Last week saw the start of the Youth Olympic Games. For the young Olympian, physical fitness is paramount, but what about mental fitness? There is no health without mental health.
The launch of the games last Tuesday coincided with International Youth Day – and the theme this year is mental health. United Nations Secretary-General, Ban-Ki Moon, emphasised the urgent need to safeguard and improve the mental health of the world’s young people. This focus is unsurprising when we consider that each year, according to a UN report, one in five youths experience a mental health problem. Even more worrying is that the rates of mental health problems diagnosed among young people are continuing to rise sharply in many nations. Of particular concern is the rapid rise in the rate of youth being diagnosed with bipolar disorder.
This disorder can be particularly severe and enduring, with sufferers experiencing episodes of both mania (excessive highs) and depression (excessive lows). The highs experienced in the manic state, undoubtedly make the depressive lows bleaker and blacker than they might otherwise have been. Sorrow cuts deeper when preceded by laughter.
Decades of research collated by psychiatrists Frederick Goodwin and Kay Jamison supports this position. In their seminal book, Manic-Depressive Illness, they describe how people experiencing bipolar disorder are far more likely to commit suicide than individuals with any other medical or psychiatric condition. This is particularly disconcerting when we consider that the Centers for Disease Control and Prevention in the US already lists suicide as the third leading cause of death for young people.
The suicide rate for people experiencing bipolar disorder has been estimated at between eight and 20 per cent, a rate that is about 20 times greater than for the general population in western nations. A study published in the British Journal of Psychiatry suggests that, in the UK, 11 per cent of all completed suicides involve individuals experiencing bipolar disorder.
Women experiencing this disorder appear to have an even greater risk of suicide. Generally, women attempt suicide two to three times more frequently than men, however men are two to three times more likely to actually complete suicide. In the context of bipolar disorder however, several studies suggest bipolar females actually have higher rates for completing suicide than their male counterparts.
Bipolar disorder is also linked to elevated rates of physical health problems and marital disruption. A US study examining 18,252 people found that those with any history of bipolar disorder had significantly higher rates of seeking medical treatment for physical health complaints, and also reported experiencing higher rates of marital disruption.
Other studies have found that those experiencing bipolar disorder have higher illness mortality rates than the general population, with the most common causes of death being cardiovascular, respiratory illnesses and cancer. Goodwin and Jamison suggest that the mortality rate for untreated bipolar patients is higher than most types of heart disease and many types of cancer.
The high rate of physical health complications associated with bipolar disorder can, at least in part, be explained by the higher rates of drug and alcohol abuse associated with this condition.
One US survey, including over 20,000 participants, found that, compared to the general population and other psychiatric disorders, individuals with a diagnosis of bipolar disorder had the highest lifetime rates for drug (41 per cent) and alcohol (46 per cent) misuse. Desperate individuals seek solace in substances that ultimately wind up doing more harm than good.
There is help for bipolar disorder and its cousin, major depressive disorder. The most effective treatments involve a combination of medication and talk-based psychotherapy such as cognitive behaviour therapy.
There is a global shortage of people appropriately trained to deliver effective talk-based psychotherapy. This means that many young people with bipolar disorder and depression will get suboptimal treatment. We wouldn’t tolerate such a situation if the illness were cancer or diabetes, why should we feel different about bipolar disorder or depression?
Justin Thomas is an associate professor of psychology at Zayed University and author of Psychological Well-Being in the Gulf States
On Twitter: @jaytee156
