This study analyzed complete mental health (CMH) as a broader indicator of well-being, including factors such as happiness, social support, and the absence of other psychiatric disorders. Overall, 23% of individuals with bipolar disorder achieved CMH, with this being more common among older, married, and non-addicted individuals. The findings reinforce the importance of approaches that consider not only mood stabilization but also the overall well-being of patients.
Bipolar disorder, previously called manic-depressive disorder, is a chronic and serious mental disorder that affects approximately 40 million people worldwide.
It is characterized by extreme mood swings, ranging from episodes of mania, marked by euphoria, excessive energy, and impulsivity, to periods of deep depression, with intense sadness, low energy, and difficulty performing daily activities.
In addition to these mood swings, bipolar disorder often occurs alongside other psychiatric problems, such as anxiety, substance abuse, and personality disorders.
It is estimated that between 50% and 70% of patients have these associated conditions, further increasing the challenges of treatment. The impact of the disease is not limited to emotional and mental health; it also carries a significant financial burden, with direct medical costs ranging from $8,000 to $14,000 per person each year, in addition to indirect costs that can reach $11,000 annually.
Despite being a long-term condition, bipolar disorder has promising remission rates. Studies indicate that almost all patients with a first episode of the illness no longer meet diagnostic criteria within two years.
In addition to improvement in symptoms of mania and depression, factors such as reduced anxiety, restored self-esteem, and improved quality of life are important in measuring recovery.
Certain groups of patients are more likely to recover, including women, married individuals, individuals in good physical health, high socioeconomic status, and those with no history of other mental disorders or drug addiction.
In addition, those who were diagnosed more recently, had fewer episodes and hospitalizations, and did not experience psychosis are more likely to resume functioning in daily life.
In contrast, individuals with a history of childhood abuse, psychosis, or use of antidepressants may have more difficulty achieving remission. Childhood trauma, such as abuse and neglect, can affect brain development, causing changes in neural systems responsible for controlling mood and thinking, which can increase the risk of bipolar disorder and make recovery more difficult.
While symptom remission is a critical step, experts have advocated for a broader approach to recovery from bipolar disorder. Because patients may also face challenges such as suicide risk, anxiety, and substance abuse, recovery should not be viewed solely as the absence of bipolar symptoms.
The concept of “complete mental health” (TMH) has been explored as a more comprehensive way to measure the well-being of these individuals. TMH assesses not only the presence or absence of mental disorders, but also positive factors such as happiness, life satisfaction, and psychological and social well-being.
To meet this criterion, a person must be free of mental disorders in the past year, have no problematic substance use or suicidal ideation, and report frequent feelings of happiness and personal fulfillment.
However, little research has explored how bipolar disorder relates to complete mental health, highlighting a gap in understanding recovery from this condition. Previous studies have examined the prevalence of complete mental health in individuals with a history of major depression and found that 39% of these individuals met the criteria for this state of well-being.
Factors associated with complete mental health include being female, having a higher income, being married, having a strong social support network, being physically active, and using religion as a coping strategy.
Conversely, individuals who suffered childhood abuse, have anxiety disorders, substance abuse, or insomnia are less likely to achieve this level of recovery.
This study seeks to fill this gap by examining recovery from bipolar disorder from a comprehensive mental health perspective using a large, representative sample of the Canadian population.
The aim is to investigate three levels of recovery: (1) remission from bipolar disorder, i.e., no longer meeting diagnostic criteria; (2) absence of psychiatric disorders, such as anxiety and substance abuse; and (3) comprehensive mental health, including emotional and social well-being.
The study analyzed data from the 2012 Canadian Community Health Survey, focusing on a sample of 555 adults with bipolar disorder. Statistical analyses were used to identify factors associated with recovery.
The results showed that only 23% of individuals with bipolar disorder achieved complete mental health, a significantly lower number than the 74% of the population without bipolar disorder.
Factors that favored complete mental health included older age, higher income, being married, having good social support, and not having a history of drug addiction or debilitating chronic pain.
However, some limitations of the study should be considered, such as the lack of information on certain mental disorders, the exclusion of hospitalized patients, and possible biased responses due to social desirability.
Despite these limitations, the study provides valuable contributions to the understanding of bipolar disorder and its recovery. By identifying the factors that promote complete mental health in this population, the research helps to direct treatment strategies that go beyond simple symptom remission, also considering the quality of life and emotional well-being of patients.
This can contribute to more effective interventions and better support for those living with this condition.
READ MORE:
The continuum of recovery among Canadians with bipolar disorder: From remission to complete mental health
Melanie J. Katz, Ishnaa Gulati, and Esme Fuller-Thomson
Journal of Affective Disorders Reports, Volume 17, July 2024, 100808
Abstract:
Research on recovery from bipolar disorder focuses primarily on symptom remission and diagnostic criteria. Less attention, however, has been paid to other aspects of mental well-being and psychosocial functioning. The current study examines the prevalence of, and factors associated with, recovery from bipolar disorder through three levels: (1) remission from bipolar disorder; (2) the absence of psychiatric disorders (APD); and (3) complete mental health (CMH), which incorporates measures of happiness, life satisfaction, psychological flourishing, and absence of mental illness. Data were drawn from the 2012 Canadian Community Health Survey-Mental Health. A subsample of 555 adults with bipolar disorder was analyzed using bivariate chi-square analyses and multivariate logistic regression models. Approximately 1 in 4 (23 %) participants with bipolar disorder achieved CMH, which was significantly lower than the 74 % of those without bipolar disorder who were in CMH. Factors associated with CMH among individuals with bipolar disorder included older age, higher household income, being married, having a confidant, utilizing religion or spirituality for coping, and being free from substance abuse or dependence and debilitating chronic pain. Absence of data on certain mental disorders, exclusion of hospitalized or unresponsive participants, and social desirability, may have biased the results. By identifying factors associated with CMH among those with bipolar disorder, this study provides insight into recovery from bipolar disorder beyond symptom remission, highlights subpopulations who may be at heightened risk of further adverse mental health outcomes, and helps inform interventions that support recovery for individuals affected by bipolar disorder.
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