THE BIPOLAR EPIDEMIC; Manic Depression, a Terrible Affliction, Has Been Rebranded as Bipolar and Is Ever More Widely Diagnosed. but Are So Many of Us Really Mentally Ill?
Byline: PAT HAGAN
WHEN Lucy Johnstone began working in mental health nearly 20 years ago, bipolar disorder -- or manic depression as it was known then -- made up a small fraction of her workload.
'Now, every other referral is someone with suspected bipolar disorder,' says Johnstone, a consultant clinical psychologist.
'More people turn up with it because they hear about it in the news. They go to their GP saying: "I think I'm bipolar".' This confirms the effect of what some feel is the 'fashion' among celebrities for being labelled bipolar, a condition that affects approximately 0.5 to 1 per cent of the adult population of Ireland: or 40,000 people.
The latest high-profile name is Hollywood star Catherine Zeta-Jones, who was reportedly admitted to a clinic for five days suffering from depression and mood swings brought on by the stress of her husband, Michael Douglas, battling throat cancer.
She joins other household names -- such as Stephen Fry, Sting, Ben Stiller and Jean-Claude Van Damme -- in declaring publicly that they suffer with the condition.
But what is bipolar disorder, and is there really a hidden epidemic? Or is it a Hollywood fad for blaming the stresses of ordinary life on a mental illness? And could this trend be misleading ordinary people into thinking they too have a psychiatric illness when they are experiencing what psychologists describe simply as 'extreme mood variations'? The term manic depression was used to describe people whose moods swung from elation to despair and hopelessness.
It's a condition which, during the manic phase, makes people feel invincible and bursting with exciting ideas.
Their speech accelerates, they sleep no more than a couple of hours a night and they can lose all sense of financial responsibility -- sometimes running up huge credit card bills.
But in the depressed stage, they struggle to make the simplest decisions and sometimes feel suicidal. Research suggests it is mostly genetic, but is triggered by a stressful experience, such as job loss, bereavement or physical illness.
Sufferers can experience 'rapid cycling', where their mood swings from one extreme to the other every few weeks.
In 1980, when psychiatrists were updating the psychiatric profession's 'bible' -- the Diagnostic And Statistical Manual Of Mental Disorders -- they changed the name to bipolar disorder.
They chose the term to reflect the fact that the elation and desperation patients feel are the polar opposites of each other.
Also, manic depression had become associated with psychotic behaviour, where the sufferer hallucinates and hears voices. In fact, very few experience this.
But as well as changing the name, psychiatrists have fine-tuned the definition, so it has gone from covering only extremes of mania and depression to milder behaviour patterns which, sceptics claim, border on normality.
Today, the umbrella term of bipolar disorder covers two forms.
BIPOLAR disorder one is when the patient has suffered at least one manic episode -- where they become highly excitable, barely sleep, talk rapidly and lose their inhibitions -- which has lasted for longer than a week, followed by severe depression.
Bipolar disorder two, the kind with which Catherine Zeta-Jones has been diagnosed, is where there may be long periods of moderate depression punctuated by mild attacks of mania.
It is characterised by hypomania, where a person can be in a semipermanent state of excitement that may be mistaken for sheer energy and enthusiasm by those around them, before slumping into a depression that can vary from debilitating to so crushing they can't get out of bed.
Even for psychiatrists, bipolar two can be difficult to distinguish from depression.
'When someone is manic, they are very high and often deluded,' says Dr Peter Byrne, a consultant psychiatrist. …