A Brain on Paper: Type I Bipolar Mood Swings Tracked on a Graph. Image: Mariana Des Forges

Most people have heard of bipolar disorder but not everyone necessarily understands what exactly it is.

Even within scientific and medical circles, bipolar is still not fully understood.

The term bipolar is often thrown around to describe something- such as the weather- that quickly changes from one extreme to another, in reference to the illness.

This is somewhat accurate to an extent but really, bipolar disorder is a very serious, nuanced mental illness that impacts every element of a person’s life.

It can be truly devastating for someone with it and those around them – one in five sufferers commit suicide.

What is it? 

Bipolar disorder is characterized by the great spectrum of moods that a sufferer experiences that swing, often rapidly, from depression up through euphoria (hypermania) to the dangerous high of total mania.

The depression can include suicidal thoughts and the mania can involve hallucinations and delusions that the person is invincible and can do anything .

This can lead to high risk-taking and life threatening behaviour.

Hypermania is a state below mania in which a person feels elated and maybe extra sociable and more confident.

Bipolar isn’t usually diagnosed until adulthood due to the difficulty in identifying the cause of the symptoms.

Due to the intense and prolonged depression and anxiety, bipolar is often mistaken for (unipolar) depression.

This  leads to misdiagnosis and so the symptoms of mania are then often left untreated.

Once a bipolar diagnosis is made, it can fall under two categories: type I and type II.

To have type I a person must have experienced at least one psychotic (manic) episode that has lasted longer than a week (as well as symptoms of depression).

Type II bipolar is often described as less extreme, with a sufferer experiencing depression and feelings of hypermania but not full blown mania.

Living with Bipolar

Sarah* was diagnosed with type I bipolar at the age of 18, comparatively young for someone with the illness.

On average people suffer with the illness for ten years before a full diagnosis is finally made.

A short radio feature Salt produced by Mariana Des Forges takes a listener into the bipolar mind, using sound to recreate what Sarah hears inside her head during her manic and depressive episodes.

Miracle Salt

Bipolar is an incurable neurological illness that is caused by a chemical imbalance in the brain (though scientists believe it can sometimes be onset by trauma, particularly in childhood.)

It can be managed with antidepressants and another key substance: lithium.

Lithium has a truly profound effect on bipolar sufferers yet why it does still remains largely a mystery to scientists and medical experts.

However, Dr Mark DeAntonio of the UCLA Mental Health Group, theorises that it could have something to do with lithium’s similarity to sodium.

It too is a naturally occurring salt.

Natural Salt: Bolivian Lithium Flats

(One Theory about) How It Works

Moods in the brain are controlled by electrical signals that are transmitted between neurotransmitters via sodium ions.

However this part of the brain – the part that controls moods- is defective in people who suffer from bipolar, causing their moods to be both extreme and to swing so intensely and rapidly.

When lithium is introduced, the brain will use the lithium ions instead, to move the electrical signals between the neurons.

It is similar enough to sodium to carry the electricity but because it is not as effective as sodium, it slows down the transmission of electrical signals, thereby slowing down the intensity of the changes in mood.

DeAntonio believes that the sluggishness of the lithium could hold the key to the way in which it stablises the extreme mood cycles in bipolar sufferers.

Could We All Benefit from a bit of Lithium?

This is the question psychiatrist Anna Fel asks in an article published in The New York Times Sunday Review. 

In the 1970s, research began to determine whether there might be a correlation between low lithium levels and poor behavior in humans.

Fel describes studies done in several countries such as Greece, Japan and America that showed that in towns where there was a higher level of lithium in the drinking water, there was a lower rate of suicide, crime, rape and theft.

She writes:

In 1990, a study was published looking at 27 Texas counties with a variety of lithium levels in their water. The authors discovered that people whose water had the least amount of lithium had significantly greater levels of suicide, homicide and rape than the people whose water had the higher levels of lithium. The group whose water had the highest lithium level had nearly 40 percent fewer suicides than that with the lowest lithium level.

Also, in a recent review of epidemiological studies of lithium in drinking water, it was reported that 9 out of 11 studies found a correlation between higher levels of lithium in local water and ‘beneficial clinical, behavioral, legal and medical outcomes.’

While the exact science of lithium remains largely a mystery, it is often described by bipolar sufferers as a wonder drug and a miracle salt.

If you think you or someone you know suffers from bipolar or another mental illness more information can be found on the Mind website.

*names have been changed to protect identity.