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Mind Over Matter Bhutan

My mother has been suffering from Bipolar disorder for the last 24 years. We are a family of four and have been dealing with this for a long time now. The situation is unbearable at times. She also happens to be the first patient to be treated with electro convulsive therapy (ECT).

My first question is, will I or my younger sister be affected with the same disorder since I find myself being stressed and at times forgetting things? 

Another question is, how well-equipped is our country to deal with the mental illness for better care and recovery. Aren’t we lagging behind? I am concerned because I believe that apart from my mother’s mental health, even our (the rest of the family’s) mental health is important.


It is unfortunate that your mother has Bipolar Affective Disorder, which is a mood disorder. Sometimes, the mood becomes very high and elated and such patients become hyperactive, reckless, disinhibited and over-confident. Sometimes, their mood becomes low, depressed and suicidal. At other times, they remain normal and carry on with their normal lives. Just like your mother, many of them marry and carry on with normal lives. About 1 – 2 percent of the population suffer from this condition. It is a chronic relapsing mental disorder. However, majority of the patients can live normal lives if they take regular treatment.

Genetic factors account for about 60 to 80 percent of the cause of bipolar disorder. That means that heredity isn’t the only cause of bipolar disorder. It also means that if you have a family history of the disorder, you won’t definitely develop it. Most family members of someone with bipolar disorder won’t develop the condition.

Therefore, it is not necessary that just because your mother has the condition, you or your siblings will also suffer the same disorder. Stress, lack of coping skills and social support are other causes of Bipolar Affective disorder. When patients remain well, it is advisable that they continue to take small doses of the medicine in order to prevent major relapse.

When relapses happen, patient needs to take increased doses. Two types of medicines are given to Bipolar Affective disorder patients – mood stabilizer drugs to stabilize their mood, and antipsychotic drugs to calm their nerves and regulate their sleep.

Rarely, Electro Convulsive Therapy (ECT), which is passing small amount of electric current into the surface of the brain is given to such patients, when they are severely ill or when they are not responding to medications. ECT is given under anesthesia and does not cause any pain or discomfort to the patient. It is a very safe treatment with very little side effect. Some patients develop temporary forgetfulness after the procedure. But they are not permanent or long lasting side effect.

I can understand your stress and frustration of having to look after your mother and her treatment. You should look after your own health so that you can help your mother. If you have any symptoms, you should seek help from our health workers. We are fortunate in Bhutan that our patients are getting the state of the art treatment in mental disorders provided free by the government. Such treatments are available in all hospitals in Bhutan.

It is not necessary for every patient to come to JDWNRH for treatment. If local doctors have problem with diagnosis or treatment of such patients, they can consult psychiatrists in Thimphu over phone, or other channels of communication.

We are fortunate that our country is now well connected through various channels of communication such as mobile phones and internet.

I would encourage you or any of your family members to consult health workers if you have any symptoms suggestive of mental disorder. It is always better to treat when the disorder is small and acute rather than when it becomes severe and chronic. I wish you and your family well.


Kuensel will feature Q & A with retried psychiatrist Dr Chencho every first Saturday of the month

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