Estimations indicate that worldwide, about 29.5 million people have bipolar affective disorders (WHO, 2017). Significant studies have been conducted globally on bipolar disorders (Chatterton et al., 2017; Fristad & Goldberg, 2003). However, little has been done on the African perspective of the disease (Mvingire, 2019). The chapter will begin with the background, followed by bipolar disorder as understood in the Eurocentric paradigm, bipolar as understood in an Afrocentric paradigm, then the effects of bipolar disorder, management of bipolar disorder, summary and finally the conclusion. To this end, the objectives of the chapter are to:
Definitions of Bipolar Disorder
Bipolar disorder, “also known as manic depression is a brain disorder that causes unusual and extreme shifts in a person’s mood. It can affect their energy levels and ability to function” (Aiken, 2010:17). Hence, it places a major burden on individuals and the wider community. Similarly, others, (Khiari, Ouali, Zgueb, Mrabet, & Nacef, 2019; Grover, Hazari, Aneja Chakrabarti & Avasthi, 2016; Bhagwagar & Goodwin, 2004) define bipolar disorder as a serious/severe, chronic and disabling mental illness. Belmaker (2004) views bipolar as one of the most distinct syndromes in psychiatry. Bipolar disorder has been described in numerous cultures over the course of history (Belmaker, 2004:476). Most people have normal ups and downs, but the mood shifts are severe in a person with bipolar disorder. It is not yet fully understood what causes bipolar. Although it is not always the case, the condition can run in families. While it can occur at any age, it typically develops between 18 and 24 years. It is relatively common, with a prevalence of one (1) person in 100 being diagnosed (Aiken, 2010:17). Bipolar disorder is a long-term illness requiring careful management throughout a person’s life. From the time of diagnosis to learning how best to cope with the ups and downs, it may take a long time (Aiken, 2010:17).
However, in Africa, there is little documented on bipolar per se. Other than a condition, it is viewed as a strange and difficult disease likened to madness, for lack of a better diagnosis (Yen & Wilbraham, 2003). In South Africa, mental health care, of which bipolar is one, makes daily practice in dealing with patients who, for various reasons, are difficult to understand, as a struggle (Yen & Wilbraham, 2003). While in the Eurocentric paradigm bipolar disorder is defined using DSM-5 (APA, 2015), in the Africentric paradigm it is very difficult and complex to diagnose bipolar disorder. Parle (2003) reports that historically, there is relatively little known about African conceptions of mental illness in the late nineteenth and early twentieth centuries. One wonders whether witchcraft or madness could be considered a phenomenon that is being dealt with. In the article, “African psychology and the Africentric paradigm to clinical diagnosis and treatment”, Nwoye (2015) states that when confronted with the needs and problems of Black African clients with difficult illness presentations (e.g. mental illness [in this case bipolar]), clinicians in some regions of Africa should use African psychology. This generally aims to enable the recognition of the strengths and limits of Western Psychology (Nwoye, 2015).