World Disability Day | Let’s make bipolar disorder part of the conversation

Living with bipolar disorder is tough. The ups and downs take a toll not just on your mental health but also on your entire life. For many, life itself is tragically cut short.

Bipolar disorder isn’t just mood swings. It’s a serious mental illness marked by extreme highs and lows — manic and depressed states. What’s even more concerning is the higher risk of dying prematurely.

A study led by a team from the University of Michigan, home to one of the world’s largest long-term studies of people with bipolar disorder, highlights this troubling reality. Published in Psychiatry Research, the study found that people with bipolar disorder are four to six times more likely to die young compared to those without the condition.

The researchers emphasised the need for stronger preventive efforts to address this disparity. “The stark difference in mortality, and the differences in health and lifestyle that likely contributed to it, should prompt more efforts at preventing early deaths,” they noted.

“Bipolar disorder has long been seen as a risk factor for mortality, but always through a lens of other common causes of death,” said Anastasia Yocum, lead author of the study and data manager at the Heinz C Prechter Bipolar Research Program, as published by Michigan Medicine, University of Michigan.

A personal perspective

As someone living with bipolar disorder, I know firsthand how crucial a timely diagnosis is. My diagnosis came late, after years of being labelled with depression and anxiety. Those years of misdiagnosis led me to a dark place, culminating in a suicide attempt. It was only when I was finally put on mood stabilisers — a treatment I should have had from the start — that my life began to change. These medications have been life-transforming, but I can't help but wonder how much suffering could have been avoided with an earlier diagnosis.

This year, I lost a dear friend to suicide — a friend who also lived with bipolar disorder. She was a mentor to me and so many others, a source of inspiration and guidance. Her death is a heartbreaking reminder of how high the stakes are for people living with this condition. It makes me question: Is there really hope for us?

The truth is, there is hope, but only if the disorder is diagnosed and treated in time. Bipolar disorder is manageable, and people with it can live full, healthy lives. But for most, the diagnosis doesn’t come early enough. Seeking treatment for mental illness is often a privilege or a decision forced by dire circumstances.

Invisible Disability

Bipolar disorder is often referred to as an invisible disability because its symptoms — such as extreme mood changes, difficulty concentrating, and energy shifts — are not outwardly visible but deeply impact daily life. Under the Americans with Disabilities Act (ADA), bipolar disorder qualifies as a disability if it significantly limits one or more major life activities. This recognition is crucial for providing protections against discrimination, and enabling access to reasonable accommodations at work and in public spaces.

The Indian context

In India, the situation presents unique challenges. Bipolar disorder is recognised as a disabling condition under the Rights of Persons with Disabilities Act, 2016. However, a significant gap remains in treatment and social inclusion. A study published in the Indian Journal of Psychiatry found that 18.4% of individuals with bipolar disorder in remission experience ‘benchmark disability’, qualifying them for government support. The most affected areas include work, interpersonal relationships, and communication, with 43.7% reporting work-related disabilities.

Despite this recognition, stigma and limited access to mental health resources hinder progress. Experts stress the need for public awareness campaigns and integration of mental health care into primary health systems to alleviate the burden of disability.

A call for change

To put the issue in perspective, while smoking doubles the risk of dying early, living with bipolar disorder raises that risk significantly higher. These statistics make it clear that bipolar disorder is not only a mental health issue but also a public health crisis.

“Bipolar disorder is never going to be listed on the death certificate as the main cause of death, but it can be an immediate or secondary contributor to a death, including in suicides,” said Yocum, who notes that cross-sectional studies have found that on average people with bipolar disorder die 8-10 years earlier than other people their age.

Support from family, partners, and friends can make all the difference in managing bipolar disorder. Having a strong support network can help individuals navigate the highs and lows, encourage adherence to treatment plans, and provide emotional stability.

But when the condition goes unrecognised or untreated, even the most well-meaning loved ones can feel helpless. That's why raising awareness and ensuring timely diagnosis is not just essential for the person living with bipolar disorder but also for their entire support system as well.

This International Day of Persons with Disabilities, let’s ensure bipolar disorder is part of the conversation. Timely diagnosis, affordable treatment, and greater understanding can make a difference. Lives are at stake — and so is hope.

(The views expressed in this article are solely those of the author, a woman from India living with bipolar disorder. The content is based on her personal experiences and research, and is not intended to replace professional medical advice. Readers are encouraged to seek guidance from healthcare professionals for proper diagnosis and treatment of mental health conditions.)

(Rashmika Majumdar is a Chennai-based former journalist and communications professional with experience in public health.)