By Kayt Sukel
World Bipolar Day has a strict mission: to address the disparity in how bipolar disorder is viewed by the general public. Susan L. McElroy, M.D., the Chief Research Officer for the Lindner Center of HOPE, says that many people have a lot of misconceptions about what bipolar disorder is—which helps perpetuate negative stereotypes.
“There is a real lack of knowledge that bipolar is a medical illness. And one that is highly genetic. It’s one of the most genetic illnesses of mankind, in fact,” says McElroy. “Too many people still view it as a person making bad choices or having a weak character or personality. That couldn’t be further from the truth.”
Another misconception, she says, is that bipolar disorder is just like depression. “These are two distinct disorders and they need to be treated differently,” she says. “The public still doesn’t have nearly as good of an understanding of bipolar disorder as they do of depression. You see that a little bit in healthcare professionals as well.”
Both depression and bipolar disorder are characterized by recurrent depressive episodes that can look very similar. But bipolar disorder also comes with episodes of mania—and has slightly different symptoms.
“We’ve learned that the earlier the age of onset, like depression in a child, the more likely it is to be bipolar disorder. Symptoms like sleeping too much or eating too much are often associated with bipolar disorder. Having psychotic symptoms is usually linked to bipolar disorder,” says McElroy. “But it can be hard to tell sometimes which disorder a patient may have if they are seeking treatment during a depressive episode.”
But there is hope that genetic studies and pharmacogenomic testing may make it easier for clinicians to differentiate between the two in the future. In fact, there have already been some great advances in our understanding of the disease at the genetic level—and how patients will respond to treatment.
“We’ve learned that this is a complex genetic illness, where a variety of genes contribute small to medium effects. We’re still working hard to understand the actual genetic mechanism of the illness so we can help with diagnosing it—and eventually help predict who is going to respond to which treatment,” she says. “In fact, there was a recent study suggesting that there are several gene variants that are linked to a positive response to lithium. This drug is kind of the gold standard of treatment for bipolar disorder. But while it is extremely effective for some people, not everyone responds. This study helps us better understand why.”
But, most of all, on this World Bipolar Day, McElroy hopes that these kinds of new studies will help people everywhere understand that bipolar disorder is a medical condition. “It’s really just like having any other illness, like diabetes or cancer. You didn’t choose to have this illness. It’s not your fault you have this illness,” she says. “And as we learn more about the genetics of this disorder, it’s my hope that people will feel more comfortable coming forward and getting treatment—because there are, even today, really effective treatments for it that can help.”