Mental health disorders and the awareness surrounding them have been frequent topics of discussion recently, resulting in numerous studies, initiatives, and policies to tackle this increasingly important and costly issue.
Though not as common as others such as major depressive disorder and generalized anxiety disorder, it has been estimated that over 3% of Canadians will meet the criteria for bipolar disorder at some point during their lifetime. In the United States, one study estimated the economic “burden of” (or costs associated with) bipolar disorder as being nearly $200 billion.
However, there are also promising signs. A recent study by researchers at the University of Toronto suggests that over 40% of Canadians who are diagnosed with bipolar disorder will eventually be free of all symptoms, and around 25% will achieve what researchers refer to as Complete Mental Health (CMH).
The spectrum of recovery
The study highlights that while there is an extensive body of research on the remission of bipolar symptoms, not many studies have investigated beyond that — including more holistic frameworks of recovery. In addition to the outcome criterion of remission from bipolar disorder, two other criteria are presented.
The first — absence of psychiatric disorders (APD) — encompasses not only a remission from bipolar disorder, but from all related disorders, including other mental disorders, substance use disorders, and suicidality. The second — complete mental health — also captures measures such as life satisfaction, happiness, and psychological flourishing, in addition to remission from mental and substance use disorders.
To understand the extent to which Canadians diagnosed with bipolar disorder experience these outcomes, the researchers utilized secondary data from 2012 Canadian Community Health Survey – Mental Health administered by Statistics Canada. Specifically, they included data from over 21,000 respondents that had answered questions regarding lifetime disorder. Of this group, they extracted a second group of 555 respondents who had been diagnosed with bipolar disorder.
They then analyzed factors associated with the three outcome variables mentioned above: 1) remission from bipolar disorder within the past 12 months, 2) APD within the past 12 months, and 3) CMH. The factors measured included socio-demographic variables, adverse childhood experiences, socioeconomic factors, social support factors, debilitating chronic pain, and coping strategies.
The results
While the percentage of respondents diagnosed with bipolar disorder who experienced complete mental health was significantly lower than those without the disorder (74%), the study still found that nearly 25% met the criteria for CMH. Additionally, 44% had experienced remission from bipolar disorder and 34% had experienced remission from all mental disorders.
Those with a history of bipolar disorder were more likely to have experienced adverse childhood experiences, generalized anxiety disorder, or substance abuse. Of the factors investigated by the researchers, those associated with CMH among individuals with a history of bipolar disorder included higher household income, being married, using spirituality or religion-based coping strategies, having a confidant to talk to, and being free from chronic pain or substance abuse.
While the research team acknowledges some limitations, including the the absence of personality disorders or schizophrenia from the survey, and the potential presence of social desirability bias, they conclude that these results can assist with “foster[ing] a comprehensive understanding of remission and recovery from bipolar disorders.”
