Untreated bipolar disorder may lead to suicide - Psychiatrist

A psychiatrist, Dr Yennusom Maalug, has cautioned that, untreated bipolar or mood disorders could lead to serious mental and social health issues, including suicidal thoughts, substance abuse and a lower quality of life.

“Due to extreme mood swings, impulsive behaviour and the quest to escape reality, patients with bipolar disorder may resort to substance abuse or self-harm.”

Dr Maalug, who works at both  the Pantang and The Bank Hospitals in Accra, gave the caution in an interview with The Mirror in Accra last Tuesday. 

He stressed the importance of seeking professional help early, noting that treatment became more challenging if symptoms worsened.

Causes
The psychiatrist , who is also a member of the Ghana College of Physicians and Surgeons, who was educating the public on the condition explained that while the exact cause remained unclear, it was believed to involve a combination of genetic, biochemical, social and environmental factors.

"Family history can play a role, but other factors such as stress, the loss of a loved one, heartbreak, failure, disappointment, and low self-esteem can trigger or worsen the condition," he noted.

Dr Maalug clarified that although bipolar disorder may have a genetic component, a person with the condition does not necessarily pass it on to his or her children.

He said bipolar disorder may sometimes be mistaken for a personality trait, but the key difference is the sudden or recent onset of symptoms.

Symptoms 
Dr Maalug the disorder typically manifested in two main phases, depression and mania, with mania being the extreme.
"During manic episodes, individuals may experience an elevated mood, excessive energy and impulsive behaviour.

This can include rapid speech, making inappropriate or vulgar remarks, difficulty focusing, nudity, trouble sleeping or engaging in harmful activities," he said.

In depressive episodes, Dr Maalug observed  that patients often exhibited low mood and energy, persistent sadness, loss of interest in previously enjoyed activities, changes in appetite, weight gain or loss, and disrupted sleep patterns.

He added that patients may also experience feelings of guilt, hopelessness and fluctuating self-esteem. These symptoms, he pointed out, could sometimes overlap. 

“In some cases, patients might boast about wealth or connections they do not have or create their own bubble or imaginative world where they are the centre of attraction”, he stated.

The psychiatrist emphasised that, although people who suffered the condition were not in control of their actions, they were often aware and conscious. 
"They know they're not sleeping well, acting right, or behaving normally, but they can’t control it. It’s similar to an asthmatic patient having an attack—they are aware they can’t breathe but are unable to stop it," he explained.

Diagnosis 
Dr Maalug, who is again the Executive Director of the Mental Health Institute, explained that diagnosing bipolar disorder could be challenging, particularly when a patient initially presented with only depressive symptoms.

"It is often only when manic symptoms appear later that we can confidently diagnose bipolar disorder," he stated.
He added that specialists begin by examining the patient’s history to determine if they had experienced manic episodes in the past.

"We need to review the full history of symptoms, including how long they have been present and what the patient’s behaviour was like before the onset. Additionally, we conduct laboratory tests and scans to rule out other possible conditions, such as thyroid disorders, substance use disorders or schizophrenia," Dr Maalug noted.

Treatment options
Dr Maalug noted that effective treatment options for bipolar disorder usually involved a combination of medication and psychotherapy.

“Medications can include antipsychotics and mood stabilisers, while psychotherapy may involve counselling, support groups, family involvement, relaxation techniques, mindfulness, and engaging in hobbies,” he explained.

He stressed that bipolar disorder was a lifelong, recurrent condition that could only be managed through consistent medication and therapy.

“Relapses are common when individuals stop taking their medication, but with adherence, they can lead a good and normal life,” Dr Maalug added.

Taking care of a bipolar patient at home
Dr Maalug stressed that love, care and support were essential when caring for a friend or family member with the disorder.

He advised encouraging open communication, offering support during both manic and depressive episodes and learning about the disorder to provide practical help, such as ensuring treatment adherence and managing daily tasks.

“In some cases, patients may refuse help or medication. It may be necessary to wait until the episode passes, discreetly include medication in their food or drink, or, in extreme cases, consider rehabilitation,” he added.