Bipolar disorder, a complex mood disorder marked by dramatic oscillations between depression and mania, affects an estimated 40 million people worldwide. It is a condition that not only tests individuals’ emotional resilience but also challenges the medical community in its search for effective, personalized treatments. In a recent episode of NPR’s podcast Short Wave, a renowned psychiatry professor from Johns Hopkins School of Medicine—herself living with bipolar disorder—opened up about her diagnosis, daily management, and the latest advancements in treatment. Her dual role as scientist and patient offers a rare, deeply personal, and scientific insight into a condition that remains stigmatized and often misunderstood in many societies, including Thailand.
The story is particularly significant for Thai readers, who face cultural and systemic barriers to mental health care. Mental illnesses such as bipolar disorder remain highly stigmatized in Thai society, with misconceptions causing many to remain undiagnosed or untreated. As rates of psychiatric conditions rise globally and recent research sheds light on both traditional and novel approaches to treatment, understanding bipolar disorder has never been more urgent. Thai families, educators, employers, and public health officials can benefit from the latest science and learn from international experiences to address these local challenges.
Bipolar disorder—formerly known as manic depression—is characterized by cycles of depression and periods of abnormally elevated mood, known as mania or hypomania, which may last from days to months. During a manic phase, an individual may exhibit excessive energy, impulsivity, and poor judgment, sometimes accompanied by psychosis. In contrast, depressive episodes bring profound sadness, hopelessness, and fatigue. According to recent consolidated estimates, about 1–5% of the global population is affected, and the condition ranks among the top 20 causes of disability worldwide, with a high risk for suicide: 6% die by suicide over a 20-year period, and about a third attempt it during their lifetime (Wikipedia).
Both genetic and environmental factors contribute to the risk, with genetics accounting for as much as 70–90%. Children with a family history, those exposed to childhood abuse, and individuals subjected to chronic stress are at particularly high risk (Wikipedia). Diagnosis typically involves identifying at least one manic or hypomanic episode, often coupled with depressive episodes. Medical testing can rule out other explanations for these symptoms, such as substance use or other psychiatric disorders.
A key narrative emerging from the Short Wave interview is the importance of individualized, scientifically backed approaches to treatment and self-management. The Johns Hopkins professor, who authored the widely acclaimed memoir “An Unquiet Mind,” shared her struggles in navigating both the emotional turbulence of the disorder and the side effects of medications, especially lithium—a commonly used mood stabilizer legendary in psychiatric treatment but also notorious for complex side effects and monitoring requirements (NPR).
In the treatment landscape, lithium remains a primary choice for stabilizing mood and preventing relapse, but side effects often limit its use. Recent research is exploring “next-generation” lithium formulations designed to be safer and more tolerable (Healio). Other medications, such as anticonvulsants (lamotrigine, valproate) and atypical antipsychotics (quetiapine, olanzapine, aripiprazole), are also mainstays, while psychotherapy serves as a vital component of long-term management (Wikipedia). However, the use of antidepressants is controversial due to the risk of triggering mania—highlighted by both clinical research and personal accounts. For severe or treatment-resistant episodes, electroconvulsive therapy (ECT) is still considered effective (Wikipedia).
Notably, the professor emphasized that self-management tools—including rigorous sleep schedules, supportive community networks, and therapy—are crucial for maintaining stability. She underscored the importance of destigmatizing mental illness, advocating for patience from loved ones, and encouraging people with bipolar disorder to seek help early, rather than waiting for symptoms to escalate.
These insights are echoed in the 2024 and 2025 research findings. For instance, a recent study published in the US Pharmacist highlights “alternative pharmacotherapies,” including the repurposing of classic drugs like ketamine and scopolamine for mood stabilization (US Pharmacist). Meanwhile, evidence is growing for non-traditional treatments such as repetitive magnetic brain stimulation, which may reduce treatment time and provide new options for those who don’t respond to medication (Science Daily; Penn Medicine).
One of the most promising frontiers is genetics and personalized medicine. In early 2025, a global study identified genetic “signatures” linked to bipolar disorder, paving the way for more targeted therapies in the future (News Medical; Keck School of Medicine USC). Thai researchers and clinicians are taking note, with efforts underway to adapt these findings to the unique socioeconomic and cultural context of Thailand. Experts at leading Thai psychiatric hospitals stress the necessity of public education, early intervention programs, and integration of mental health services with primary care.
Thailand’s approach to mental health, while improving, faces significant challenges. Public hospitals in Thailand provide some psychiatric support, but there remains a shortage of trained mental health professionals, especially in rural provinces. Furthermore, Buddhist cultural perspectives, while potentially supportive of meditation and mindfulness for stress management, can sometimes perpetuate stigma by interpreting mental health conditions as spiritual weakness or the result of “bad karma.” Psychiatrists at Thailand’s largest mental health institutes have called for ongoing campaigns to destigmatize all psychiatric disorders, promote help-seeking behavior, and better educate both the public and healthcare workers about the biological basis of these illnesses.
For families, awareness of the symptoms—especially early signs in teenagers and young adults—is critical. As mood disorders typically manifest between the ages of 20 and 25 and can have lasting effects on education, work, and family life, Thai educators are encouraged to collaborate with parents and mental health professionals to provide supportive environments and appropriate referrals. According to preventive health officials, around one-quarter to one-third of people with bipolar disorder face profound financial and social difficulties, which places further emphasis on the need for holistic care that includes vocational, financial, and social support (Wikipedia).
Recent Thai government initiatives have begun piloting digital mental health platforms and community outreach programs, aiming to better reach at-risk populations. Learning from global best practices and integrating personal stories like that from Johns Hopkins, Thai policymakers and healthcare managers are increasingly focused on reducing barriers to care and improving access to modern medications and therapies.
Looking ahead, the future of bipolar disorder treatment—both in Thailand and globally—appears promising but demands coordinated efforts. Novel medications and brain stimulation therapies are likely to supplement, rather than replace, established approaches in the coming years. Genetic research will contribute to individualized medicine, but ensuring equitable access remains a challenge, particularly in resource-limited settings. Cultural change—destigmatizing mental illness and supporting affected individuals and their families—will be crucially important in improving outcomes.
Actionable recommendations for Thai readers include seeking reliable information about bipolar disorder from trusted sources, such as the National Alliance on Mental Illness, the Depression and Bipolar Support Alliance, and respected psychiatric institutions. If you or someone you know displays symptoms of bipolar disorder, do not hesitate to reach out to mental health professionals for assessment and support. Families are encouraged to educate themselves, provide consistent emotional backing, and advocate for integrated care from medical, educational, and community service providers. Workplace leaders can develop mental health support policies and break the silence around psychiatric conditions.
Above all, remember that, as the professor and many other experts attest, living well with bipolar disorder is possible. Thailand’s journey in modernizing its mental health care system—and reshaping social attitudes—will be accelerated by compassion, science, and a shared commitment to the well-being of all.
Sources:
- NPR: Bipolar disorder treatment, lithium, and lived experience (2025)
- Wikipedia: Bipolar disorder
- US Pharmacist: Current and Emerging Therapies for Bipolar Disorder (2024)
- Penn Medicine: New therapy reduces treatment time for bipolar disorder (2024)
- Science Daily: Bipolar Disorder News (2024)
- News Medical: New genomic insights could transform bipolar disorder treatment (2025)
- Keck School of Medicine USC: Brain signatures of bipolar disorder (2025)
- Healio: Next-generation lithium treatment for bipolar disorder