Treating bipolar disorder can be tricky, advocate says

TORONTO — Treating bipolar disorder requires as much art as science, says Karen Liberman, executive director of the Mood Disorders Association of Ontario.

“There are no tests to diagnose bipolar, so doctors really have to understand [the symptoms]. All they have to go on is what they told,” Liberman said.

She will be speaking on bipolar and anxiety disorder at a community presentation being held at the Lipa Green Building, fourth floor, on Feb. 21, sponsored by Jewish Family and Child in co-operation with the Mood Disorders Association of Ontario.

Liberman, who recovered from a decade-long battle with severe clinical depression, has been honoured by Chatelaine magazine as a health hero, was featured on the CTV documentary Fighting the Dragon, and was a 2003 recipient of the Centre for Addiction and Mental Health’s Courage to Come Back Award.

People diagnosed with bipolar disorder, formerly known as manic depression, are on a “roller-coaster” of wild highs and devastating lows, she said.

“Mania includes racing thoughts, extreme irritability, excessive talking and energy, poor judgement and decreased need for sleep,” Liberman said.

“During the inevitable depressions, people are [among other symptoms] in sad moods with feelings of uselessness or hopelessness. [They’re] lethargic, suicidal, agitated, and have a loss of interest in work, hobbies and people.”

But there are so many forms of bipolar disorder that it’s extremely hard to diagnose, she said. “Bipolar II, for example, is characterized by the same depression, but the mania is not quite as high, so physicians often miss it.

“Those with Bipolar II have energy, productivity, and an [outgoing nature] that is often rewarded. They are in a great state of mind. It is dangerous, though, because eventually they will crash. Physicians often don’t pick up on this because patients don’t report the hypomanic episodes. They’re only treated for the depression, but they need to be on mood stabilizers.”

It’s a tricky business, she said, because even when physicians do diagnose the illness, they have to find the proper medication, and many medications have powerful side effects.

“The good news is that 80 to 90 per cent of cases can be treated, but they need to be treated early before the disease becomes too complicated.”

The challenge, said Liberman, is to educate people to recognize the symptoms of bipolar disorder and get into treatment.

“If we could get people treated at the first signs it could change the course of their illness. How are we letting people get so sick they’re forced to go on long-term disability?”

It’s “crazy,” she said, that people hesitate to get help for a mental illness. “If people have a rash that a cream doesn’t cure, they go to the doctor. There is no shame. A mental illness, though, is seen as shameful.

“It always amazes me that people talk about cholesterol and diabetes openly and without shame. Depression, though, is talked about in hushed tones.”

People are talking about it a little more than they used to, Liberman said, “but we have such a long way to go. Our constant imperative is to increase people’s understanding and make them feel better about disclosing.

“The more you find out, the faster you can get the illness managed so you can get on with the rest of your life. Too many people are living with suffering and pain.”

For information or to register for the presentation, call Shawna Sidney of Jewish Family and Child at 416-638-7800, ext. 215.