Those with bipolar disorder go through phases of mania and depression — but it’s important to recognize that those phases “do not define” a person, says psychiatrist Dr. Samar McCutcheon

By Julie Mazziotta
July 24, 2020 11:21 AM
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Kanye West
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On Wednesday, Kim Kardashian West asked for “compassion” for Kanye West as he manages a new cycle in his bipolar disorder.

The rapper, 43, has spoken openly in the past about his history with the mood disorder, which he was first diagnosed with about three years ago. West likened bipolar disorder to having “a sprained brain, like having a sprained ankle.”

“And if someone has a sprained ankle, you’re not going to push on him more,” he said in 2019.

At that point, West was doing well with the disorder, but he is now “struggling again,” a source told PEOPLE last week.

Bipolar disorder is “a mood disorder that can involve episodes of mania, hypomania and depression,” Dr. Samar McCutcheon, a psychiatrist at the Ohio State University Wexner Medical Center, tells PEOPLE.

Bipolar disorder is likely genetic, she says, though researchers have not been able to identify exactly which genes contribute to the illness. And for the most part, patients are able to live symptom-free in a “typical baseline mood.” But during the manic, hypomanic or depressive phases, which are often triggered by environmental factors, like life stressors or seasonal changes, they need more help.

Those episodes of mania “present with periods of elevated or irritable mood, increased energy and activity, decreased need for sleep and increased self-esteem lasting several days,” McCutcheon explains — and in some cases the episodes can go on for weeks or months.

To manage these periods, patients need therapy and medication.

“Manic episodes require rapid medication intervention to treat symptoms,” McCutcheon says. “At times manic episodes can require inpatient psychiatric hospitalization to ensure a patient does not engage in behavior that cause unintended long-term consequences — like impulsive financial decisions or risky behavior with substances or sexual activity.”

It's often difficult, though, to help patients experiencing a manic phase.

“Unfortunately, a hallmark of mania is that a person can lose insight into the severity of their illness,” she says.

McCutcheon advises planning in advance, if possible. People with bipolar disorder can authorize release-of-information, a signed document that allows their doctor to alert their family members if a person suspects they are having a manic episode. She also suggests having a conversation about involuntary hospitalization, which would allow family members to seek treatment for a patient if they are unable to do so themselves, though it is not allowed in all states.

And in emergencies, family members can call 911 for help if a person with bipolar disorder is becoming threatening or aggressive.

McCutcheon emphasizes, though, that these phases are just a portion of a person’s life with bipolar disorder.

“Patients with bipolar disorder are stable and functional when not in a severe mood episode,” she says. “The mood episodes do not define them; they are not voluntary, occurring even when someone is in the best treatment. The general public can be most helpful by having compassion, reserving judgment and being open to learning more about mental illness.”

If you or someone you know needs mental health help, text "STRENGTH" to the Crisis Text Line at 741-741 to be connected to a certified crisis counselor.