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Highs and Lows: Understanding Bipolar Disorder

By Dr. Gbonjubola Abiri

Dee walked into my consulting room with an infectious energy that filled the space before he even sat down. He spoke rapidly, ideas tumbling over each other. He had just launched three businesses in the same week, written a proposal for a fourth, and was planning to relocate. He laughed easily and told me he barely slept.


His wife, seated quietly beside him, looked worried.
“This is how it starts,” she said softly. “He hasn’t slept properly in days. He is spending money we don’t have. Last time this happened, he crashed badly.”
Dee dismissed her concerns away.
Three months later, he returned, looking very different. Shoulders were slumped, voice barely audible. The businesses had collapsed. The relocation plan had fallen through. He struggled to get out of bed and life felt heavy and exhausting.


He was not simply going through mood swings, he was living with bipolar disorder.
Bipolar disorder is a condition that is often misunderstood, misdiagnosed and sometimes stigmatised. The word bipolar is often ascribed to weather and fleeting feeling states. It is however much more than occasional emotional ups and downs and is characterised by significant shifts in mood, energy, activity levels, and the ability to function.


Two extremes typical occur: the first is mania or hypomania where there are periods of unusually elevated mood, increased energy, decreased need for sleep, impulsive decisions, excessive spending, risky behaviour or feeling unusually confident or invincible. During these periods, individuals may feel highly productive and creative, but their judgment is often impaired.


The second is depression with periods of sadness, hopelessness, loss of interest, difficulty concentrating, withdrawal from others, and sometimes thoughts that life has lost meaning. These episodes can be deeply disabling and emotionally painful.
Between these extremes, some people experience periods of stability, while others cycle more frequently.


What makes bipolar disorder particularly challenging is that the “highs” can sometimes be mistaken for success, productivity, or even personality. Beneath the surface however, the brain is working overtime, and the eventual emotional crash can be devastating. It is often described as a ‘chameleon’ as even in the same patient and at different times, the symptoms may differ significantly from one episode to another.


With the right support, including medication, therapy, structured routines, sleep regulation, and supportive relationships, many individuals with bipolar disorder live stable, fulfilling, and productive lives. With Dee’s journey, with treatment, he gradually regained balance. He learned to recognise some early warning signs: reduced sleep, racing thoughts, persistent low mood or sudden grand plans. His wife also learned how to support him without fear or judgment. Together, they built stability.


As our awareness increases, perhaps the most powerful thing we can do is to listen more carefully, judge less quickly, and recognise that behind the highs and lows, there are real people seeking understanding, compassion, and hope.
Remember there is no health without mental health.

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