What is bipolar disorder? What you need to know about the mood disorder and Kanye West

Kim Kardashian has asked media and the public to have compassion for her husband, Kanye West, who suffers from bipolar disorder.

The reality TV mogul posted a statement on her Instagram story last Wednesday after a week of teary-eyed appearances, rambling speeches, and incoherent tweets from West, who says he is running for president . “As many of you know Kanye has bipolar disorder,” she wrote. “Anyone who has this or has a loved one in their life who has it, knows how incredibly painful and complicated it can be.”

West first revealed that he has bipolar disorder when he released his album Ye in 2018, which bore the phrase “I hate being Bi-Polar its awesome” on the cover. Later that year, Kardashian confirmed in an interview with Vogue that he had been diagnosed, and said that the couple was in a “good place” regarding his mental health. West also discussed his mental health in a 2019 interview with David Letterman. He said he was diagnosed in 2016 and explained what it was like to have an episode.

University of Toronto professor Roger McIntyre said that bipolar disorder is in fact “fairly common” and affects between one and three per cent of all people in North America and up to 80 million people worldwide. He spoke to the National Post’s Devika Desai about how to recognize bipolar disorder and how family and friends can help someone with the mood disorder.

What is bipolar disorder?

The mood disorder is characterized by three aspects: alternating moods of depression and mania (elation), racing thoughts and out-of-character behaviour. “The mood is typically very volatile and very unpredictable” during an episode, McIntyre said. “These disturbances … are all occurring at the same time and is clearly not normal to anyone in their space.” While most people experience both depressive and manic episodes, about five per cent of people with the disorder only experience mania, McIntyre said. In a 2018 interview, West told Jimmy Kimmel that he does not experience depressive episodes.

During a manic episode a person could experience speedy thinking, like “an avalanche of thoughts coming really fast,” he said. People often decide to carry out ideas that are not well thought out or are risky to their well-being, like speeding or out-of-character use of drugs or alcohol. They may also engage in unusual behaviour, such as inappropriate spending, or being hyper-talkative or incoherent. Manic episodes typically last between two to three months, although McIntyre stressed that the length of an episode can vary.

During a depressive episode, a person can experience low moods, negative thinking, loss of interest in activities and friends, and unusual changes in sleep, appetite and libido. It’s possible to experience some mania during a depressive episode — “we call this a mix,” McIntyre said. Depressive episodes typically last between six to nine months, but also vary. It can be difficult to distinguish bipolar depression from depression, so bipolar disorder is diagnosed based on whether someone also experiences manic episodes.

The way people experience depressive and manic episodes varies, he said. For some, the pattern is predictable. Their cycle may begin with a manic episode, followed by one of depression and then a wellness period. For others, their cycle may start with an episode of depression or even occur seasonally. Others cannot detect a pattern and their episodes appear random.

Is it caused by genetics or environmental factors?

“There’s no question that there’s a genetic component,” McIntyre said. Scientific evidence has indicated that about 70 to 75 per cent of a person’s risk for bipolar disorder is genetic, higher than most other mood disorders.

Psychiatrists still aren’t sure what causes these tendencies to manifest into a disorder, but are usually able to diagnose the presence of bipolar disorder as early as a person’s teenage years, usually in their mid-20s.

How do you know whether to get tested for bipolar disorder?

If you experience depression, it might be because you have bipolar disorder, McIntyre said. “Out of every 10 people who have been in a family doctor’s office with depression, two or three of them have bipolar disorder,” he said. People with bipolar disorder are more likely to seek treatment during the low points of their episodes rather than the high points. McIntyre recommends seeking an assessment for mood disorder if someone experiences severe depression. Most of the time, they will be diagnosed with a major depressive disorder, he said, but if the person has also experienced episodes of mania, then they could be diagnosed with bipolar disorder.

What happens during an episode?

In his interview with Letterman, Kanye West said he would become “hyper-paranoid” during manic episodes. “Everything’s a conspiracy. You feel the government is putting chips in your head. You feel you’re being recorded. You feel all these things,” he said, adding that others experience the disorder differently.

McIntyre said that it’s common for people to attempt new activities during a manic episode, for example start a business that hasn’t been well thought out. “They often have all kinds of new plans,” he said.

It’s quite common for people to not realize they’re in the middle of a manic episode, or attribute their mood to factors other than the disorder. “Their insight into the illness is not as it should be,” McIntyre said, and as a result, they may refuse to visit the doctor or seek necessary treatment. “Usually, but not always, the insight is better when they’re well,” he said, and people are more likely to seek treatment during a depressive episode.

How can family and friends support someone with bipolar episode?

“Support is the key word,” McIntyre said. Helping the person maintain a daily structure, keep them from making risky or harmful decisions, being aware of support education resources. McIntyre referenced the Canadian Mental Health Association and the Depression and Bipolar Support Alliance (a U.S.-based organization) as resources on ways to support someone in the middle of an episode. “If there’s concerns with the person’s immediate safety, you can certainly always call 911,” he said.

While getting a person who doesn’t recognize that they’re having an episode to seek treatment can be challenging, McIntyre noted that most people will often, if begrudgingly, go to their care provider at the urging of their family. “But one always has to recognize that a person has their inalienable rights of making their own decisions and it’s frustrating — for example, watching a family member rack up the credit card debt and spend (all the money in their) savings account,” he said. But “there’s no crime.”

Can it be treated?

Treatment usually combines medication withe a form of psychotherapy or counselling, McIntyre said and the success of it often depends on the individual, their lifestyle and their reaction to their treatment. Sleep, exercise, a structured life and a strong support system play a role in reducing the severity of an episode, McIntyre said.

Twenty-five per cent of his patients have been able to return to their lives and careers with minimal or no symptoms. Thirty to 35 per cent of his patients “don’t have it quite as good but do reasonably well,” experiencing fewer and milder episodes. Those who still experience episodes while on treatment, may experience at least one episode every three to five years, McIntyre added.

The rest of his patients still have episodes, as their bipolar diorder only partially responds to treatment. That doesn’t mean that they’re doomed to a miserable life, McIntyre said, and the condition may eventually start to “cooperate” with the treatment and recede.

Several celebrities have previously revealed that they have been diagnosed with bipolar disorder, including Catherine Zeta Jones, Mariah Carey, Chris Brown and Russell Brand. Politicians and historical figures who reportedly lived with the disorder include Abraham Lincoln, Winston Churchill, Virginia Woolf and Vincent Van Gogh.

The fact that the disorder has been diagnosed in artists and politicians has led some to believe that bipolar mania fuels productivity, McIntyre said. “There is this notion that people like to be manic, that manic is good for your productivity,” he said. “But that’s not what’s making them great. Manic episodes are hurting them.”


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