|
TeresahRN
26676 posts
back to top
|
|
|
TeresahRN
26676 posts
back to top
|
Bipolar Disorder Fact Sheet
All of us experience changes in our moods. Some days we might feel irritable and frustrated; other days, we’re happy and excited. However, individuals with bipolar disorder experience severe mood swings that impair their daily life and negatively affect their relationships.
Approximately 2.6 percent of American adults have bipolar disorder (formerly called manic depression and manic depressive disorder), according to the National Institute of Mental Health. These mood swings include “highs” (mania), when individuals feel either on top of the world or on edge, and “lows” (depression), when they feel sad and hopeless. Suicide attempts are common in bipolar disorder, especially during depressive episodes.
Bipolar disorder can be effectively treated with medication and psychotherapy. With proper treatment, individuals with bipolar can lead fulfilling, productive lives. This is why it’s so important to recognize the symptoms and see a mental health professional for an evaluation.
What Causes Bipolar Disorder?
There is no single cause for bipolar disorder. Indeed, like all psychological disorders, bipolar disorder is a complex condition with multiple contributing factors, including:
•Genetic: Bipolar disorder tends to run in families, so researchers believe there is a genetic predisposition for the disorder. Scientists also are exploring the presence of abnormalities on specific genes.
•Biological: Researchers believe that some neurotransmitters, including serotonin and dopamine, don’t function properly in individuals with bipolar disorder.
•Environmental: Outside factors, such as stress or a major life event, may trigger a genetic predisposition or potential biological reaction. For instance, if bipolar disorder was entirely genetic, both identical twins would have the disorder. But research reveals that one twin can have bipolar, while the other does not, implicating the environment as a potential contributing cause.
What Are the Different Types of Bipolar Disorder?
•Bipolar I is considered the classic type of bipolar disorder. Individuals experience both manic and depressive episodes of varying lengths.
•Bipolar II involves less severe manic episodes than bipolar I; however, their depressive episodes are the same.
•Cyclothymia is a chronic but milder form of bipolar disorder, characterized by episodes of hypomania and depression that last for at least two years.
•Mixed episodes are ones in which mania and depression occur simultaneously. Individuals might feel hopeless and depressed yet energetic and motivated to engage in risky behaviors.
•Rapid-cycling bipolar individuals experience four or more episodes of mania, depression or both within one year.
What Are the Risk Factors for Bipolar Disorder?
Risk factors include having:
•Cyclothymia (see definition above). About half of individuals with cyclothymia will experience a manic episode.
•Any other psychological disorder
•A family history of bipolar or other psychological disorders
•Alcohol and substance abuse
•Medication interactions. For instance, antidepressants may trigger mania.
•Major life changes
•Severe stress
|
|
TeresahRN
26676 posts
back to top
|
Symptoms of Bipolar Disorder
There are four possible bipolar states:
1.Mania
2.Hypomania
3.Depression
4.A mixture of mania and depression (called a “mixed episode”).
Mood states are highly variable. Some people can experience mood changes in one week, while others can spend months or even years in one episode.
What Does Mania Look Like?
•Feelings of euphoria and elation or irritability and anger
•Impulsive, high-risk behavior, including grand shopping sprees, drug and alcohol abuse and sexual promiscuity
•Aggressive behavior
•Increased energy and rapid speech
•Fleeting, often grandiose ideas
•Decreased sleep (typically the individual doesn’t feel tired after as few as three hours of sleep)
•Decreased appetite
•Difficulty concentrating; disorganized thoughts
•Inflated self-esteem
•Delusions and hallucinations (in severe cases)
What Does Hypomania Look Like?
Hypomania is less severe than a full-blown manic episode. Hypomanic individuals can seem pleasant, friendly, energetic and productive. Though it doesn’t sound problematic, increasing hypomania can lead to risky behaviors and full mania.
What Does Depression Look Like?
