Helps cocaine with a bipolar

Psychiatry, Psychosomatics & Psychotherapy


Bipolar disorder causes pronounced mood swings

Full of power, then again without any drive: This is how people with so-called bipolar disorders live. In the course of life, the disease can occur again and again in those affected. However, it is possible to counteract this with medication and the right therapy.

When he hit rock bottom in 2003, Martin Kolbe's illness had been a dark shadow for more than two decades. His marriage was broken and debts had piled up. “Everything was broken,” says Kolbe today. The musician suffered from bipolar disorder.

It all started in 1979 when Kolbe was 22 years old. But the disease was only recognized much later, as with so many people. "Adolescence crisis," the doctors said to him when he was treated in a psychiatric clinic. That sounded obvious to Kolbe. But in the years that followed, there were always new burglaries. Eight years later he was diagnosed with bipolar disorder. He doesn't want to reproach the doctors: "Usually you have to go through a few episodes before the period can be identified."

Bipolar disorders run in depressive and manic phases

During depression, those affected are depressed, lack drive and see no perspective. Quite different during a mania: "Then you could hug the whole world", says Prof. Andreas Reif, Director of the Clinic for Psychiatry, Psychosomatics and Psychotherapy at the University Clinic in Frankfurt. They are full of energy and optimistic, hardly need any sleep. They can also get aggressive and take risks without thinking. Careless spending of money, for example, is typical.

Kolbe can also tell about this: Once he was sitting in the Bayerischer Hof hotel in Munich during a manic phase. Five-star hotel, best location in the center. "I just thought that it was my right now," he says, looking back. He couldn't really afford that.

The difficulty is to recognize a mania as a problem, explains Kolbe. You feel as euphoric as on «cocaine to the power of ten». Those affected have seven to eight phases on average in their life. The manic ones last two to three months, the depressed five to six months. “In between, people are healthy,” says Reif. But he also emphasizes: these are average values. The disease progresses individually for each individual. The phases change differently often, last different times and are differently intense.

Early diagnosis is important

According to the professor, around one percent of the population suffers from bipolar disorder - one in 100 people in Germany. That is estimated “conservatively”, says Reif. Many bipolar disorders went undetected for a long time. Reif sees reasons, among other things, in the lack of knowledge about this disease: “Many patients take a long time to go to the doctor.” A quick diagnosis is particularly important: the earlier you treat, the better the prospects. Lithium, for example, is a drug that works in around a third of patients and "switches off" the disease to a certain extent, according to Reif.

A combination of drugs and psychotherapy has proven to be particularly effective for treatment - not just during one phase, but also beyond, says Tomislav Majic from the Clinic for Psychiatry and Psychotherapy at the Charité in Berlin. This also applies to drugs whose dose is higher during treatment in one phase and then reduced accordingly.

According to Majic, bipolar disorders are among the "lifetime diagnoses". This means: You have a significantly higher risk of developing mania or depression again throughout your life. On the other hand, according to Majic, it is quite possible that those affected will no longer fall ill for a long time, despite some manic and depressive phases. Most people get sick between the ages of 20 and 30. The suicide rate among those affected is higher than in any other mental illness, says Reif. Research is carried out on bipolar disorders at the University Clinic in Frankfurt. An app is also used for this purpose: In April, a new application is to be tested on 200 test subjects in Frankfurt and at other research locations. It passively measures data by creating movement and speech patterns. Researchers want to recognize when and how phases are announced.

According to Majic, sleep disorders are an early warning signal for a phase. “With depression, those affected are often up early and have a morning low.” With mania, they sometimes don't sleep at all and are still full of energy and zest for action. In general, mood swings can be a sign. Sufferers should not ignore such signs. Rapid help is available from psychiatrists, in clinics or in institute outpatient departments, says Majic.

Anyone who already has depression has a higher risk of developing the disease. Bipolar disorders are often genetic. There is also a statistical connection between illness and creativity, explains Reif. Martin Kolbe joins the scheme as a musician: in the 1970s and 1980s he was part of the guitar duo "Kolbe & Illenberger" and played more than 1,000 concerts in 40 countries. Until 1987 it stopped. His career had to rest for 25 years before he found the strength to be creative again a few years ago.

In an album released three years ago, Kolbe processed his experiences with the disease. He wants to educate and is on the board of the German Society for Bipolar Disorders (DGBS). Most recently, Kolbe, together with other affected artists, initiated a music and literature event for World Bipolar Day on March 30th in Frankfurt. Further events are planned for autumn in Berlin and Neubrandenburg. It's about the disease, but above all about entertainment, says Kolbe: "It shouldn't be a difficult evening."
Martin Kolbe can live with the disease. Since 2003 he has been spared new phases. He can listen to his inner self and knows how to avoid relapses. However, many do not manage to get back on track - "they drive their lives up against the wall." Often, friends and family withdraw because they simply can no longer reach people and can no longer stand their moods. These people, says Kolbe, then die a “social death”.

German Society for Bipolar Disorders
Bipolar Roadshow cultural event
Bipolife research network

Source: dpa