Paul Fallon received funding from the Department of Health Research for his research fellowship 2002-2009

Bipolar disorder is a severe mental health condition. But in recent years it has become the one mental health diagnosis that patients are willing to accept. Research shows that to some people it has actually become “desirable” when compared with other mood disorders.

This could be because of bipolar disorder’s association with creativity. For example, Charles Dickens and Beethoven are thought to have had bipolar disorder. The de-stigmatising effect of considerable media coverage could also be factor. As could its association with successful celebrities such as Stephen Fry, Kanye West and Carrie Fisher.

Figures like Fry – who made the revealing BBC television documentary, The Secret Life of the Manic Depressive – have used their positions to bring home the disturbing realities of the condition.

But it could be said that celebrities like West are skewing the perception of it in the public. For example, in a high profile interview with David Letterman, West said he “felt a heightened connection with the universe” when he was “ramping up”. Also, on his album Ye (which carried the banner I Hate Being Bipolar It’s Awesome) he refers to it as a “superpower”.

This is not to say that people are hoping to be diagnosed with a mental health condition. But it would seem from the most recent evidence that people who do have mental health issues, especially mood disorders, say they would rather be diagnosed with bipolar disorder than other conditions.

The fact is most people with bipolar disorder do not enjoy “a heightened connection with the universe”. Bipolar disorder is in fact a very destructive condition with a lifetime prevalence of suicide attempts of up to 30%, which is higher than for any other psychiatric disorder. During a depressive phase with low energy levels, poor concentration and negative thoughts, people struggle to maintain a normal level of functioning, nevermind display any behaviour likely to have them thought of as a creative genius.

Also, people in a state of elevated mood (a hypo-manic state) can engage in seriously socially embarrassing behaviour, such as being sexually dis-inhibited or while experiencing grandiose delusions may engage in excessive spending leaving them in financial difficulties. So the reality is that bipolar disorder can have negative as well as positive effects on people’s lives and can leave people in need of extended hospital treatment.

The often cited positive association with creativity is, at best, only part of the picture. Though people may have increased energy and believe themselves to be more creative, the reality of bipolar disorder is somewhat different for most people. When people’s mood becomes elevated they often find it difficult to concentrate on one task or train of thought. Such a state of mind may be conducive to creativity for some but cause chaos for others.

Researchers have argued that for some people it is the grandiosity associated with manic states that sustains them in their endeavours, no matter the opinion of others, helping some creative people through long periods of hardship where their works go unrecognised.

But other studies point out that many creative people are encouraged from childhood to concentrate their energies in areas where they are seen to have a particular talent, rather than being driven by some form of psychopathology. So the relationship between their mental health issues and artistic creativity is by no means clear. Even in artists who openly discuss their depression, like the writer Joseph Conrad, who referred to the “madness” in one of his most famous characters in Heart of Darkness.

One of the biggest dangers of an increase in desirability for bipolar disorder is that it could be leading to increased rates of misdiagnosis. This could mean people being treated for a condition they don’t actually have or not receiving treatment for one that they do. This is important because the mood stabilising drugs used to treat bipolar disorder carry the risks of significant side-effects. Some of the mood stabilisers are very harmful to foetuses, for example, and so should not be given to women of child-bearing age unless they are prepared to use contraception.

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Some are also very toxic in overdose and so require careful monitoring. These drugs should not be given to people where it is not clear they actually have bipolar disorder. The pressure to diagnose bipolar in those that don’t have it can also lead to conflict when doctors refuse to do so. Anecdotally, I have both seen and heard of this occurring in the teams across the city where I work.

It is no doubt true that the increased awareness of mental health issues brought about by anti-stigmatising campaigns and famous people talking about their mental health has had a positive impact on perception. But society must ensure that this does not lead to certain conditions becoming the one to have. It gives a false impression about the seriousness of those disorders and could have serious consequences if people are misdiagnosed.

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