•Feelings of hopelessness and sadness
•Inability to sleep or sleeping too much
•Loss of interest in formerly enjoyable activities; loss of energy (sometimes to the point of inability to get out of bed)
•Changes in appetite and weight
•Feelings of worthlessness and inappropriate guilt
•Inability to concentrate or make a decision
•Thoughts of death and suicide
What Does a Mixed Episode Look Like?
Mixed episodes involve simultaneous symptoms of mania and depression, including irritability, depressed mood, extreme energy, thoughts of suicide and changes in sleep and appetite.
A Note about Suicide
Because of the high suicide risk in those with bipolar disorder, it’s important to note the warning signs. In addition to those mentioned in the depression symptoms above, others include:
•Withdrawing from loved ones and isolating oneself
•Talking or writing about death or suicide
•Putting personal affairs in order
•Previous attempts
For more information about suicide, check out Frequently Asked Questions about Suicide.
How Is Bipolar Disorder Diagnosed?
There are no medical tests to diagnose bipolar disorder. However, a psychologist, psychiatrist or other trained mental health professional can diagnose the disorder by conducting a face-to-face clinical interview. Your clinical interview will include detailed questions about your and your family’s medical and mental health history and your symptoms.
What Treatments Exist for Bipolar Disorder?
Bipolar disorder can be effectively managed with a combination of medication and psychotherapy to help in reducing both the number of episodes and their intensity. Treatment also can help prevent future episodes if the individual is willing to work on personal issues and develop healthy habits.
What Kinds of Medication Are Used for Bipolar Disorder?
•Mood stabilizers. These medications are prescribed to help stabilize manic symptoms, prevent future episodes and reduce suicide risk. The most well-known of these is lithium, which is effective in 60 to 80 percent of manic and hypomanic episodes. Anticonvulsant (or anti-seizure) medications also have mood stabilizing effects. These include valproate (Depakote), carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurotin) and topiramate (Topamax).
Every medication has its own set of potentially serious side effects. For instance, Lamictal can cause Stevens-Johnson syndrome, a potentially fatal skin disease, though this is rare and is entirely avoidable by careful, slow dose titration.
•Atypical antipsychotics. The newest medications, atypical antipsychotics were originally developed to treat psychosis (a symptom of schizophrenia). Like the mood stabilizers above, atypical antipsychotics help to control mood swings. These seven medications are commonly prescribed for bipolar: aripiprazole (Abilify), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), clozapine (Clozaril) and olanzapine/fluoxetine (Symbyax).
Contrary to popular belief, these medications aren’t without significant side effects, including rapid weight gain, high cholesterol and risk for diabetes, which occurs most commonly with olanzapine and clozapine. In some cases, atypical antipsychotics have been associated with a life-threatening condition known as diabetic ketoacidosis (DKA).
In June 2004, the U.S. Food and Drug Administration (FDA) requested that all companies who manufacture atypical antipsychotics include a warning about the elevated risk for hyperglycemia and diabetes (see here ).
In addition, several organizations, including the American Diabetes Association and American Psychiatric Association, have published recommendations for doctors on how to treat patients taking these medications. For more information, read the press release at the American Diabetes Association website.
•Calcium-channel blockers. Used to treat angina and high blood pressure, these medications — including verapamil (Calan, Isoptin, Verelan) and nimodipine (Nimotop) — also have mood stabilizing effects. They have fewer side effects than other bipolar drugs but aren’t as effective.
•Combination therapy. When one medication isn’t working, a doctor might prescribe two mood stabilizers or a mood stabilizer along with an adjunctive medication to treat symptoms such as anxiety, hyperactivity, insomnia and psychosis. For example, Xanax (alprazolam), a fast-acting benzodiazepine, typically is taken for two weeks before mood-stabilizing medication starts to work. Antidepressants might be prescribed for patients who are in a depressive phase, but research suggests they aren’t effective, can trigger mania and exacerbate episodes long term.
Psychotherapy
Psychotherapy is a crucial component of long-term bipolar disorder management. Even when your mood swings are under control, it’s still important to stay in treatment.
Several different psychotherapeutic methods have proved to be effective in treating bipolar disorder.
