x Abu Dhabi, UAESaturday 22 July 2017

Stigma and sufferers’ denial make for long delays in diagnosis of disorder

Medical experts warn that bipolar patients are being given anti-depressants when other treatment is needed.

ABU DHABI // Doctors are taking as long as eight years to diagnose bipolar disorder.

Medical experts warn there is a lingering stigma and denial surrounding the debilitating condition that prevents early medical intervention, and that more research is needed about its prevalence in the UAE.

“The initial presentation usually is depression and these patients are unsuccessfully treated with antidepressants for many years before being diagnosed with bipolar disorder,” said Dr Veena Luthra, a consultant psychiatrist at the American Centre for Psychiatry and Neurology in Abu Dhabi.

Warning signs are extreme mood swings, ranging from extreme depression to extremely elevated or irritable moods.

“There are periods during which the patient feels on top of the world, super confident, has too much energy and can keep working all day and night and does not want to sleep,” she said. “They can engage in reckless, impulsive behaviour, including spending too much money, gambling, drinking, driving too fast.

“They feel grandiose and believe he or she has special abilities or can be very explosive and irritable.”

During periods of depression that follow, bipolar patients have no energy, often cannot get out of bed, isolate themselves and have no motivation, said Dr Luthra.

Another red flag is family history.

“It is important to ask every patient with depression about family history of bipolar disorder, which if present requires screening for manic symptoms,” she said.

Dr Luthra said she sees about two or three patients with the condition daily.

Dr Deema Sihweil, clinical psychologist and director of the Carbone Clinic, based in Dubai Healthcare City, said 10 per cent of her patients suffered from some form of bipolar disorder.

She said an accurate diagnosis could be difficult to determine for two reasons.

“The first being a misconception of what bipolar is and how it can be differentiated from the typical and normal ‘ups’ and ‘downs’ that we all experience,” she said.

“The second reason is the denial that is often associated with mental illnesses. It is very difficult for one to acknowledge that he or she may have a chronic and often debilitating disorder, and resist getting diagnosed and treated.”

While there is no cure for bipolar disorder, early diagnosis and the right treatment can help manage the condition, which is typically treated with medication, psychotherapy and, in extreme cases where neither of the two work, electroconvulsive therapy, she said.

“The earlier the diagnosis, the earlier one can get relief from the distressing physiological and psychological symptoms.”

Dr Sihweil believes there is a lingering stigma surrounding the disorder.

“Often people who suffer from bipolar feel out of control or helpless in their mood swings – there is an incredible shame that is associated with these episodes,” she said.

“It is the responsibility of the family and other loved ones to understand the disorder, have patience and compassion and encourage one to seek treatment without feeling shameful.”

jbell@thenational.ae