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Doc Ayomide: The Misconception About Bipolar Disorder

Doc Ayomide

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unnamedSo the other day on the Fox show, Empire, one of the main characters experienced a bipolar episode, and on Twitter, a mental health advocate went into rant mode.
The character was Andre, and the Twitter rant was Bassey Ikpi’s (@basseyworld).

People reacted to Bassey’s tweets in varied ways. Most supported her for speaking up, but there were a few takedown attempts, including someone who wondered what right she had to question the show, not being a doctor herself. (As though her personal experience of bipolar,which she has bravely chosen to make public, is not more than enough reason.)

I say well done, Bassey, for speaking up!
Personally I’ve written before about TV shows not portraying mental illness properly, so I totally get it. I don’t follow Empire myself, but one major issue I could see from the mentions was how TV shows play up the negative aspects of mental illness for the drama.

That might look like it’s not a big deal, until you think about how many people watch these shows and how many people they mislead. I won’t go today into that issue again, although someday soon I’ll talk about how TV can do a better job of portraying mental illness. What I want to do today is address a key misconception about bipolar disorder.

Bipolar disorder is a mood disorder, but it’s not the same as mood swings.
Let me unpack that.

Bipolar disorder is just one type of mental disorder.
You probably know there’s more than one type of mental illness, but you might not realise how diverse the types are. It’s huge. (I’ve written about this before: “We talk about mental disorders like whites talk about Africa.”) Plus, apart from the fact that mental and behavioural disorders span a wide range, even for the same disorder, no two people with it are the same. (And that’s apart from the fact that even bipolar has more than one type.)
Bipolar has two sides (or “poles”).

To understand this more clearly, you need to understand depression a bit better. You can find a miniseries on depression on my blog, but the key point here is that depression is one-sided. That is, whenever someone with depressive disorder has an episode (what is commonly called a “breakdown”), it will be depression.

In bipolar, though, an episode can go either way. It can be a “down” episode (depressive), or an “up” episode (manic — often confused with maniac, but by no means related, except historically). Or it could be, for some people, a combo of both, a mixed episode. (Bipolar used to be known as manic-depressive disorder.)

FACT: The full name for bipolar is bipolar affective disorder — “bipolar” for “two poles” or “double extremes”; “affective” is an oldish word for “mood.” So another way to think of it is something like, “two-sided mood disorder.” (In an unfortunate coincidence, that abbreviates to BAD.) More often though, it’s commonly called bipolar disorder, or just bipolar.

Bipolar is not the same as mood swings.
This is a very common misconception, but it’s easy to understand why it happens.
The most striking thing about bipolar is the extreme mood changes. Most people hearing this for the first time try to relate by reaching for their own experience of mood swings. So they assume they either have bipolar (like celebrities sometimes say in interviews) or that bipolar must be some kind of extreme mood swing.
It’s not.

Here’s the difference (I actually hinted at it earlier): episodes in bipolar tend to be marked by a prevailing mood, either up or down. Even in a person experiencing a mixed episode, it’s not so much mood swings, as being in the up phase for maybe a few weeks, and then switching to the down phase for maybe another couple weeks or so. Or vice versa.

One more thing. In your typical mood swing, you can often carry on with life as usual. In bipolar, the ability to maintain normal function can be affected without medication or therapy to stabilise the moods.
Bipolar’s more than just mood swings, extreme or otherwise.

There’s way more I could say, of course, but this is a start. Going forward, let’s just all be open to learn, and especially from people like Bassey, who have much to teach us all, professional or otherwise.

Here’s a short, detailed and clear factsheet on bipolar disorder, from Rethink.

Your turn now. Have you heard about bipolar before? Did you personally fall without realising it into any of these ideas? Share in the comments!

If you’ve been diagnosed with bipolar before and would like to share your experience living with it to help others, email me: [email protected], with the subject: “My bipolar story.”

Dr Ayomide Adebayo is a medical doctor, mind health consultant and founder of Maximise Your LIFE, a community for people who want to live to the full. Grab your copy of his FREE resources here — plus instant access to his potentially life-changing email course!He writes at DocAyomide.com and tweets @DocAyomide. To ask a question, book a session — or just say hello — simply e-mail him ([email protected]).

16 Comments

  1. Meh

    March 9, 2015 at 8:24 pm

    I think (personally) that as much as the writers have made a thing of Andre’s condition, they have also made it clear that he was going to pretty soon have a breakdown episode. He has been very on and off about his medication in the last few episodes. His wife knows about his condition and usually, it seems, keeps him on track (having that kind of support is invaluable). I am interested to see how they will manage the fall out fr last week’s breakdown before I have a psychiatrist shaped rant.

  2. DoroAnon

    March 9, 2015 at 8:48 pm

    Mbanu!!! I didn’t boder to readddd Dr Ayo u r fineeee but Dr Craig is Finer! Bella bring Dr craig back

    • bb

      March 9, 2015 at 9:03 pm

      lmfaooooo

    • Sugar

      March 10, 2015 at 11:53 am

      Doc Craig is on Honeymoon presently. Please bear with him and stay tuned!

  3. missusK

    March 9, 2015 at 8:53 pm

    Personally I think the writers managed his bipolar storyline well. He was off his meds, skipped hospital visits. So it’s not like it was just one episode of crazy. It was a steady build up.
    Not sure what Bassey expected of the show but IMO they managed it quite well.