•Cognitive behavioral therapy (CBT) helps individuals develop strategies to cope with their symptoms, change negative thinking and behavior, monitor their moods and predict their mood to try to prevent a relapse.
•Interpersonal and social rhythm therapy is a combination of interpersonal therapy and CBT. This newer treatment focuses on circadian rhythms to help clients establish and maintain routines and build healthier relationships.
•Psychoeducation teaches individuals about their disorder and treatment and gives them the tools to manage it and anticipate mood swings. Psychoeducation also is valuable for family members.
How Else Can I Manage Bipolar Disorder?
•Take your medication.
•See a therapist regularly.
•Learn more about bipolar disorder and its treatment
•Participate in online communities or in-person support groups
•Adopt healthy habits, including exercising, practicing stress management techniques, eating healthy, avoiding alcohol and drugs, getting seven to eight hours of sleep and avoiding any potential triggers.
|
|
TeresahRN
26676 posts
back to top
|
5 Persistent Myths About Bipolar Disorder
Bipolar disorder is a serious and difficult illness that affects all facets of a person’s life: their education, work, relationships, health and finances, said Julie A. Fast, author of several bestselling books on bipolar disorder, including Loving Someone with Bipolar Disorder and Take Charge of Bipolar Disorder, and a coach who works with partners and families.
Fast was diagnosed with rapid-cycling bipolar disorder II at 31 years old in 1995, a time when very little was discussed regarding the diagnosis. Fortunately, knowledge and media coverage of bipolar disorder have improved dramatically over the years. “I’m astonished at how much more people know about the illness,” she said.
Even TV shows are featuring more accurate portrayals of bipolar disorder. “In the past, people with bipolar disorder were practically frothing at the mouth,” Fast said. Today, writers and producers make it a point to get it right. Recently, Fast served as one of the advisors on the hit Showtime series “Homeland” and talked with Claire Danes about her character’s bipolar disorder.
While information has gotten much better, many misconceptions still exist and endure.
Below, you’ll find five persistent myths about bipolar disorder
1. Myth: Bipolar disorder and depression are completely different diagnoses.
Fact: Bipolar disorder and depression — also known as unipolar depression — are not completely different illnesses, according to Francis Mondimore, MD, associate clinical director of the Department of Psychiatry at Johns Hopkins. In fact, he believes this is one of the most misunderstood ideas about bipolar disorder. (He blames psychiatrists for the misconception.)
Patients who believe this myth may oppose the diagnosis “if they don’t have the full-blown ‘manic-depressive’ picture and also resist taking “bipolar” medications like lithium,” said Dr. Mondimore, also author of Bipolar Disorder: A Guide for Patients and Families.
It’s more accurate to think of bipolar disorder and depression as “probably represent[ing] two ends of a spectrum of illnesses,” he said. “The designation ‘bipolar II’ has helped crack this a bit, but this is why the term ‘bipolar spectrum disorder’ continues to gain ground,” he said.
2. Myth: People with bipolar disorder experience dramatic mood swings followed by complete remission of symptoms.
Fact: Some people with bipolar disorder experience this pattern, Mondimore said. (Lithium is typically very effective for these individuals, he said.) However, “Many patients have periods of residual symptoms and less severe but still significant mood fluctuations between episodes of more severe symptoms,” he said. This is especially common if people don’t engage in healthy habits to manage the illness.
3. Myth: Medication is the only treatment for bipolar disorder.
Fact: Medication is an important part of managing bipolar disorder. But it’s not the only answer. Viewing medication as your only treatment option “can lead to fruitless reaches for the ‘right’ medication,” Mondimore said. And it can lead you to avoid making valuable lifestyle changes and seeking therapy, he said.
As Fast writes on her website, “Medications take care of half of the illness, the other half is management.”
Both Fast and Mondimore stressed the importance of leading a healthy lifestyle, including avoiding alcohol and drugs, cultivating good sleep habits, exercising and effectively coping with stress.
