. Hello, I am a 51-year-old male, I was diagnosed with Bipolar disorder in 2011. This is when I was nose-diving in life, by then I had seen a life which very few people have experienced that include globe-trotting, affiliation with power circles and pinnacle of luxury. I was highly successful in business and was blessed with money and full of joy. It all began in the year 2004 by losing money, assets, friends, relatives, business and contacts. I was descending faster than one can imagine. I was jobless and gradually I accepted that no one treats me the way as they used. I found it difficult to live without any source of income, I have had exhausted all my savings around 2006 and began to sell my properties which also included my home. I lived with the money which I gathered through sales of my assets. I could not sustain for long and then with great difficulty I found a job which too did not last more than 18 months. I had entered into the political system (to which I had access during my shiny patch) and had contested two major elections (parliamentary and legislative assembly) as nominee of one of the largest political parties in India and lost. The experience rendered an access to power coteries, even with which I could not continue beyond 6 years. After having exhausted all means, today I work as a sports facility manager at an isolated location as an administrator for a salary which is equivalent to my monthly phone bill 20 years ago. I am cut-off from all my contacts, relatives, friends except my immediate family. Some information which may be vital in your assessment: I have quit non-vegetarian diet 20 years ago, I am very concerned about animal welfare ? especially the stray and uncared. I cannot tolerate loud music and noise. I do not watch television. I would like mention that in 2011 I did not take medication for Bipolar disorder. I had discontinued the same within 3 days as that made me sleepy for the whole day. I do not see any hope to recover as nothing seems to work in my favor, in any minutest way. Today I have nothing with me, home or any asset. The present work does not give me to save even a penny, I see no meaning to stick to it and have been considering the option to seek isolation in ashrams or spiritual centers in the hills. I am really clueless as to what I should be doing next. I would like to know whether the diagnosis was right and do I need medical help? If so, can I expect some changes and hope to live again? I will appreciate some advice and help. Thank you.

Dr. Saul PereiraPsychologist46yrs exp

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You certainly need medical help but along with counseling, which I think you have not resorted to at all till now. Under no circumstances are you to discontinue medication without consulting your doctor because bipolar medicines take time to work and there are always side-effects to contend with. Bipolar used to be only a late-onset disease in the past but now it seems to come up earlier. In that connection, you seem like one along with all the other symptoms you have described. You can use the manic phase to become successful if someone professional monitors you during that phase and helps you out of the dumps during the depressive phase. There is a long-term effort involved and perhaps a lot of expense. So you do have a problem financially and also psychologically. Whatever happens, you should never become dysfunctional: it will ruin you. If you do not trust the doctor’s diagnosis, you should seek a second opinion. It can be a crippling disease if not treated and if treated early the prognosis is good. So quickly visit a psychiatrist and seek his/her opinion and you must then follow the medication prescribed. Comply with all the medical prescriptions and work in tandem with a counselor for a long time and learn coping skills and techniques to handle the daily challenges you will face. There are certain adaptations that will suit you during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime, you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in an appropriate manner. I suspect that much of this anger may have origins in early childhood that you may never be aware of now. Talk to your parents and explore that angle. This information will help the counselor too. Also, you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation is good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. Bipolar is characterized by two extreme poles i.e. Feeling very high (mania) and suddenly feeling very low (depression). You can ask the doctor for the symptoms he noticed in you for a personal understanding. 

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