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Opinions of Monday, 9 September 2002

Columnist: Dakwa, Kwame Dwamena

Bipolar disorder

Bipolar disorder, also known as manic-depressive illness, or manic depression, is a mental illness involving episodes of serious mania and depression. The person's mood usually swings from overly ?high? and irritable to sad and hopeless, and then backs again, with periods of normal mood in between. Manic-depressive illness or bipolar disorder, is a serious brain disease that causes extreme shifts in mood, energy, and functioning

Our Ex-President seems to exhibit some of these symptoms. Bipolar disorder typically begins in adolescence or early adulthood (from the records our ex-presidents adolescence and early adulthood was filled with these behaviors) and continues throughout life (he still exhibits it). Case in point, his recent speech in Kumasi was just an ?episode? of his serious mood swings. One day he is in the Volta region urging the people to support the Kuffour administration, the next he is calling for ?positive defiance?. We Ghanaians know that it is often not recognized as an illness, and people who have it may suffer needlessly for years or even decades. Our dear ex-president could be suffering from this known disease and may be crying for medical help. Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating complications. This disease is known to create havoc not only in the lives of those who bear it but all those around them, these may include marital break-ups, job loss, alcohol and drug abuse, and suicide. Out of these, I can confidently say that our ex-president qualifies for one; job loss. Could the others follow? Not if he seeks medical assistance.

There has been a tendency to romanticize manic-depressive disorder. We often hear, ?oh, that is how so-and-so is?, you should be used to him by now, as for this guy dei you have to be careful around him oooh, he can erupt any time. The best one I believe is, ?Hwee, akoaa wen dei oye one-plug ooh? (look, this guy operates on one-plug). Yeah, right. He/she has a bipolar disorder or is manic-depressive or to put it bluntly, he/she is crazy. Many artists, musicians and writers have suffered from its mood swings. And in truth, many lives are ruined by this disease. When left untreated, the illness leads to suicide in approximately 20 percent of cases. Men and women are equally likely to develop this disabling illness. Different from normal mood states of happiness and sadness, symptoms of manic- depressive disorder can be severe and life threatening. To reiterate this, manic-depressive illness typically emerges in adolescence or early adulthood and continues to flare up across the life course, disrupting or destroying work, school, family, and social life. Hmmmm, do I need to say more about this? Having a leader who may suffer from this disease, and if he does, has been left untreated seems to have sent some shockwaves into all these aspects of Ghanaian life; work, school, family, and social life. The ex-presidents 20-year rule has left indelible marks on many families, from Agbozume to Nakpanduri, from Nandon to Abene, from Elubo to Kenynasi and Atebubu the heart of Ghana.

Here are some basic facts about manic-depressive illness:

    ? Millions of people around the world suffer from manic-depressive illness. For those afflicted with the illness, it is extremely distressing and disruptive.

    ? Like other serious illnesses, bipolar disorder is also hard on spouses, family members, friends, and employers.

    ? Family members of people with bipolar disorder often have to cope with serious behavioral problems and the lasting consequences of these behaviors.

    ? Bipolar disorder tends to run in families and is believed to be inherited in many cases. Despite vigorous research efforts, a specific genetic defect associated with the disease has not yet been detected.

    ? Bipolar illness has been diagnosed in children under age 12, although it is not common in this age bracket. It can be confused with another often misdiagnosed disease attention deficit/hyperactivity disorder (ADHD), so careful diagnosis is necessary.

> More than two-thirds of people with manic-depressive disorder have at least one close relative with the illness or with unipolar major depression, indicating that the disease has a heritable component. Studies seeking to identify the genetic basis of manic-depressive disorder indicate that susceptibility stems from multiple genes. Despite tremendous research efforts, however, the specific genes involved have not yet been conclusively identified.

Scientists are continuing their search for these genes using advanced genetic analytic methods and large samples of families affected by the illness. For our ex-president, it would be interesting to learn which gene is responsible for this disorder, the Ghanaian or Scottish gene. That is if he is diagnosed. Researchers are hopeful that identification of susceptibility genes for manic-depressive disorder, and the brain proteins they code for, will make it possible to develop better treatments and preventive interventions targeted at the underlying illness process. Genetics researchers believe that a person's risk for developing manic-depressive disorder most likely increases with each susceptibility gene carried, and that inheriting just one of the genes is probably not sufficient for the disorder to appear. The particular mix of genes may determine various features of the illness, such as age of onset, type of symptoms, severity, and course. In addition, environmental factors are known to play an important role in determining whether and how the genes are expressed.

A National Institute of Mental Health should be initiated at Ankaful, where a large-scale study to determine the most effective treatment strategies for Ghanaians with manic-depressive disorder. Anyone diagnosed with bipolar disorder should be under the care of a psychiatrist skilled in the diagnosis and treatment of this disease. Other mental health professionals, such as psychologists and psychiatric social workers, can assist in providing the patient and his or her family with additional approaches to treatment. I will strongly suggest that after the Kumasi speech, our ex-president should seek medical help.

Kwame Dwamena Dakwa
Educational Psychologist
Bloomington, IN.
USA

Views expressed by the author(s) do not necessarily reflect those of Ghanaweb.