2 days ago
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Trigger warning: suicide
March 30 is World Bipolar Day, observed on the birthday of Dutch painter Vincent Van Gogh, who was posthumously diagnosed as likely to have had bipolar disorder. Birthed by the International Society for Bipolar Disorders (ISBD), the International Bipolar Foundation (IBPF), and the Asian Network of Bipolar Disorder (ANBD), it seeks to “bring world awareness to bipolar disorders and to eliminate social stigma and discrimination” and promote the latest treatments.
Behind Rhea’s façade of control was a mind that never stopped spiraling, swinging between overwhelming highs and soul-crushing lows.
One night a decade ago, Rhea (not their real name) took sixteen tablets of Benadryl. “I planned it,” she says. “My girlfriend wanted to break up with me. I just wanted to never wake up.”
Then, the panic. Her body rebelled against her mind’s decision. And suddenly, in the haze of it all, she called her girlfriend. She doesn’t remember what she said exactly. But it was enough. Help arrived. She was rushed to the hospital, where doctors stabilized her.
It wasn’t the first time. She had, in the past, tried to commit suicide several times — always planned.
After careful assessment in the span of a year, Dr. Jannel Cleto of Medical City diagnosed Rhea with bipolar II disorder — a condition that made her experience extreme mood swings, from hypomanic highs to debilitating depressive episodes. Unlike bipolar I, where manic episodes can be severe and even psychotic, bipolar II is often mistaken for regular moodiness or depression, making it harder to diagnose.
Dr. Cleto says, “Bipolar II is most often mistaken especially in the beginning as depression or major depressive disorder. That’s why there are also patients where antidepressants don’t help. Some would say it even the worsened their mood and even worsened suicidal thinking. Maybe because there’s a higher possibility that the patient actually has bipolar II.”
Dr. Cleto explained that Rhea’s hypomanic episodes — where she would feel energetic, inspired, and hyper-focused—were deceptive. “During these periods, people often feel like they’re invincible,” she says. “But what follows is the crash — a depressive episode that can feel impossible to climb out of.”
Rhea had spent years misinterpreting these patterns. She was fighting an illness she didn’t know she had. Medication was the first step. Rhea was prescribed a mood stabilizer known to help with bipolar depression.
Unlike traditional antidepressants, which can sometimes trigger manic episodes in bipolar patients, her mood stabilizer helped regulate her mood swings. She also started taking a low-dose antipsychotic. Dr. Cleto explains, “The dose of the medicines needs to be thoroughly considered. It has to be at the dose that can address the hypomania or mania which usually are higher doses compared to if they have depression or bipolar depression — usually at lower doses.
What you can expect with bipolar patients is when they have a maintenance or when they have maintenance medications, the doses aren’t expected to always be the same. For example, unlike in hypertension, where you can go for years having the same dose, for bipolar disorder, since they have episodes such as depression, mania or hypomania, you might have to change the doses of the medications.”
At first, Rhea struggled with accepting medication. “I didn’t want to depend on pills,” she admits. “But then I realized — if I had diabetes, I wouldn’t refuse insulin. Why was I treating my mental illness any differently?”
Dr. Cleto says, “For some, bipolar disorder or any mood disorder is a weakness of character: you’re not resilient. But we have to understand that the brain is also an organ, just like, of course, the heart, the lungs, the kidneys, and that things can also be imbalanced.
Or there are things in the brain or there are aspects in the brain that are also working not right all the time. So sometimes I tell my patient, that’s also why psychiatrists are doctors, that’s also why we give medications. Because mental health conditions are really medical conditions.”
Rhea held a corporate job for several years — and excelled, especially during manic phases — but recently quit due to stress. She went from being on five medications at the beginning of her therapy a decade ago to just one at the moment. Therapy became a regular part of her life.
In her sessions, she learned how to recognize triggers and the causes of her actions. Her life has improved overall. Some days, she still finds herself compulsively shopping online or speaking a little too fast because she has so many thoughts in her head at once — both of which are symptoms of her mania.
Dr. Cleto says, “There are many things that we had to work on with Rhea, since she has tendencies of borderline personality disorder with her suicide ideation and her black and white thinking. She underwent dialectical behavior therapy, but not the formal kind.
It’s what we call ‘eclectic,’ a type of therapy that includes concepts of dialectical behavior therapy and cognitive behavior therapy. With dialectical behavior therapy, she had to address the black and white tendencies so that she would become more open, more balanced in her thinking.