Fast includes medication and alternative therapies as part of her treatment plan. Still, she cautioned against thinking “that we can exercise, diet, meditate, walk and rethink our way out of this illness.” (In fact, this is another big myth that persists, Fast said.)
Think of bipolar disorder like any other long-term illness, such as diabetes and high blood pressure, Mondimore said: It requires commitment and comprehensive management.
4. Myth: After having a severe episode, people with bipolar disorder should be able to bounce back.
Fact: If a person with bipolar disorder experiences a severe episode — one that requires hospitalization, for instance — there’s an expectation that afterward they’ll be able to get back to their work and life, Fast said. However, she equated this scenario to people who’ve been in a car crash. You wouldn’t expect someone with broken bones simply to get up and start sprinting.
5. Myth: People with bipolar disorder aren’t trying hard enough.
Fact: People wonder why someone with bipolar disorder just doesn’t try harder. They think that if they exert more effort, they’d have the life they want. They wonder why everyone else who experiences mood swings can cope with them but someone with bipolar disorder can’t. Sometimes Fast has even wondered the same thing about herself.
But this implies that bipolar disorder is a choice, she said. “Would you ever say that to someone with diabetes or pneumonia?” she said.
People just don’t realize how serious bipolar disorder is, Fast said. Thankfully, though serious, it’s highly treatable. Managing the illness is hard work, and finding the right medication takes time. But as Fast said, “Keep trying. Never give up.”
|
|
TeresahRN
26676 posts
back to top
|
Bipolar Disorder
(Manic Depression)
Bipolar disorder, also known by its older name “manic depression,” is a mental disorder that is characterized by constantly changing moods. A person with bipolar disorder experiences alternating “highs” (what clinicians call “mania“) and “lows” (also known as depression). Both the manic and depressive periods can be brief, from just a few hours to a few days, or longer, lasting up to several weeks or even months. The periods of mania and depression vary from person to person — many people may only experience very brief periods of these intense moods, and may not even be aware that they have bipolar disorder.
A manic episode is characterized by extreme happiness, hyperactivity, little need for sleep and racing thoughts, which may lead to rapid speech. A depressive episode is characterized by extreme sadness, a lack of energy or interest in things, an inability to enjoy normally pleasurable activities and feelings of helplessness and hopelessness. On average, someone with bipolar disorder may have up to three years of normal mood between episodes of mania or depression.
Bipolar disorder is recurrent, meaning that more than 90% of the individuals who have a single manic episode will go on to experience future episodes. Roughly 70% of manic episodes in bipolar disorder occur immediately before or after a depressive episode. Treatment seeks to reduce the feelings of mania and depression associated with the disorder, and restore balance to the person’s mood.
Those with bipolar disorder often describe their experience as being on an emotional roller coaster. Cycling up and down between strong emotions can keep a person from having anything approaching a “normal” life. The emotions, thoughts and behavior of a person with bipolar disorder are often experienced as beyond one’s control. Friends, co-workers and family may sometimes intervene to try and help protect their interests and health. This makes the condition exhausting not only for the sufferer, but for those in contact with her or him as well.
Bipolar cycling can either be rapid, or more slowly over time. Those who experience rapid cycling can go between depression and mania as often as a few times a week (some even cycle within the same day). Most people with bipolar disorder are of the slow cycling type — they experience long periods of being up (“high” or manic phase) and of being down (“low” or depressive phase). Researchers do not yet understand why some people cycle more quickly than others.
Living with bipolar disorder can be challenging in maintaining a regular lifestyle. Manic episodes can lead to family conflict or financial problems, especially when the person with bipolar disorder appears to behave erratically and irresponsibly without reason. During the manic phase, people often become impulsive and act aggressively. This can result in high-risk behavior, such as repeated intoxication, extravagant spending and risky sexual behavior.
Some people with bipolar disorder may even hear voices.