    • Asgrl

      March 10, 2015 at 2:41 am

      Yes but what was potrayed was almost a schizophrenic break.

      I applaud Doc Ayomide and Bassey on highlighting this.

      It’s the same way tv and film likes to portray rape as always violent, bloody and by an unknown assailant. When it could be as simple and silent as saying no but your best friend of umpteen years taking advantage of you while inebriated or sleeping and saying sorry afterwards.

  4. tunmi

    March 9, 2015 at 9:38 pm

    If the person who suffers from it says that is not an accurate portrayal, and you who has never suffered says “they managed it quite well” then you are truly wallowing in your own ignorance. It’s like someone who does not know you writing about you and your life, and someone else (who still does not know you) saying “oh that’s good enough). Stop it.

    • Eva

      March 9, 2015 at 11:14 pm

      Just like other “illnesses” people’s symptoms are different. I have worked in a psychartric unit and some cases are mild, while others are serious just as Andre. My point is one person experience doesn’t describe every bipolar case. The most important thing is we are having mental illness conversation in the black community

    • Miss_Flygerian

      March 10, 2015 at 8:41 am

      Really? I have a friend who was diagnosed with bipolar disorder type 1 at the age of 14. And according to her, that was an accurate portrayal by Andre. I read the comments on facebook and some blogs and many bipolar patients agreed that Trai Byers’ execution was perfect. Bassey is the first I’m seeing who is saying otherwise. Like Eva said, every person’s experience is different. It was revealed right in episode 1 that he was bipolar. He had been skipping his doctors appointments because he was too busy trying to get the company to go public. He sacrificed everything for his father’s company, continuously covering up his father’s countless sins, only for the father to blatantly tell him that he (Andre) will never take over Empire. From what I understand, the greatest thing a bipolar patient can receive is love and his ungrateful father was giving him none of that. Dude started throwing away his meds. It was a steady build up that led to his reaction. He was going through a LOT.

  5. dem

    March 9, 2015 at 11:11 pm

    As a Uk psychiatric nurse , I find your definition too lay man . You refused to quote diagnostic theory . More so I found it hard to understand your write up about bipolar . It could start with manic episode and not only depressive episode ,failed to explain major symptoms, why patient may find it difficult, most especially the family.

    • Lois

      March 9, 2015 at 11:25 pm

      Thank you Dem. You expressed my feelings exactly. I’m sorry doc but there was no flow to your article….it didn’t just flow. In as much as I was so interested in the topic, I seem to be more confused. A more comprehensive and logical article will be appreciated s. Thank you anyway

  6. ms.b

    March 10, 2015 at 1:06 am

    From the beginning of empire, it was already stated that he was bipolar abi schizo. same way we knew lyon has ALS n jamal was gay. Sum ppl just talk without proper info

    • Olaola

      March 10, 2015 at 10:47 pm

      …oops, but being gay is not an illness.

  7. Underdog

    March 10, 2015 at 6:35 am

    With all due respect, this article is not in anyway informative or educative. It reads more like an average 3 rd year medical student presentation. Coming from a Psychiatrist, I expected more well known facts from both knowledge and experience. I have had the privilege to manage numerous folks with Bipolar Disorder both inpatient and outpatient, the most common symptom they actually report is MOOD SWINGS. You’re absolutely correct about the 2 poles with alternating mood which deviates from the norm and enough to have a significant impact on the patient’s well being. Impulsivity, delusions of grandiosity, frivolous spending, hypersexuality, racing thoughts, Irritability, agitation, aggression, sleep disturbances are some of the manic symptoms which may be mild in cases of hypomania. Depression is the other end to the spectrum when suddenly the patient who was energetic, hypersexual, irritable, etc crashes and is depressed (mild to severe). It’s quite baffling to the patient’s partner, friends and family because they can’t quite comprehend the MOOD SWINGS. Schizophrenia, Bipolar disorder and other mental illnesses do have one thing in common which may occur; PSYCHOSIS. So in response to the above, psychosis – delusions, hallucinations, etc may occur in both Schizophrenia and Bipolar.

  8. Ifemelu

    March 10, 2015 at 6:48 am

    Thank you for this. Better flow next time but thank you for this. Please, more topics on mental health, it is very important.

  9. Dale Biberman

    March 19, 2015 at 4:08 pm

    So, Dr. Ayo is saying that a person with BP will have “mood changes” rather than “mood swings”? Okay. Nice use of a euphemism. He’s also, in essence, saying that BP is much worse than someone simply having “mood swings”, which is true. But he also failed to mention that a person is diagnosed with either Bipolar I and Bipolar II, with Bipolar I being the worst of the two as Bipolar I individuals experience “full blown mania,”(life threatening) whereas those with Bipolar II experience hypomania. .

    So many people want to make sure everyone knows that “everyone is different” who has this illness, but let’s face reality here. They have SIMILARITIES across the board or they wouldn’t be given the same diagnosis. Yes, some have more severe symptoms than others but there are very real similarities. What Dr. Ayo also failed to mention is that there could be what’s called “comorbidity,” which means that a patient can experience two illnesses at once. For example, he may have BP with psychotic features. Or he may have diagnoses on Axis II, which are the personality disorders. So, a person could be bipolar and have psychopathy. Therefore, the person who has comorbidity will look very different from the person who just has BP.

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