Dealing with Bipolar Disorder & Relapse: A Bumpy Road
There may not ever be a last episode, but there are ways to fend off and mitigate the next one.
Although she was hospitalized during a manic episode and diagnosed with bipolar disorder, doctors never mentioned that it could happen again. Instead, Elly was stabilized, handed a prescription for mood stabilizers and discharged. She had no idea that she’d be battling mania and depression for the rest of her life.
“I was told that as long as I took my medications, I’d be okay,” recalls Elly, a mental health coach in Toronto, Ontario.
Elly experienced at least eight relapses between her diagnosis in 1978 and 1991. Each time, she was hospitalized, often placed in restraints and taken to the psychiatric ward in a police car or ambulance. Upon discharge, Elly always promised herself it would be her last hospital admission—but she had no idea how to stave off future relapses.
In bipolar disorder, relapse is defined as the return of depression or a manic or hypomanic episode after a period of wellness. According to a 1999 study published in the American Journal of Psychiatry, 73 percent of those diagnosed with bipolar disorder experienced at least one relapse over a five-year period; of those who relapsed, two-thirds had multiple relapses.
“You can never say that someone with bipolar disorder has had their last episode; relapse is part of the illness,” explains Alan C. Swann, MD, professor and vice chair for research in the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical School at Houston and director of research for the University of Texas Harris County Psychiatric Center. “Relapse is self-perpetuating; once it happens, the more likely it is to happen again.”