During severe manic or depressed episodes, some people with bipolar disorder may have symptoms that overwhelm their ability to deal with everyday life, and even reality. This inability to distinguish reality from unreality results in psychotic symptoms such as hearing voices, paranoia, visual hallucinations, and false beliefs of special powers or identity. They may have distressing periods of great sadness alternating with euphoric optimism (a natural high) and/or rage that is not typical of the person during periods of wellness. These abrupt shifts of mood interfere with reason, logic and perception to such a drastic degree that those affected may be unaware of the need for help. However, if left untreated, bipolar disorder can seriously affect nearly every aspect of a person’s life.
Identifying the first episode of mania or depression and receiving early treatment is essential to managing bipolar disorder. In most cases, a depressive episode occurs before a manic episode, and many patients are treated initially as if they have major depression. Usually, the first recognized episode of bipolar disorder is a manic episode. Once a manic episode occurs, it becomes clearer that the person is suffering from an illness characterized by alternating moods. Because of this difficulty with diagnosis, family history of similar illness or episodes is particularly important. People who first seek treatment as a result of a depressed episode may continue to be treated as someone with unipolar depression until a manic episode develops. Ironically, treatment of depressed bipolar patients with antidepressants can trigger a manic episode in some patients.
|
|
TeresahRN
26676 posts
back to top
|
Symptoms of Bipolar Disorder
Bipolar disorder (also known as "manic depression") is a disorder that is often not recognized or misdiagnosed as simply depression by the patient, relatives, friends -- and even physicians. An early sign of bipolar disorder may be hypomania -- a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior. Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.
In its early stages, bipolar disorder may masquerade as a problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance.
If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged manic episodes and depressive episodes.
One of the usual differential diagnoses for bipolar disorder is that the symptoms (listed below) are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
And as with nearly all mental disorder diagnoses, the symptoms of manic depression must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Symptoms also can not be the result of substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition.
There are four possible bipolar states:
1.Mania
2.Hypomania
3.Depression
4.A mixture of mania and depression (called a “mixed episode”).
Mood states are highly variable. Some people can experience mood changes in one week, while others can spend months or even years in one episode.
|
|
TeresahRN
26676 posts
back to top
|
Specific symptoms of the various types of bipolar disorder:
Bipolar I Disorder
Bipolar I Disorder represents a number of separate diagnoses, depending upon the type of mood most recently experienced.
•Bipolar I Disorder, Single Manic Episode
◦Presence of only one Manic Episode and no past Major Depressive Episodes.
Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms.
•Bipolar I Disorder, Most Recent Episode Hypomanic ◦Currently (or most recently) in a Hypomanic Episode.
◦There has previously been at least one Manic Episode or Mixed Episode.
•Bipolar I Disorder, Most Recent Episode Manic ◦Currently (or most recently) in a Manic Episode.
◦There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.
•Bipolar I Disorder, Most Recent Episode Mixed ◦Currently (or most recently) in a Mixed Episode.
◦There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.
Bipolar II Disorder
•Presence (or history) of one or more Major Depressive Episodesand at least one Hypomanic Episode. Additionally, there has never been a Manic Episode or a Mixed Episode.
|
|
TeresahRN
26676 posts
back to top
|
Treatment of Bipolar Disorder (Manic Depression)
Although bipolar disorder is viewed as a long-term, often chronic condition, there are a variety of effective treatments available. People with bipolar disorder often seek out treatment according to what part of the cycle they’re in. When a person with bipolar disorder is in a manic or hypomanic phase, they may believe they have no further need of medications and stop taking them. When in a depressive phase, they often return to treatment.
Medication is nearly always a part of the recommended treatment course for bipolar disorder. People with undiagnosed bipolar disorder will sometimes self-medicate with alcohol or drugs to try and relieve their symptoms. However, such solutions rarely provide the type of long-term relief most people desire.
The types of treatment that are commonly prescribed for bipolar disorder include:
•Mood stabilizers
Older medications, such as lithium, which are reliable and well-tolerated by most. Once the first-line treatment for bipolar disorder, they have largely been supplanted by atypical antipsychotics.
