Celebrated designer Kate Spade was found dead in her New York apartment this week in an apparent suicide that shocked the fashion world.
Her older sister Reta Brosnahan Saffo said that, while tragic, Spade’s death was “not unexpected”, claiming the 55-year-old had long struggled with bipolar disorder, People magazine reports.
Bipolar disorder is a common but serious mental illness characterised by intense mood swings that affects millions of people around the world.
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So what are the causes and symptoms, and is there a cure?
What is bipolar disorder?
Bipolar disorder is characterised by extreme shifts in mood and fluctuations in energy and activity levels that can make day-to-day living difficult, Medical News Today says.
“Previously known as manic depression, it is a serious mental illness that, if left untreated, can destroy relationships, undermine career prospects, and seriously affect academic performance. In some cases, it can lead to suicide,” the site explains.
What causes it?
Less is known about the causes of bipolar disorder than about many other mental disorders, but factors including genetics and hormone and brain chemical imbalances are understood to play a part in triggering the illness, according to mental health charity Rethink.
The charity says you are five times more likely to develop bipolar disorder if someone in your immediate family - such as a parent, brother or sister - has bipolar disorder. This risk is even higher if both of your parents have the condition or you have a twin with the condition.
Stressful life events, such as childhood abuse or the loss of a loved one, are also thought to be a trigger, increasing the risk of suffering depressive episodes.
What are the symptoms of bipolar disorder?
People with the illness suffer extreme mood swings, ranging from extreme highs (mania) to extreme lows (depression), with episodes lasting anywhere from weeks to months, according to the NHS website.
The mood swings suffered are far more severe and debilitating than those experienced by most people. Hallucinations can also be a symptom.
Some sufferers have clear mood swings, with symptoms of mania and then depression each lasting for several months, or with months of stability between them. Some spend months or even years in a “high” or “low” mood.
A “mixed state” is when a manic and a depressive episode happen at the same time. The person may feel negative, as with depression, but they may also feel “wired” and restless.
Some studies have shown that people with bipolar disorder may have enhanced creativity. However, mood swings can make it hard to maintain attention and follow through with plans, resulting in the person starting lots of projects but not finishing them.
An overactive thyroid gland can also mimic the symptoms of bipolar disorder, and it is important that this is ruled out by a blood test during diagnosis.
How many people suffer bipolar disorder?
An estimated 29 million people worldwide, according to latest figures.
In a 2016 NHS Digital survey, around 2% of the UK population screened positive for the disorder, says Bipolar UK.
The majority (60%) of people who screened positive were not receiving appropriate medication or therapy, while one in eight had unsuccessfully requested treatment during the previous 12 months.
How is bipolar treated?
There is no cure for bipolar disorder, but with treatment, many people with the condition can work, study and live a full and productive life.
Medication, talking therapies and changes to lifestyle choices such as diet and exercise can help restore a sufferer’s mental state to a functioning level, the NHS website says.
The site offers advice on coping with the disorder, and a range of helplines are available.
To talk to someone confidentially, you can call the Samaritans, free of charge, on 116 123.
