4 min readDec 25, 2024 09:39 PM IST
First published on: Dec 25, 2024 at 12:58 PM IST
Recently, rapper Honey Singh opened up about his challenges of living with bipolar disorder that cost him his music career. He would be psychotic, his brain, in his own words, “would overwork and spiral out of control.” And while everybody attributed it to mood swings born out of a hectic work life, it took a while for Singh to be diagnosed.
Challenges of diagnosis are not new to Dr Shaunak Ajinkya, psychiatrist at Kokilaben Dhirubhai Ambani Hospital, Mumbai, who has seen many young people go through similar symptoms, which he feels are often dismissed as mood swings or anxiety born out of performance pressure rather than being seen as a mental health problem. Listen in:
SIGNS AND SYMPTOMS
Alok, a 28-year-old software developer, had been experiencing severe mood swings for a year when he came to see me. He was hyperactive, unable to sleep more than three hours every day. He was impulsive, a shopaholic, a compulsive gamer (he lost a lot of money) and was into rash driving. But what scared his family was the day he became paranoid about his fiancé, thinking she would harm him. He would swing between manic and depressive episodes, and feel depressed, guilty, with feelings of worthlessness. Alok reported being fatigued all the time, isolated himself, struggled to find interest in activities he once enjoyed, and faced difficulty in concentrating at work.
Analysing his symptoms, and ruling out substance abuse and other medical conditions, we diagnosed him with bipolar disorder.
WHAT CAUSES BIPOLAR DISORDER?
Research suggests that genetics may account for around 80 per cent of the causes. Alok had had episodes of mood instability since his late teens but parents attributed it to the stress of academics and sleeping late. But his uncle had been diagnosed as well.
Stressful life events, such as the death of a loved one, the breakdown of a relationship, or physical or emotional abuse can trigger or worsen symptoms. Imbalances in neurotransmitters, which are chemicals that help brain cells communicate and regulate mood, may be linked to bipolar disorder. Using alcohol or certain recreational drugs may increase the risk.
WHAT’S THE TREATMENT ALL ABOUT?
This involves a combination of strategies. Serious patients need mood stabilisers and antipsychotics to deal with paranoid delusions. Antidepressants may be used cautiously to address depressive symptoms.
Alok had Cognitive Behavioural Therapy (CBT), which helps to manage negative thought patterns and develop coping skills. We even got in family members to improve communication and support. We set up a lifestyle routine to guide Alok back to normalcy, like sticking to consistent sleep, meal, and activity schedules. He exercised regularly (physical activity helps regulate mood and reduce stress), ate clean, avoided excessive sugar and caffeine. Patients should avoid alcohol and drugs as these can worsen mood swings and interfere with medications. Alok took up yoga and mindfulness exercises for stress management.
Peer support groups help. Now there are mood tracking apps or journals to monitor changes in mood, sleep, and activity. Recognising triggers that may lead to mood episodes, such as stress or lack of sleep, can help the person seek help early in times of crisis. That’s why they should also have a trusted contact and healthcare provider. There is a need for regular check-ins with a therapist as healing the mind is a long process.
After six months of treatment consisting of regular bi-monthly follow-ups, Alok reported a significant reduction in the frequency and intensity of mood swings.
CAN BIPOLAR DISORDER BE MANAGED WITHOUT MEDICATION?
This approach could be more feasible for people with the milder Bipolar 2 Disorder. Most individuals benefit from a combination of medication and therapy for long-term stability. Otherwise unmanaged mood swings can disrupt their personal and professional life.
There is an increased likelihood of relapse and progression to more severe episodes. Medication is a cornerstone of treatment for those with moderate to severe symptoms.
WHY IS SLEEP IMPORTANT?
People with bipolar disorder often have irregular biological clocks, leading to erratic sleep-wake cycles. Lack of sleep can trigger manic episodes. Excessive sleep or irregular patterns can contribute to depressive episodes. Sleep helps regulate brain chemicals critical for emotional balance.
People with bipolar disorder often have irregular biological clocks, leading to erratic sleep-wake cycles. Lack of sleep can trigger manic episodes. (File Image) 
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