•Atypical antipsychotics
Newer, more expensive medications for bipolar disorder that may provide greater symptom relief, but also have greater side effects.
•Psychotherapy & Self-Help Strategies
Psychotherapy and self-help strategies can keep someone with bipolar disorder stabilized and prevent relapse.
•Other treatment strategies
Other treatments for bipolar disorder may include prescribing a combination of medications for bipolar, including antidepressants for bipolar.
Treatment for bipolar disorder can be divided into three general categories. Acute treatment focuses on suppressing current symptoms and continues until remission, which occurs when the symptoms are diminished for a period of time. Continuation treatment prevents a return of symptoms from the same manic or depressive episode. Maintenance treatment prevents a recurrence of symptoms. The risks of long-term medication use must be weighed against the risk of getting sick again (relapse).
|
|
TeresahRN
26676 posts
back to top
|
Who Treats Bipolar Disorder?
A wide range of mental health professionals help treat bipolar disorder. Medications are usually prescribed by a psychiatrist (or generally should be — a general practitioner or family physician doesn’t have the extensive background and experience in prescribing these medications on a long-term basis). Psychotherapy to help learn better ways of coping and unlearn unhelpful thinking and patterns of behavior is usually provided by a psychologist or licensed clinical social worker. Usually for an initial diagnosis, it is recommended that you consult a psychologist or psychiatrist.
People who are experiencing life-threatening symptoms, such as life-endangering impulsive behavior (e.g., substance abuse, promiscuity or aggressiveness) or psychotic symptoms (e.g., hallucinations or delusions), as well as anyone who is severely suicidal, should be evaluated by a physician. Depending on the level of potential harm to self or others, they should go to an emergency room. Doctors there often will refer them to a psychiatrist for further treatment. In some cases, hospitalization in a psychiatric facility is a standard approach.
|
|
TeresahRN
26676 posts
back to top
|
Prognosis for Bipolar Disorder
With appropriate treatment, the outlook for someone with bipolar disorder is favorable. Most people respond to a medication and or combination of medications. Approximately 50 percent of people will respond to lithium alone. An additional 20 to 30 percent will respond to another medication or combination of medications. Ten to 20 percent will have chronic (unresolved) mood symptoms despite treatment. Approximately 10 percent of bipolar patients will be very difficult to treat and have frequent episodes with little response to treatment.
On average, a person is free of symptoms for about five years between the first and second episodes. As time goes on, the interval between episodes may shorten, especially in cases in which treatment is discontinued too soon. It is estimated that a person with bipolar disorder will have an average of eight to nine mood episodes during his or her lifetime.
|
|
TeresahRN
26676 posts
back to top
|
Bipolar Disorder Fact Sheet
All of us experience changes in our moods. Some days we might feel irritable and frustrated; other days, we’re happy and excited. However, individuals with bipolar disorder experience severe mood swings that impair their daily life and negatively affect their relationships.
Approximately 2.6 percent of American adults have bipolar disorder (formerly called manic depression and manic depressive disorder), according to the National Institute of Mental Health. These mood swings include “highs” (mania), when individuals feel either on top of the world or on edge, and “lows” (depression), when they feel sad and hopeless. Suicide attempts are common in bipolar disorder, especially during depressive episodes.
Bipolar disorder can be effectively treated with medication and psychotherapy. With proper treatment, individuals with bipolar can lead fulfilling, productive lives. This is why it’s so important to recognize the symptoms and see a mental health professional for an evaluation.
|
|
TeresahRN
26676 posts
back to top
|
What Causes Bipolar Disorder?
There is no single cause for bipolar disorder. Indeed, like all psychological disorders, bipolar disorder is a complex condition with multiple contributing factors, including:
•Genetic: Bipolar disorder tends to run in families, so researchers believe there is a genetic predisposition for the disorder. Scientists also are exploring the presence of abnormalities on specific genes.
•Biological: Researchers believe that some neurotransmitters, including serotonin and dopamine, don’t function properly in individuals with bipolar disorder.
