Can I live a normal life with bipolar disorder? With Dr Pearlene Ng - Podcast Shownotes
When a person is diagnosed with a potentially severe and/or terminal illness, both they and their family may wonder if they can still live a normal life. The same is true with bipolar disorder.
We all have our emotional ups and downs but for someone who has bipolar disorder, these peaks and valleys are much more severe. Unlike ordinary mood swings, the mood changes between manic and depressive episodes are so intense that they could interfere with one’s daily life. However, it can be overcome with the right treatment, medication and support.
Podcast excerpts
The following interview has been edited for brevity and clarity.
Sabrina: I would like to understand a bit more about bipolar II disorder. What does it look like and how does it present itself from person to person?
Dr Pearlene: Bipolar II disorder is one of the four basic types of bipolar disorder. In general, bipolar disorder is a mental health condition that affects your mood. Patients with bipolar disorder experience mood swings from one extreme to another. For example, experiencing very low and depressive moods to episodes of mania; feeling very high and overactive.
If someone is diagnosed with bipolar II, they would experience at least one hypomanic and one depressive episode.
Sabrina: My diagnosis made me feel like I had to let go of everything and that I can never expect to have a normal life again. How do you help your clients reframe their perspectives towards their diagnoses?
Dr Pearlene: There are two types of recovery. The first is what we call symptomatic recovery. This is when you witness a reduction in the symptoms you have.
The other type of recovery is more about personal recovery. This is when you’re able to manage your mental conditions and continue to lead a meaningful life.
We start by addressing what recovery means to them and what exactly is a normal life? I think we all have different lives and normal life doesn’t quite exist but what are their goals (short, middle and long term) and how can we continue to achieve those goals while managing the symptoms of bipolar II disorder?
Sabrina: With regards to symptomatic recovery, what does that process look like and how do you guide your clients through that recovery process?
Dr Pearlene: The first thing we have to do is to determine if they are experiencing bipolar II disorder or are facing other kinds of difficulties. We would typically do a psychological assessment to understand their mental health needs - are there any comorbidities such as OCD or immune anxiety disorder that they’re experiencing.
Once we get a clear picture that it is bipolar II disorder that they are primarily experiencing, then we consider the treatment options for them. Most people with bipolar II disorder do go on to get some pharmacological treatment. If needed, we may also refer them to a psychiatrist to get their medication and recommend them to attend psychological therapies like cognitive behavioural therapy (CBT) which has been proven to be quite effective in supporting somebody with bipolar II disorder.
Sabrina: What is treatment like for individuals who have bipolar II disorder along with other comorbidities?
Dr Pearlene: There might be comorbidities such as the prevalence of other mental health conditions. For example, some type of anxiety disorder. In such cases, for the psychological part of treatments, we focus on treating one before the other.
We will look at the primary difficulty that they are experiencing. Is it bipolar II disorder or is it (for example) OCD? To ascertain that, we ask the magic wand question - if there’s one day I wave my magic wand, and you recover from OCD. Would you still experience bipolar II disorder and vice versa?
A lot of times, my client would tell me that they think it’s bipolar II disorder that is maintaining the OCD. That’s when we treat bipolar II disorder first because we want to focus on the root cause of the problem. Most of the time, they might find that once the primary problem is resolved, the other disorders go away.
Sabrina: I wonder whether the concept of self stigmatisation is something that comes up for your clients and what are your thoughts on it?
Dr Pearlene: It is quite common. Some of my clients actually say “Hey, I don’t think I can do this because of my mental condition,” or just deprive themselves of opportunities because they believe that they are not normal or that they can’t recover. They stigmatise themselves a lot more than the peers around them.
Sabrina: So how do you guide people along this journey of overcoming self stigmatisation?
Dr Pearlene: Sometimes when we experience things in our lives, we develop certain core beliefs about ourselves. What we do in therapy is to relook at all these thoughts and beliefs to see whether they make sense or is there a more objective way of looking at ourselves or perceiving the situation. Sometimes we get them to try out behavioural experiments just to test our predictions. More often than not, they realise that their predictions are developed from the critical thoughts that they have of themselves but it’s not quite true.
The more they try things out, the more they test their predictions and the more they realise that their predictions are not accurate. Slowly, they start developing a more objective way of looking at situations and then they slowly change their perspective.
Sabrina: Once you’ve been diagnosed with bipolar disorder, can you be fully recovered or are you always in recovery?
Dr Pearlene: Tons of research has shown that you can recover from bipolar disorder and that it’s a highly treatable condition. I’ve seen studies where recovery rates are as high as 70-85%. Again, it goes back to the idea of recovery and what it means for different people.
Researchers have also shown that a combination of treatment such as psychotherapy and medication is especially effective. To cite a study that I’m familiar with, there was a comparison between people using CBT with medication and those using just medication alone. Those who had a combination of treatments saw a 60% reduction in chances of relapse.
Another study over a 9 month period saw that patients who combined family-focused treatment with medication experienced an 11% rate of relapse as opposed to those on medication alone with a 61% chance of relapse.
This suggests that recovery is possible and there are things that one can do to increase the rate of recovery while reducing relapses.
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Calm Conversations is a podcast series launched and facilitated by Calm Collective Asia. As a means of sharing personal experiences, lessons, and advice, we speak to people from all walks of life about topics that are universally relevant yet often still taboo in the hope of normalising conversations about mental health.
Available on Spotify, Google, and Apple, you can tune in whenever and wherever. We hope that by listening in, you feel less alone, learn something new, and find the courage to continue these conversations with the people around you. Stay calm!