Tiffany sits in a room at Metropolitan State Hospital in Los Angeles. She is severely mentally ill and has bipolar disorder and a history of drug abuse. photo by Robert Gauthier of Los Angeles Times .

Staff Reporter

Manic highs, deep depression and frequent hospitalisation.

That is the reality of hundreds of local participants of an online survey, living with Bipolar Disorder.

Over 400 people participated in the survey conducted by the South African Depression and Anxiety Group (Sadag) – which aimed to address the gap in local knowledge of this commonly misunderstood disorder.

And the results were staggering.

They also indicated a dire need for extensive treatment among participants, as 65% of respondents reported having manic highs, 81% experienced deep depression, and 67% had been hospitalised at least once in their lifetime.

Furthermore, 84% had attempted or considered suicide.

Of those that had previously attempted suicide, 27% were younger than 30, and 28% were earning less than R12 000 per month.

Overall, 77% of people who participated in the survey had received treatment from a psychiatrist in private practice, even though 53% said they earn R12 000 or less per month.

This, according to the organisation, raised questions about the affordability of these services. SADAG Operations Director, Cassey Chambers said: “This is definitely a difficulty. Many patients battle to afford upper-level medical aid plans. When their medical aid runs out – often half way through the year or after a limited number of psychiatric visits – they stop treatment because the bills are too high. This is likely to lead to relapse, and it raises the risk of suicide.” The SADAG survey results also revealed that of respondents who had stopped their medication, 24% had done so due to finances.

In addition, 40% indicated they had stopped attending face-to-face counselling sessions because they could no longer afford it.

While Sadag said it was positive to see that most respondents had told a family member, friend or colleague about their condition, and that the responses were largely supportive, 26% still faced lack of understanding, disinterest, dismissal, insults, prejudice, or hostility.

Of greater concern for the group was that 45% reported experiencing discrimination in the workplace.

"This kind of discrimination can take many forms, such as being labelled as ‘difficult to work with’, or being fired due to time taken off work for doctor’s appointments or hospitalisation. Patients may also not be accommodated when they’re going through a rough patch, or they could be unfairly reprimanded for tasks they are unable to perform," the group said.

Sadag explained that the disorder was not easily identified, but a severe mood disorder that affects between 1% and 3% of the global population.

The group further added that it was a chronic illness and generally required long-term management. Left untreated, the disorder could worsen.

"A patient may have more frequent and severe episodes than they initially did, and delays in not getting the correct diagnosis and treatment prevent people from leading healthy and productive lives. This disorder tends to negatively impact on the ability of those affected to carry out day-to-day tasks, maintain relationships, and perform at work or at school," Sadag added.

The disorder can also be mistaken for normal, everyday shifts in mood and energy levels – the regular ups and downs of daily life. But Bipolar Disorder is not ‘regular’.

“People with this disorder experience unusually intense fluctuations in emotional states,” psychiatrist, Dr Frans Korb explained.

“These emotional swings usually occur from the overjoyed highs of a manic episode to the crushing lows of depression, and people with Bipolar Disorder swing between these two polar opposites. People may be irritable or aggressive, sad or hopeless; they may experience extreme changes in energy, activity and the need for sleeping and eating. These signs can all be part of the mood fluctuations."