Bipolar disorder

Bipolar disorder is what used to be termed ‘manic depression’. Some people, including sufferers, still feel that this is a more accurate description of the condition, because it is usually experienced as severe mood swings between these two extremes. These days the condition can be classified according to severity as bipolar 1, 2 or 3, and some prefer to highlight the variety of extreme experiences by referring to the condition as ‘multipolar’.

In a recent Channel 4 documentary* psychotherapist Philippa Perry considered the rise in the number of people diagnosed with bipolar disorder. She interviewed three sufferers, and medical professionals, about what causes and maintains this condition, what triggers specific episodes of it and what, ultimately, can be done to relieve sufferers or even heal them.

As the programme acknowledges at the outset, there is currently no clear agreement about any of these things amongst the misconceptions, stigma and fears surrounding the condition. It is not unusual for counselling clients to be concerned about whether they are suffering from bipolar disorder. Sometimes this will simply be because their mood changes or because someone has suggested they might be bipolar or because a family member has the condition and they fear they are genetically predisposed to it.

The prevailing medical view is that bipolar is primarily a biological condition requiring medication. This view is challenged in the documentary and it is a view that is not by any means fully accepted within the counselling and psychotherapy profession. How much of the cause is really down to genetics and ‘chemical imbalances in the brain’ as opposed to environmental factors? How much of the condition might instead be a reaction to what are perceived as threatening aspects of our environment and past experience?

As Philippa Perry indicates, the problem with accepting that bipolar is simply a medical condition is that this closes down a wider exploration of its causes. There are even differing views within the medical profession about what chemicals are supposed to be out of balance and about what the evidence is for this. One doctor feels that counselling could be useful merely as an adjunct to medical treatment. Another believes that medication helps only by dampening down intolerable emotions to provide temporary relief and is not a long-term solution. Yet another says that while environmental factors are an important consideration, we can be overly sensitised to these by our genetic makeup.

This strongly suggests that the causes of bipolar are a combination of both genetic and environmental factors. This in turn suggests that counselling can have an important place in the treatment regime of sufferers. But more than anything, the clear message seems to be that sufferers of this condition are all different and have arrived at where they are as a result of their unique individual experiences. It can’t therefore be helpful to classify sufferers under one bipolar label. Their treatment should be as individual as they are.

*Being Bipolar – Channel 4, 4 March 2015