Mental Health

Mandy Kloppers

The lack of research into suicide that’s destroying too many bipolar lives

Dr Tania Gergel

In an article published on Friday (14 June) in The Lancet Psychiatry, the Director of Research at Bipolar UK, Dr Tania Gergel, together with Dr Frances Adiukwu and Professor Melvin McInnis from the ‘Global Bipolar Cohort’, highlights the urgent need for increased resources to research and prevent bipolar suicide.

Suicidal thinking is a recognised symptom of bipolar. Globally, approximately 15–20% of people with bipolar disorder die by suicide, with another 30-60% making at least one attempt.

Attempts amongst those with bipolar experiencing suicidal episodes are also more lethal than attempts among the general population.

Yet, it remains an area of research that is underfunded and under-resourced, says Dr Gergel, adding: “Suicide deaths are a major contributory factor in premature mortality from bipolar disorder, which occurs up to 20 years earlier than within the general population.

“Nevertheless, neither bipolar disorder nor suicide in people with bipolar disorder are research priorities, resulting in major knowledge gaps in both. This can and must change.

“Suicide prevention and research are substantially under-resourced. Despite the specificity and scale of suicide in people with bipolar disorder, substantial knowledge gaps remain, resulting in few evidence-based clinical interventions.”

Through the report, Dr Gergel highlighted a range of known risk factors for suicide for those with bipolar, including previous suicide attempts, long episode duration, and family history.

Despite the obvious correlation, and recognition of suicidal thinking as a symptom, people with bipolar are often seen to have a “low risk of suicide” even in the weeks leading to a death.

Dr Gergel says, “This discrepancy suggests major gaps in understanding suicide in people with bipolar disorder, including divergence between clinical understanding and lived experience.”

Dr Gergel says that in the short term, research to improve our understanding will lead to better recognition and care using currently available clinical treatments. She also explains why it is so important that this research draws on the lived experience of people with bipolar who have themselves experienced suicidal episodes.

Using the example of her own lived experience of bipolar, she illustrates how improved understanding can help manage risk, and advocates for the use of Advance Choice Documents where level of risk and key indicators of illness severity, impaired decision making, and risk can be outlined.

In the longer term, she calls for more research to develop more effective treatments for bipolar and in turn save lives, concluding, “The high human cost of suicide in people with bipolar disorder and the current impasse create a moral imperative to advance and embrace opportunities for increasing survival.”

CEO of Bipolar UK, Simon Kitchen, added: “Bipolar is a complex mental health condition characterised by extended periods of extreme highs, depressive lows and mixed states.

“Dr Gergel’s article in The Lancet Psychiatry is a stark reminder of the high risk of suicide in people living with bipolar and highlights the urgent need for more understanding and research to prevent more lives being lost.

“The message we want to get out to anyone who’s struggling with any bipolar symptoms – including suicidal thinking – is that we are here.

“Anyone affected by bipolar can reach out our friendly peer support team and get support from people who understand bipolar best: peer support groupspeer support line and eCommunity.

We also have lots of helpful resources, including our 20-minute eLearning course and Mood Tracker app. And are conducting and developing research into suicide in bipolar – if you or your loved ones have lived experience of bipolar and are interested in being involved, please join our Research Community.”

To read the article hereregister for free at The Lancet Psychiatry

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