And what I also observed in Rhea previously, she couldn’t really handle being alone. She always had to be with her mom or with someone, especially when she was going out. But as the years passed by, she became more independent and also more self confident. And she didn’t rely so much already on her partner or relationships to feel better about herself. So in many ways, she has also matured.”
Rhea has a strong support system, which helps her tremendously. Her family doesn’t mind her in the morning until she speaks first; they want to make sure her mood is stable and not cause any upset. If Rhea needs extra funds, her parents are the first to help, particularly when it comes to her therapy and her medications.
Dr. Cleto stresses the importance of family: “The help of family is very important, especially in accepting acceptance of the illness. For example, for Rhea, her family, especially her mom, has always been there for her and has always encouraged her to the point also that when there were times before that she was depressed or suicidal, her mom even kept her medications for her because of the risk that she was going to overdose again.
The family understands that whenever the person with bipolar disorder has an episode, they would be irritable. They would, for example, for depression, have difficulty functioning, or if they have mania or hypomania, they would easily get angry or cause fights. They understand that it’s the bipolar part that they’re seeing, not necessarily the patient herself.”
She takes her medication every day. She practices self-compassion, reminding herself that healing isn’t linear. And most importantly, she has learned to separate herself from the illness.
I am not my bipolar disorder. I am not my past attempts. I am still here.
Private vs. public healthcare for bipolar patients
Dr. Cleto discusses another important aspect in managing the disorder: government support, and mental health promotion in our hospitals.
The doctor says, “The mental health law is very important since one of its objectives is to also make mental health of course available to everyone. So right now with government hospitals, we can see that there is effort to increase the mental health services. There are several government hospitals that also offer outpatient services.
Usually these are run by resident doctors in training among psychiatry residents. In government hospitals, actually, help is very accessible if you fit the criteria for having bipolar disorder. You can say you need to see a doctor because you might have to switch up your medicine because you’re going through hypomania.
And if you want therapy, sometimes they can refer you to the psychology department. Many times, though, they won’t be able to give you much time, unlike of course with a private psychiatrist.”
Support groups can be sought out too, which build a sense of community and harness solidarity among those who suffer from the disease. One of these is called Mood Harmony in Makati Medical Center.
Mood harmony: two decades of mental health support and community
For 20 years, Mood Harmony has been more than just a support group — it has been a lifeline for individuals facing mood disorders, offering guidance, solidarity and a renewed sense of control over their lives.
Founded in 2005 by Dr. Maria Teresa “Dido” Gustilo Villasor, chief psychologist at Makati Medical Center, and Dr. Elizabeth Rondain, a psychiatrist, the group emerged from hospital-based psychoeducation lectures and the realization that many patients sought a deeper sense of community.
What began as a small gathering for individuals with depression soon expanded to include those living with bipolar disorder and anxiety, creating a dynamic support network. The main facilitator is Dr. Johanna Sison, a psychologist and guidance counselor. The group meets twice a month for structured psychoeducation sessions and sharing circles, where members exchange experiences and emotional support.
Mood Harmony operates on clear principles that ensure its effectiveness and longevity. “A support group does not replace therapy,” explains Dr. Sison. “It complements psychiatric care, counseling, and psychotherapy. We are here to support that journey, not substitute it.” This distinction helps members balance professional treatment with the emotional reassurance that comes from shared experiences.
Beyond emotional support, Mood Harmony emphasizes self-care as a key to stability. Members are encouraged to follow the H.E.N.S. framework — Hygiene, Exercise, Nutrition, and Sleep — as fundamental pillars of mental wellness.
Over the years, Mood Harmony has evolved into more than just a support group — it has become a thriving community. Its members, spanning from teenagers to retirees in their 80s, have built strong bonds, offering encouragement and friendship across generations.
As Mood Harmony enters its third decade, its mission remains clear: to break the stigma surrounding mental health and to remind individuals that their condition does not define them.
With continued support, education, and an unwavering sense of community, the group stands as a powerful testament to the fact that healing happens not in isolation, but together. – Rappler.com
The Department of Health also has national crisis hotlines to assist people with mental health concerns: 1553 (landline), 0966-351-4518, and 0917-899-USAP (8727) (Globe/TM); and 0908-639-2672 (Smart/Sun/TNT).
