination of talking treatment and medication.
Kay Redfield Jamison, who has bipolar disorder, is professor of psychiatry at Johns Hopkins in the United States. Photo: Johns Hopkins
The medications used to treat bipolar disorder have not changed much, says Kaye: “Everything is lithium-based and lithium has been around since the beginning of time.”
Lithium is an element that takes its name from the Greek ‘lithos’, meaning rock. It is the lightest solid element and is highly reactive and flammable.
The Australian psychiatrist John Cade is credited with popularising its use in the treatment of mania in 1949 as a mood stabiliser. This drug helps reduce the severity and frequency of mania, and can relieve or ward off depression. Studies show it can reduce suicide risk.
Kaye, who can be heard presenting ‘Sharp Pains’ on RTHK Radio 3’s 123 Show, learned that having therapy and taking meds was the bare minimum she could do. She began to dissect her condition forensically, “with the enthusiasm of an amateur sleuth”, and adopted healthy lifestyle choices with creative outlets.
Creativity “assists recovery” in many ways, she says – helping channel energy, rebuild esteem and make sense of emotions. The combination allows her to feel the benefits of her medications and therapy for longer and reduce the amount of medication needed to keep her well.
Recovery, she believes, is enhanced by adopting a holistic approach – healthy lifestyle choices, rigorous self-monitoring of mood swings and what triggers them, and including family and friends in your treatment plan. It is important not just to rely on experts’ advice, but to take a proactive and creative approach to your own treatment rather than being a passive victim.
This is why Kaye has recast her mental illness as positive. “Mental illness is portrayed in the media as a burden. The focus is on suffering. But I think if you measure your life by your suffering it leads you to a dangerous place.”
She avoids the term “sufferer” and replaces it with “artist”. She is more than her bipolar condition, she says: you have to “accept it, make peace with it, but not let it define you”.
Kay Redfield Jamison, professor of psychiatry at Johns Hopkins University in the United States, was already clinically trained when she was first diagnosed with bipolar disorder. She would agree with Kaye. She has described herself as an exuberant person who longs for peace and tranquillity but in the end prefers “tumultuousness coupled to iron discipline” to a “stunningly boring life”.
The cover of Redfield Jamison’s book. Photo: Picador
In her bestselling memoir An Unquiet Mind, Redfield Jamison writes: “I long ago abandoned the notion of a life without storms. It is, at the end of the day, the individual moments of restlessness, of bleakness, of strong persuasions and maddened enthusiasms, that inform one’s life, change the nature and direction of one’s work, and give final meaning and colour to one’s loves and friendships.”
Kaye agrees. “Every documentary (her 30-minute TV film The Bipolar Express was highly commended by the Association for International Broadcasting), every podcast I produce is aimed at positively and proactively influencing the way mental health is perceived by those who have it, and those who are affected by it.
“I want to make a difference to people’s lives in creative and practical ways, because I believe mental illness can either be your prison – or it can set you free.”
By Anthea Rowan
#RobertReview: 9 | 10
How to regulate Bipolar Disorder, channel it into creativity and a productive, healthy lifestyle