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Bipolar - a family perspective

Steve has one word to describe the impact bipolar has had on his family: “disruptive”.

Two of his sisters have been diagnosed as having bipolar. His younger brother had it. And his paternal grandfather, ‘cashiered and dismissed from the Indian Army in the 1900s’, almost certainly had it too.

We know that bipolar is hereditary – that it has a genetic base. If one of your parents has bipolar disorder, then you have a 15-25% chance of having bipolar disorder yourself too. But Steve has a better understanding than most of what that means in reality.

“My eldest sister Rosie was the first in my family to suffer from depression, when I was in my late 20s. However it was more than 10 years before she was diagnosed as bipolar after a major breakdown. About 20 years after that my younger brother Mike was similarly diagnosed. During my brother’s illness, my other sister Grace told me that she too had been under treatment for some years.”

“Rosie’s condition has been well managed and pretty stable for about 25 years. But her career – as an ordained Church of England Reader and would-be Deacon – was blighted, largely because of her mental health history… To her family, she has never since seemed quite ‘normal’ compared to before – but her idiosyncrasies are now part of who she is.”

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Bipolar is a serious illness that is notoriously difficult to diagnose. In fact, it takes almost 11 years on average to receive a correct diagnosis. During this time those affected will receive an incorrect diagnosis on average four times. That means years of confusion, frustration and uncertainty. And whilst progress has been made, the main treatment for bipolar – Lithium – has not really been improved in decades. We still are not much further along in our ability to manage the effects bipolar has on an individual.

Of course, for those unable to manage their condition, the impact can be extremely dangerous. Family relationships and friendships can be damaged. Problems between partners are common. 

Steve saw the impact it had on his own family:
“My mother was an enormous source of strength to all her children. She spent a huge amount of time and energy helping Rosie in particular. When Mike became ill, she was already over 80. She was clearly very distressed by the changes she saw in him (she lived in Mike’s town by then) but when he was most ill he often slept at her house.

But most alarmingly, the condition can be deadly too. 1 in 4 of those with bipolar disorder type 1 have a reported history of attempting suicide.

“Mike [Steve’s younger brother] attempted to take his own life seven times over 2-3 years. Luckily his terms of retirement were generous and he didn’t need to work – but this fed his self-belief that his life was worthless. One day he took an overdose and had to be flown from Devon to a specialist unit in Birmingham, for an operation. A few months later, he managed to get out of a supposedly secure hospital, and take his own life. I still miss him on family occasions: when well, he was THE life and soul of any party.”

All of Steve’s family history highlights the dire need for change. It screams of a condition in desperate need of greater research. To improve diagnosis. To transform treatments. But also to enhance and challenge our understanding of the condition and how it develops.

Given his family’s history, Steve’s one wish for research is that it be able to help “find appropriate treatment sooner.” It should be a simple request, but one that seems sadly so far off when it comes to bipolar disorder.

More funding in mental health research will help. As will a more interdisciplinary approach – matching biological research with the societal and psychological – to really view the condition from a 360-degree perspective. As Steve’s family shows, the condition cannot be studied from one viewpoint. The life course you take can be as impactful on your condition as the genes you inherited. The two exist side by side.

Last updated: 9 June 2016

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