A study has revealed that over 1.2 million Italians are affected by bipolar disorder, with a higher prevalence among women.

Frequently regarded as ‘glamour’, linked to creativity, imagination, and flair, the notion of ‘I want to be bipolar’ can be seen as a ‘stigma in reverse’. However, bipolar disorder is, in reality, a serious and recurring condition that can significantly impact the quality of life and the psychosocial well-being of those affected by it.

Currently, it impacts more than a million Italians, accounting for approximately 1 to 2 percent of the overall population. Notably, there is a marginally higher occurrence among women, with the condition often emerging between the ages of 15 and 30.

However, this represents a significant underestimation, merely the tip of the iceberg of a multifaceted disorder, whose symptoms frequently bear resemblance to those of other mental health conditions, including depression and schizophrenia.

It is hardly unexpected that late or erroneous diagnoses are prevalent: around 70 percent of those affected have been given an incorrect diagnosis, with 30 percent of these individuals having experienced it more than once.

Typically, there is a span of approximately eight years from the initial onset to the point of diagnosis and the commencement of treatment. On the occasion of World Bipolar Disorder Day, the Italian Society of Psychiatry emphasises the critical importance of early diagnosis and appropriate therapeutic management, alongside the urgent need to dismantle the stigma that continues to surround this condition.

Bipolar disorder

“This disorder leads to considerable, at times severe, disruption not just in mood, but also in cognitive function, willpower, and physiological regulation, profoundly affecting the everyday lives of both the individuals afflicted and their loved ones,” states the professor.

Liliana Dell’Osso, the esteemed president of the Italian Society of Psychiatry -. Bipolar disorder is marked by alternating episodes of mania or hypomania and phases of depression, impacting one’s ability to function, regulate emotions, and maintain social relationships. Although bipolar disorder is quite common, it is frequently misinterpreted, and numerous individuals living with this condition endure the weight of societal stigma.

Moreover, bipolar disorder presents further risks for those affected, as it frequently goes unrecognised and misclassified, occasionally being confused with unipolar depressive disorder.

“Milder hypomanic phases might indeed go unnoticed during the medical history gathering, as the patient, viewing these times as episodes of heightened well-being, may fail to mention them. This lack of recognition of their pathological nature, or reluctance to accept a diagnosis of bipolar disorder—often accompanied by a certain stigma—was highlighted by the president of the SIP.” Moreover, it is essential to remember that any disorders affecting the brain deserve our utmost consideration, much like any other organ in our body. The consequences of neglecting treatment can be dire, particularly when it comes to the risk of suicide.

The significance of prompt diagnosis

“Early diagnosis and targeted therapeutic intervention are crucial for enhancing the disease’s trajectory, thereby lessening its effect on the quality of life for those affected,” emphasises Antonio Vita, vice president of SIP and professor of psychiatry at the University of Brescia. It is essential to pay close attention to patients and gather a precise medical history, potentially with the assistance of family members, to prevent the prescription of unsuitable therapies that may exacerbate the situation rather than enhance it. The potential consequences of a diagnostic error can be quite serious, as treatment options may differ greatly, and there may also be a general unawareness of the underlying condition among patients and their families. At present, we possess medications specifically designed for mood stabilisation, which are now firmly entrenched in clinical practice. These aim to diminish or eradicate the recurrence of depressive and/or hypo/manic episodes. Additionally, there are psychosocial treatments with demonstrated efficacy that must invariably be prescribed and overseen within a specialist environment. Research is indeed thriving, particularly in the pursuit of a more precise clinical and biological characterisation of the disorder, aimed at enhancing the personalisation of treatments.

A day dedicated to fostering increased awareness

“Today, on this awareness day, we aim to foster a deeper understanding of the daily challenges encountered by individuals living with bipolar disorder,” concludes Prof. Dell’Osso. “The aim is to foster a more inclusive society, enabling individuals grappling with bipolar disorder to acknowledge their condition without the burden of stigma while also ensuring they can obtain prompt diagnoses and effective treatments. This approach seeks to enhance their quality of life and mitigate the risks associated with the illness.”

The Van Gogh Incident

In the essay “Premature Children of the Future”, published by Alpes Italia, Prof. Dell’Osso elucidates a psychobiographical analysis of Vincent van Gogh, suggesting a diagnosis of an autism spectrum disorder. Challenges in social engagements, including unstable relationships and misunderstandings with peers and colleagues, alongside feelings of isolation; focused and repetitive interests, particularly an obsession with colour and light; strict routines and heightened sensory sensitivity, evident in his strong reactions to changes and deep immersion in painting.

Alongside his autistic traits, van Gogh exhibits signs of bipolar disorder. “There are numerous accounts of episodes marked by elevated mood and hyperactivity (manic phases), accompanied by a diminished need for sleep, during which he engaged in painting with remarkable fervour,” elucidates Dell’Osso. “Equally notable are the profound depressive episodes accompanied by thoughts of self-harm, as well as the catatonic phases that can be seen in both autism and bipolar disorder. These episodes often manifest as periods of stillness and silence, reminiscent of those experienced during his time in Saint-Rémy. Additionally, the repetitive and ritualistic movements that defined his intense painting style, alongside alarming self-injurious actions such as the mutilation of his ear, further illustrate the complexities of his mental state.”

Van Gogh could be seen as a quintessential example of a journey through mental illness, beginning with an autism spectrum disorder that later evolved into catatonia linked to bipolar disorder.

“The intense concentration associated with autism, coupled with the vibrant creativity of manic episodes, fuelled his remarkable artistic output, whereas the depths of depression and solitude ultimately led to a tragic conclusion,” Dell’Osso remarks. “Essentially, Van Gogh exemplified not just a remarkable artistic vision but also the profound interplay of neurodiversity, showcasing how it can give rise to both extraordinary brilliance and deep anguish simultaneously.”

Source: Today.it/Statista