One sunny afternoon, while on a break at the hospital cafeteria, I spotted Rohan, an old friend from school. We hadn’t seen each other in years—he had gone on to become a computer engineer, and I’d become a doctor. He approached with a tentative smile and a look that spoke of something serious on his mind.
After a few minutes of catching up, Rohan confided, “I really needed to talk to you… it’s about Aditi.” He spoke of his girlfriend, whom he’d been dating for two years, and how he’d recently started thinking about marriage. But lately, something had left him feeling uncertain and worried.
“She’s either on top of the world, laughing and full of ideas, or completely withdrawn and quiet,” he said, his voice filled with concern. “I thought maybe it was just, you know, her hormones? Her moods do seem to change with her cycle. Should I suggest she see a VOG? Or an endocrinologist?”
Seeing his confusion, I listened closely, understanding that Rohan’s worries went beyond typical relationship challenges. “Rohan,” I began gently, “it sounds like Aditi may be experiencing something more complex than hormonal changes alone. Based on what you’ve shared, she could be dealing with bipolar disorder.”
Unpacking Bipolar Disorder
My response seemed to catch him by surprise, and he looked at me with a mix of curiosity and hope, perhaps relieved to have a name for his worries. I explained that bipolar disorder is a mental health condition that causes significant mood swings. These “highs” and “lows” are not typical mood shifts; they’re intense episodes that affect thoughts, behavior, and even one’s ability to function. In the U.S. alone, roughly 5 million people live with this condition, so it’s more common than many might think.
“It’s a lifelong condition, but with treatment and support, many people with bipolar disorder find ways to manage it and lead balanced lives,” I assured him.
The Highs and Lows of Bipolar Disorder: What Rohan Saw in Aditi
Rohan was eager to understand more, so I broke down what he’d been seeing in Aditi through the lens of bipolar disorder.
The “Highs” of Hypomania: Aditi’s Bright Moments
Rohan described Aditi’s “good days” with a sense of awe and fondness. “Sometimes, she’s absolutely magnetic,” he said. “She’ll be up all night planning new projects, laughing, suggesting spontaneous trips. It’s like she’s buzzing with energy.”
I explained that these moments sounded like hypomania, a common feature of bipolar II disorder. During hypomania, a person feels unusually energized, creative, and driven. Hypomanic episodes can bring a strong sense of optimism, leading to impulsive decisions—sudden plans, overspending, or late nights filled with ideas and excitement. While hypomania is typically milder than full-blown mania (seen in bipolar I disorder), the difference is often clear to loved ones. “If her high-energy days feel intense but manageable, that’s likely hypomania rather than mania,” I explained.
In cases of manic episodes, more common in bipolar I disorder, these highs can be even more pronounced and may include risky behavior, like driving too fast, spending recklessly, or even hallucinations. But in Aditi’s case, the highs he described seemed more aligned with hypomania.
The “Lows” of Depressive Episodes: When Aditi Retreats
Rohan nodded, his expression growing somber as he talked about the days following Aditi’s highs. “After those incredible highs, it’s like she just… disappears. She becomes quiet, avoids everyone, and doesn’t seem interested in anything. It’s as if she’s lost a part of herself,” he said, his voice heavy with concern.
These “down” days, I explained, sounded like a depressive episode, another common feature of bipolar disorder. Depressive episodes often leave a person feeling drained, disconnected, and hopeless, sometimes for weeks at a time. During these periods, activities that once brought joy seem pointless, and even basic tasks feel overwhelming. For Rohan, seeing Aditi go from an enthusiastic partner to someone lost in sadness had been incredibly hard.
“These lows can be just as challenging as the highs,” I explained. “It’s important to know that it’s not something she can just ‘snap out of.’”
Bipolar Disorder, Women, and Hormones: Rohan’s Initial Theory
Rohan was surprised when I mentioned that his initial thought about hormone changes wasn’t entirely off. Hormones don’t cause bipolar disorder, but hormonal shifts—like those during menstruation, pregnancy, and menopause—can influence mood symptoms in people who already have bipolar disorder. In fact, women with bipolar disorder are more likely to experience rapid cycling (frequent changes in mood episodes) and may find that their mood symptoms intensify with hormonal changes.
“So, seeing a VOG or an endocrinologist wouldn’t directly address her mood shifts, but it’s possible that hormonal changes are adding to her experience,” I explained. “A mental health specialist would be the best place to start.”
Treatment Options for Aditi and Others Living with Bipolar Disorder
Rohan’s next question was about getting help for Aditi. “Can she get better?” he asked, hopeful but nervous.
I reassured him that bipolar disorder has many effective treatment options and that, while it’s a lifelong condition, people with bipolar disorder can manage their symptoms and live fulfilling lives. The key, I explained, is finding the right combination of treatments.
- Medications: Many people with bipolar disorder find stability with mood stabilizers, antipsychotics, or sometimes antidepressants. Each person responds differently to medications, so it often takes time to find the best fit.
- Therapy: Cognitive Behavioral Therapy (CBT) is effective for people with bipolar disorder, helping them manage thoughts and behaviors that contribute to mood shifts. Another approach, Interpersonal and Social Rhythm Therapy (IPSRT), focuses on maintaining daily routines, such as consistent sleep, meals, and exercise. Regular routines can help reduce mood swings and create a sense of stability.
- Lifestyle Adjustments: Regular sleep, exercise, and a balanced diet are simple yet powerful ways to support overall health and emotional stability. These aren’t a substitute for medical treatment but can provide a solid foundation for managing bipolar disorder.
Considering Supplements
Some people explore supplements like omega-3 fatty acids, which may support mood stability. However, these should be discussed with a doctor to ensure they don’t interfere with prescribed treatments.
Causes and Risk Factors: Why Does Bipolar Disorder Happen?
Rohan was curious about why some people develop bipolar disorder. I explained that it’s a complex mix of genetic, biological, and environmental factors. If a close family member has bipolar disorder, a person’s risk is higher. Differences in brain chemistry and structure can also play a role. Life stressors or trauma can sometimes trigger symptoms in people predisposed to the condition.
Supporting Aditi: Rohan’s Role in Her Journey
Rohan’s main concern was how he could best support Aditi. I shared a few tips that could make a difference:
- Encourage Routine: Consistent daily routines, especially with sleep, meals, and exercise, can help bring more stability to her mood.
- Be a Source of Stability: A strong support system, including family, friends, and support groups, can provide her with the encouragement she needs.
- Track Moods Together: Keeping a mood journal can help Aditi identify patterns and potential triggers, which she could then discuss with her therapist.
A Journey of Understanding: Final Thoughts
As Rohan prepared to leave, he seemed lighter, more reassured. He now understood that Aditi’s mood changes weren’t just “hormonal” or something she could control; they were symptoms of a complex mental health condition that could be managed with the right support and treatment. He realized that with empathy, patience, and the right professional guidance, he could stand by Aditi and help her navigate this journey.
Bipolar disorder is not a simple or easy path, but with a dedicated support system and effective treatment, people living with it can find ways to lead balanced, fulfilling lives. And, as Rohan learned, understanding and compassion are often the best starting points for supporting a loved one with bipolar disorder.
I’m Dr. Priya Sammani, and I am deeply heartened by Rohan’s commitment to caring for his partner through her challenges. Let’s all be a little more like Rohan. Life is short, and a little extra kindness can mean the world to those around us.