The truth behind bipolar disorder

On World Bipolar day, we pause to sit with a condition that is far more than its clinical name suggests, far more common, and far more misunderstood, than most people know.

By the numbers

Bipolar disorder is not a rare edge case. It is one of the most prevalent psychiatric conditions on the planet, and one of the most underdiagnosed. An estimated 54 million people worldwide are living with bipolar disorder today, with the condition affecting roughly 2.4% of the global population across the bipolar spectrum, according to the WHO World Mental Health Survey. Since 1990, its prevalence has risen by nearly 59%, a shift largely attributed to population growth and improved diagnostic awareness rather than a sudden surge in cases. What’s often overlooked is how early it begins: the average age of onset for bipolar I is around 17, meaning many first experience its symptoms during adolescence, at a time when emotional instability is often dismissed as part of growing up.

In Lebanon specifically, the WHO's landmark LEBANON survey, the only Arab country included in the WHO World Mental Health Survey Initiative, found that 17% of Lebanese adults met criteria for at least one mental disorder in a given year, with mood disorders among the leading categories. The treatment gap, however, is stark: only about 11% of those with diagnosable mental disorders in Lebanon received any treatment at all.

Raghida Melki: "Emotional regulation is not just an individual responsibility, it’s a collective one.”

Psychologist Raghida Melki describes bipolar disorder not as a simple fluctuation in mood, but as a condition defined by emotional extremes that reshape a person’s inner world.

Bipolar disorder is a condition that involves shifts in mood, periods of depression and episodes of mania or hypomania.

Each state carries its own weight. “During depressive episodes, a person may feel low, exhausted, disconnected, and unable to find pleasure.” In contrast, manic or hypomanic phases can feel almost intoxicating, “an intense surge of energy, like they aree ‘on top of the world,’ with heightened confidence, reduced need for sleep, and increased impulsivity.”

Yet what exists clinically as a spectrum of symptoms is often flattened socially into misunderstanding. Melki points to a persistent tendency to dismiss those experiencing bipolar disorder as “dramatic or overly emotional,” a framing that strips the condition of its seriousness and isolates those living within it. “This is not the right way to understand it,” she says. What is needed instead is recognition and timely intervention. “What truly helps is when individuals seek professional support… whether through therapy, medical guidance, or structured support systems.”

But in Lebanon, the challenge deepens. Bipolar disorder does not exist in a vacuum; it exists within a country where stability itself is fragile. “War doesn’t only destroy buildings or harm people physically, it also disrupts systems of safety, stability, and routine,” Melki notes. And for those living with bipolar disorder, routine is not a luxury, it is a lifeline.

Stability is essential, things like daily routines, sleep patterns, and stress management.

Which is why, Melki insists, the response cannot be individual alone. “Emotional regulation… is not just an individual responsibility, it’s a collective one. We need to support each other, maintain small daily routines, and create safe emotional spaces for those who are struggling.”

Living with Bipolar: Matt Rahi’s story

Matt Rahi, a patient living with bipolar disorder in Lebanon, shares a candid glimpse into the realities of life with the condition. For Matt, it took three to four years before he received a proper diagnosis from a psychiatrist capable of accurately identifying his condition. “It’s a very long process… with questionnaires and evaluations to really understand what’s going on. After that, the diagnosis takes place, which is another step,” he recounts.

Treatment, he emphasizes, is not straightforward.

The treatment plan was both medication and therapy. However, bipolar is different from case to case; not one medication works for everybody.

He highlights a common challenge for patients: “Sadly, some people withdraw because it’s not working, they think it’s not working and have a down episode again. Proper follow-up and commitment are essential… for chronic bipolar disorder, medications are usually lifelong.” Therapy, he adds, can eventually conclude, but by that stage, “you know yourself, your triggers, and can manage independently.”

Matt vividly describes the destabilizing impact of the disorder. “One word: destabilizing. It can destabilize your job, your relationships. Shifts happen automatically, without warning. Bipolar I comes with very manic episodes and depression, while bipolar II, which I have, involves smaller manic episodes. You might see hyperactivity, high energy, less sleep, but not extreme behavior, until you crash into depression. Life becomes unpredictable; nothing is stable.” This instability, he explains, can profoundly affect work and personal life: “You can lose a job if off medication or neglecting self-care… relationships can suffer, you might withdraw, leave people, or even distance from family. Mood swings can be extreme and destabilizing.”

Matt also addresses misconceptions about the illness. “Many confuse it with borderline personality or daily mood swings. This is not about liking someone or a temporary mood fluctuation. Bipolar is chronic, affects brain chemistry, energy, and perception. It’s not moodiness. Imagine having the flu, then suddenly being the most energetic person, fluctuating every few weeks. Most of the time, it’s beyond control, especially early on or before diagnosis.”

Looking back on his journey, Matt offers a message of resilience and hope:

What you’re going through is extraordinary and challenging, but don’t let it define you. Eventually, you realize life is life, everyone has challenges, and this will no longer define your identity.

What this day is asking of us

World Bipolar Day asks for precision, in language, in listening, and in care. Precision in language means refusing the casual, diminishing use of the word. Precision in listening means taking seriously what people say about their own inner experience, without rushing to reframe it as weakness or drama. And precision in care means recognizing that stability is a practice, sustained by medication, therapy, community, and the slow work of self-knowledge.

Persistence, ordinary and extraordinary at once, is what millions of people with bipolar disorder do, quietly, every day. Today is a good day to notice.