Bipolar disorder Pendulum: stories and information World Bipolar Day Monday 30 March is World Bipolar Day (WBD), although few people are aware of it in the UK and Europe, not even my psychiatrist! It is an initiative of the International Society for Bipolar Disorders (ISBD), Chicago, the International Bipolar Foundation, San Diego, and the Asian Network of Bipolar Disorder, Hong Kong. The date of 30 March was chosen as it is the birthday of the Dutch painter, Vincent van Gogh, who was posthumously diagnosed to have had this disorder by various psychiatrists. The first World Bipolar Day was celebrated in 2014. The aim of WBD is to increase awareness of bipolar disorder and to eliminate social stigma, as well as informing the world about what it is. This year’s WBD will be rather muted by the COVID-19 pandemic. Bipolar UK’s chief executive, Simon Kitchen was planning to walk over 30 miles from Bradford on Avon to Bristol. Starting at 7.30 am on 30 March, meandering his way along the River Avon for as long as his legs would carry him. However, he has had to postpone his efforts due to the coronavirus clampdown. All money raised was to go towards the room hire of Bipolar UK support groups. He had already raised about £700. Bipolar organisations Bipolar UK was 37 years old in January this year and is one of the oldest bipolar support groups in the world. Its German counterpart, Deutsche Gesellschaft für Bipolare Störungen eV, Frankfurt, is only about half its age, having been founded in 1999. The ISBD was also founded in 1999. Its official launch took place at the 3rd International Conference on Bipolar Disorders in Pittsburgh, which ISBD now organises every year, although this year’s event in June might well not take place. ISBD has so-called “chapters” in 27 countries, including eight in Europe, namely: Austria, Denmark, France, Italy, the Netherlands, Norway, Portugal and Switzerland. Bipolar in the UK and diagnosis An estimated 1.3 million people in the UK suffer with bipolar, previously known as manic depression. Bipolar UK was originally the Manic Depression Fellowship. Diagnosis of bipolar is not easy and can take up to ten years or more. Most are diagnosed in their late teens or early twenties. There are two main forms, Bipolar I and Bipolar II, with the latter having less extreme bouts of mania. About 5% of Bipolar I sufferers only experience manic episodes and do not get depressed, according to research in France and the UK. What causes bipolar is unclear although genetic and life circumstances play a role. My own experiences of bipolar The father of one of my friends at secondary school, Dr Hullin, was a psychiatrist in West Yorkshire and a pioneer in the first uses of lithium for his patients in the 1960s. I was aware of his work through my friend and the local newspaper. Little did I think that I would be eventually diagnosed as bipolar in my early fifties and need lithium myself. I had a severe nervous breakdown and the impact was devastating for me, my family, my friends and my work, mainly because the first diagnosis of reactive depression was incorrect and the right diagnosis of bipolar took several years. Looking back, I probably first had symptoms when I was 18, but neither I nor my parents or friends realised it at the time. I had a nervous breakdown at 23, but recovered completely, as I then thought, and just wanted to put it behind me. There was no specific diagnosis at the time. A university friend had some mental health problems and was prescribed lithium. He has been relatively stable on it for over thirty years. My life might have run much more smoothly if the same had happened to me. A second cousin of mine, a nurse, told my sister that she thought I was bipolar over thirty years ago, but unfortunately neither told me. Whether I would have taken heed is another matter. Bipolar UK Conference Some 300 delegates attended Bipolar UK’s conference last year, over half of whom were bipolar. There was a panel session, which was also filmed by BBC TV’s Horizon for a future programme about the comedian, Tony Slattery, due to be broadcast this year. The panel of four, including Slattery, debated whether they would prefer to remain bipolar or turn it off and eliminate the condition permanently. All the panel acknowledged that they owed much of their careers and creativity to being bipolar. Bipolar UK took a poll of 85 bipolar attendees before the conference took place. Some 76% replied that they would turn off their bipolar if they could. In a poll at the end of the panel session, 65% of bipolar attendees indicated that they would prefer to eliminate their bipolar condition, suggesting that some opinions had been changed by the panel debate. It seems a substantial minority of sufferers sees their condition as providing something positive for their lives, despite the considerable drawbacks that come along with it. I sided with the majority in not wanting to remain bipolar, but can see that it may have brought some positive features to my life, not least great enthusiasms and focus. As for being creative, I can be sometimes, but maybe this is more down to being left-handed than being bipolar. Better bipolar treatments needed Speaking at Bipolar UK’s conference last year, Professor Allan Young, Chair of Mood Disorders at King’s College London commented that current treatments with lithium and other products show nowhere near the efficacy and selectivity of cancer treatments and this is something that needs to be rectified. Current research efforts are focussing on biological causes, new targets for drug treatment, better treatments, better diagnosis, genetic components and strategies for living well with bipolar disorder. It is just over 70 years since the Australian researcher John Cade authored the first research paper showing that lithium carbonate is an effective mood stabiliser and anti-manic agent. Let’s hope it will not be too long before another ground-breaking research paper and a Lithium Mark 2 is discovered, with fewer side effects and more efficacy!