Worldwide, the month of May has been dedicated to better understanding mental illnesses, with specific focus on schizophrenia and bipolar disorder.
An estimated 3-4% of South Africans have bipolar disorder and about 1% of the population will develop schizophrenia during their lifetime.
While different, both share common traits, which make them difficult to diagnose.
Abdurahmaan Kenny, Mental Health Portfolio Manager for Pharma Dynamics explains:
“People with bipolar disorder tend to experience episodes of extreme mood swings -emotional highs (mania) and lows (depression) – with periods of stability in between. Similar to schizophrenia, some bipolar patients also experience psychosis, such as hallucinations or delusions.”
He says there are many different types of bipolar, but the three primary ones are:
• Bipolar I: The most intense type, where sufferers have episodes of mania and periods of major depression for 1-2 weeks at a time.
• Bipolar II: Symptoms are slightly less intense. Often experiencing hypomania (a mild form of mania) and major depressive episodes.
• Cyclothymia: Alternating periods of lower grade depression and hypomania that can last for weeks, but aren’t severe enough to be classified as full manic or depressive disorders.
“Symptoms of mania can involve irritability, difficulty sleeping, excessive energy or restlessness, high self-esteem, expansive mood, increased engagement in pleasurable activities, such as sexual activity or drug use, racing thoughts and reckless behaviour.
“Depressive symptoms are characterised by either sadness or hopelessness that persists for two weeks or longer, but it can also cause a significant loss of interest in pleasure in daily activities. Other common symptoms include changes in appetite, insomnia or hypersomnia, low energy or fatigue, anxiety, low self-esteem, psychosis (losing touch with reality), including suicidal thoughts or behaviours.
Kenny explains that while there are some overlapping symptoms, a schizophrenia diagnosis looks for some distinct differences in behaviour, particularly relating to psychosis.
“Schizophrenia affects a person’s thoughts, emotions and behaviours. These include delusions (false beliefs, like being famous or that they’re being stalked or that something terrible has happened to them), hallucinations (hearing, seeing, smelling or tasting things that aren’t there), disorganised thinking and speech, unusual behaviour (acting childlike, assuming strange postures), inability to function normally, psychosis and depression, which often leads to substance abuse.”
The likelihood of having bipolar disorder or schizophrenia can vary depending on a person’s family history, biochemical and/or psychological makeup. Having a family member with bipolar disorder or schizophrenia doesn’t mean that someone will definitely have the same diagnosis, but the odds of having either condition increase when a parent or sibling has it.
To diagnose whether you or a loved one has either or both of these disorders, a doctor will usually ask about your family history, followed by both a physical and psychiatric examination. A mental health practitioner will then likely use the DSM-5 criteria for bipolar disorder and schizophrenia to assist with making a diagnosis.
Both conditions require lifelong treatment.
Bipolar disorder is typically treated with psychotherapy and medications, which can include mood stabilisers, anti-depressants and antipsychotics. Schizophrenia is treated with antipsychotic medication, which helps to balance chemicals in the brain.
If left untreated, both disorders can have serious impacts on an affected person’s quality of life.
Other strategies that can help people with bipolar disorder include:
• avoiding alcohol and drugs
• eating healthily
• exercising regularly
• getting enough sleep
• managing stress
• seeking help and support from family, friends, and others
When a person with schizophrenia is able to manage their symptoms through medication, they may benefit from psychological and social interventions, such as:
• psychotherapy in both individual and family settings
• social or behavioural skills training to improve interactions with other people
• employment support to help them secure or perform a job with greater ease
• daily living support to help them find housing and manage daily responsibilities
Other coping strategies include:
• avoiding alcohol and drug use
• joining a support group
• learning about schizophrenia
• maintaining certain lifestyle habits, such as eating a balanced diet, exercising, and following a sleep schedule
• managing stress through strategies such as meditation, exercise, and yoga
• seeking help from family and friends
Kenny says living with bipolar disorder and schizophrenia can be difficult, but with proper treatment, along with support and self-care, sufferers can lead fulfilling lives.
He urges the public to do their bit on World Schizophrenia Day (24 May) and World Bipolar Day (30 May) to break the stigma and raise awareness, whether it’s learning more about these disorders, posting about it on social media, hosting an awareness event or talking to family and friends about it.