Psychiatrist and professor Annemiek Dols views mental health as a continuum on which everyone strives to maintain balance. In her inaugural lecture, “Tightrope walking”, she calls for greater understanding of people living with mood dysregulation disorders, such as bipolar disorder. To better support them, she emphasizes the need to reduce stigma and provide care tailored to each patient’s individual needs.
A poor night’s sleep, falling in love, or the disruption of jet lag—according to Annemiek Dols, Professor of ‘Personalized Psychiatric Care for Severe Mood Disorders’, these experiences resemble what people with mood disorders go through, only in a much more intense and prolonged way.
“Ladies and gentlemen, we are all tightrope walkers,” she said during her inaugural lecture. “All of us are trying to maintain balance between extremes, but some of us are doing so on a very thin rope or while facing strong gusts of wind.”
This insight can help society better support people with mood disorders such as bipolar disorder. Many individuals living with these conditions feel ashamed of their symptoms, avoid discussing them, or delay seeking professional help.“Stigma serves a purpose: it creates distance. ‘He or she is different, weak, crazy, and so on,’” Dols explains. “In other words: ‘That could never happen to me.’”
She therefore advocates for greater understanding and less judgment. By reflecting on our own experiences, we can better appreciate what people with bipolar disorder are going through.“An open, non-judgmental attitude from us—the people around them—can help reduce stigma. As a result, individuals can receive more support and understanding. That is vital.”
Mental well-being is not the only concern for people with bipolar disorder. The condition also has major consequences for physical health. On average, these patients die 10 to 15 years earlier than the general population and are three times more likely to develop dementia.“We call this accelerated aging,” Dols says. “Their biological age is higher than the age listed in their passport.”
However, she stresses that it is too early to conclude that bipolar disorder alone causes accelerated aging. “We see that people with this condition are more likely to be exposed to factors that also affect physical health, such as stress, smoking, and obesity. That is why it is important to pay greater attention to lifestyle and physical health within psychiatric care.”
Providing care that aligns with a patient’s personal needs is equally important. Medication often forms the foundation of treatment. At the same time, population studies show that a large group of people with bipolar disorder do not use these medications. Dols aims to better understand who these individuals are and how they manage mood fluctuations.
She also wants to look beyond medication alone. “Treating bipolar disorder requires more than medication, including psychotherapy, social support, and meaningful daily activities,” she says. “To give patients greater control over their treatment, we need long-term, large-scale research. This will help us better understand who can safely reduce or discontinue medication, when this is possible, and how to do so responsibly.”
A second research line focuses on electroconvulsive therapy (ECT), an effective treatment for people with severe mood disorders. Yet ECT is often only used after other treatments have failed. According to Dols, this raises an important question: why do we reserve such an effective treatment as a last resort?
Together with colleagues, she studied nearly 2,000 people who received ECT for depression. Based on these data, the researchers developed a tool that predicts which patients are most likely to respond well to treatment, using factors such as age and medication use. “We now want to bring this tool into clinical practice,” Dols says. “Our ultimate goal is to move toward treatment recommendations tailored to the individual patient.”
