Every year on World Bipolar Day, mental health professionals, families, and individuals living with bipolar disorder come together with a shared purpose: to build understanding around a condition that continues to be widely misunderstood, and in many communities, invisible.
Here in Kenya, bipolar disorder is too often mistaken for ordinary moodiness, a dramatic personality, or simply being too emotional. In other cases, its symptoms are interpreted through spiritual or cultural frameworks in ways that delay access to clinical care, sometimes by years. The consequences of that delay are not abstract. They show up in broken relationships, lost employment, repeated hospitalisations, and lives lived in unnecessary suffering.
This reflection is written not to lecture, but to open a window. Because before anything can improve, whether access, treatment, or the stigma that surrounds mental illness, people need to understand what bipolar disorder actually is.
What Is Bipolar Disorder?
Bipolar disorder is a clinical mood disorder characterised by significant, recurring shifts in a person’s mood, energy, and behaviour. These shifts are not the ordinary emotional fluctuations of daily life. They are prolonged, often intense, and they disrupt functioning in meaningful ways.
At its core, the condition involves two poles: episodes of elevated mood and heightened energy, known as mania or hypomania, and episodes of depression. These two states feel so opposite to each other that people close to someone with bipolar disorder often describe the experience as living with two different people.
During an elevated episode, someone may feel unusually energetic, euphoric, or irritable. They may sleep very little without feeling tired, speak rapidly, pursue multiple projects at once, or make impulsive decisions they later regret. During a depressive episode, the same person may struggle to get out of bed, feel empty or hopeless, lose interest in things they once loved, and find that even simple tasks feel impossibly heavy. Left unaddressed, these episodes significantly affect relationships, employment, sleep, and overall well-being.
Bipolar I and Bipolar II: Two Different Presentations
Bipolar disorder is not a single, uniform illness. It presents differently from person to person, and understanding those differences matters both for accurate diagnosis and for appropriate treatment. The two most commonly diagnosed forms are Bipolar I and Bipolar II, and their distinctions are clinically meaningful.
Bipolar I Disorder
Bipolar I is defined by the presence of at least one full manic episode, an intense period of elevated or irritable mood that lasts at least one week and significantly disrupts a person’s daily life. A person in a manic episode may have a dramatically reduced need for sleep while still feeling energized, experience racing thoughts and rapid speech that others struggle to follow, and hold inflated or grandiose beliefs about their abilities or importance. They may engage in impulsive or risky behaviour such as excessive spending, reckless decisions, or unrealistic plans. In severe cases, mania may include psychotic symptoms such as hallucinations or delusions.
Because the level of disruption can be significant, hospitalisation is sometimes necessary. A person can be diagnosed with Bipolar I even without a history of depression, though depressive episodes frequently occur alongside the condition.
Bipolar II Disorder
Bipolar II is often less dramatic on the surface, but it is no less serious. Instead of full mania, it involves hypomania, a milder and shorter period of elevated mood lasting at least four days. During hypomanic periods, a person may seem more productive, sociable, or energised than usual. Because hypomania rarely leads to hospitalisation and can even feel pleasant, it is frequently overlooked or normalised by both the individual and those around them.
What defines Bipolar II is not the hypomania. It is the depression. Depressive episodes in Bipolar II are often severe and prolonged, and they are typically what drives people to seek help. This creates a clinical challenge: when someone presents with depression alone and has never mentioned the hypomanic periods, it is easy to misdiagnose the condition as major depressive disorder (Ndetei et al., 2009). That misdiagnosis matters because treatment approaches differ significantly between the two conditions.
Bipolar Disorder in the Kenyan Context
Mental health professionals across Kenya continue to see increasing numbers of individuals presenting with mood disorders, including bipolar disorder. The data, where it exists, is instructive.
Research conducted at Mathari National Teaching and Referral Hospital, Kenya’s largest psychiatric institution, found that while many patients showed meaningful improvement in their manic and depressive symptoms following treatment, fewer than half achieved full functional recovery (Wahome & Degu, 2026). In other words, symptoms reduced, but people were still struggling to return to the lives they had before. This points to something important: medication alone is often not enough, and sustained psychological and social support must accompany pharmacological treatment.
A separate study examining relatives of patients with bipolar disorder at a Kenyan referral hospital found elevated rates of psychotic and substance use disorders within those families (Katwa et al., 2024). This has implications not only for understanding the genetic and environmental dimensions of the condition, but for thinking about the family system as a whole. Families need support, not just the identified patient.
Stigma cuts across all of this. In many Kenyan communities, the behavioural symptoms of bipolar disorder, including grandiosity, impulsivity, and withdrawal, are interpreted through frameworks that delay or prevent clinical engagement. People seek prayers or traditional remedies, or they simply keep suffering quietly, because the idea of a mental problem carries shame (Ndetei et al., 2009). This is not unique to Kenya, but it has a particular texture here, shaped by culture, religion, and limited public awareness of what mental illness actually is.
Research on patients with bipolar disorder in Kenyan referral hospitals has also highlighted the additional burden of metabolic and movement-related complications associated with long-term psychiatric medication, an important reminder that physical health monitoring must accompany any treatment plan (Mumello, 2018).
Why Early Support Changes Everything
There is a well-established principle in psychiatry: the earlier a mood disorder is recognised and treated, the better the long-term outcomes tend to be. Not because early treatment cures the condition, but because it shortens the duration of untreated episodes, reduces the risk of relapse, and gives people tools to recognise and manage what is happening in their own minds.
Treatment for bipolar disorder typically combines medication, most commonly mood stabilisers, with psychotherapy, lifestyle support, and family involvement. The psychological component is not a supplement to the real treatment. It is central to recovery. Therapy helps people understand the nature of their condition, identify the early warning signs that a mood episode may be building, develop strategies for managing stress and sleep, and rebuild the relational and occupational ground that episodes may have disrupted.
With appropriate, sustained care, many people with bipolar disorder live stable, productive, and fulfilling lives. The condition is not a sentence. But it does require understanding, both from the person living with it and from the people around them.
Where to Seek Help
If you or someone you know has been experiencing persistent and unexplained mood changes, periods of unusual energy or reduced need for sleep, impulsive behaviour followed by stretches of deep sadness, fatigue, or withdrawal, these are patterns worth discussing with a mental health professional. You do not need to have all the answers before reaching out. A thorough assessment can help clarify what is happening, rule out other conditions, and open the door to the right support.
At Dove International Wellness Centre, we offer psychological assessment, individual counselling, and therapeutic support for individuals and families navigating mood disorders and other mental health concerns. We work with clients in a way that is grounded, compassionate, and culturally informed.
Seeking help is not a weakness. It is, quite often, the most courageous and practical thing a person can do.
A World Bipolar Day Reflection
Opil Sam
Psychologist
