When I make the diagnosis of bipolar disorder and discuss it with a patient, I am often confronted with a negative reaction. Worries of the associated stigma are expressed and stereotypes derived from the lay press are expressed freely as are insurance and employment worries. This is particularly unfortunate since bipolar spectrum disorder is present in 4 to 6 % of the population and has a lifetime suicide rate of between 10 to 15%. It is also associated with a higher rate of medical comorbidities.
The fact that this mental illness is very treatable and can have positive features is often overlooked by patient and treating professional alike. In the previous blog the association of bipolarity and creativity was exemplified in the life of Goethe. Another characteristic that is shown in depressed people more than non-depressed people is realism. Depressed people assign errors to themselves more often that control subjects. This realism may be an insight in depression. The reverse is true in mania.
The positive aspects of bipolar spectrum disorder should be stressed because social stigma influences quality of life in psychiatric patients with this disorder. They have to cope with their illness as well as the negative attitudes in the community. Often these patients are seen as somewhat responsible for their illness and are not accepted as a patient with a physical illness would be. They are often met with anger, seen as dangerous, and infrequently offered empathy. A more balanced and nuanced view of bipolar spectrum disorders will help in the treatment of these individuals..