•Environmental: Outside factors, such as stress or a major life event, may trigger a genetic predisposition or potential biological reaction. For instance, if bipolar disorder was entirely genetic, both identical twins would have the disorder. But research reveals that one twin can have bipolar, while the other does not, implicating the environment as a potential contributing cause.
|
|
TeresahRN
26676 posts
back to top
|
What Are the Different Types of Bipolar Disorder?
•Bipolar I is considered the classic type of bipolar disorder. Individuals experience both manic and depressive episodes of varying lengths.
•Bipolar II involves less severe manic episodes than bipolar I; however, their depressive episodes are the same.
•Cyclothymia is a chronic but milder form of bipolar disorder, characterized by episodes of hypomania and depression that last for at least two years.
•Mixed episodes are ones in which mania and depression occur simultaneously. Individuals might feel hopeless and depressed yet energetic and motivated to engage in risky behaviors.
•Rapid-cycling bipolar individuals experience four or more episodes of mania, depression or both within one year.
|
|
TeresahRN
26676 posts
back to top
|
What Are the Risk Factors for Bipolar Disorder?
Risk factors include having:
•Cyclothymia (see definition above). About half of individuals with cyclothymia will experience a manic episode.
•Any other psychological disorder
•A family history of bipolar or other psychological disorders
•Alcohol and substance abuse
•Medication interactions. For instance, antidepressants may trigger mania.
•Major life changes
•Severe stress
|
|
TeresahRN
26676 posts
back to top
|
What Does Mania Look Like?
•Feelings of euphoria and elation or irritability and anger
•Impulsive, high-risk behavior, including grand shopping sprees, drug and alcohol abuse and sexual promiscuity
•Aggressive behavior
•Increased energy and rapid speech
•Fleeting, often grandiose ideas
•Decreased sleep (typically the individual doesn’t feel tired after as few as three hours of sleep)
•Decreased appetite
•Difficulty concentrating; disorganized thoughts
•Inflated self-esteem
•Delusions and hallucinations (in severe cases)
|
|
TeresahRN
26676 posts
back to top
|
What Does Hypomania Look Like?
Hypomania is less severe than a full-blown manic episode. Hypomanic individuals can seem pleasant, friendly, energetic and productive. Though it doesn’t sound problematic, increasing hypomania can lead to risky behaviors and full mania.
What Does Depression Look Like?
•Feelings of hopelessness and sadness
•Inability to sleep or sleeping too much
•Loss of interest in formerly enjoyable activities; loss of energy (sometimes to the point of inability to get out of bed)
•Changes in appetite and weight
•Feelings of worthlessness and inappropriate guilt
•Inability to concentrate or make a decision
•Thoughts of death and suicide
|
|
TeresahRN
26676 posts
back to top
|
What Does a Mixed Episode Look Like?
Mixed episodes involve simultaneous symptoms of mania and depression, including irritability, depressed mood, extreme energy, thoughts of suicide and changes in sleep and appetite.
A Note about Suicide
Because of the high suicide risk in those with bipolar disorder, it’s important to note the warning signs. In addition to those mentioned in the depression symptoms above, others include:
•Withdrawing from loved ones and isolating oneself
•Talking or writing about death or suicide
•Putting personal affairs in order
•Previous attempts
|
|
TeresahRN
26676 posts
back to top
|
How Is Bipolar Disorder Diagnosed?
There are no medical tests to diagnose bipolar disorder. However, a psychologist, psychiatrist or other trained mental health professional can diagnose the disorder by conducting a face-to-face clinical interview. Your clinical interview will include detailed questions about your and your family’s medical and mental health history and your symptoms.
|
|
TeresahRN
26676 posts
back to top
|
What Treatments Exist for Bipolar Disorder?
Bipolar disorder can be effectively managed with a combination of medication and psychotherapy to help in reducing both the number of episodes and their intensity. Treatment also can help prevent future episodes if the individual is willing to work on personal issues and develop healthy habits.
|
|
TeresahRN
26676 posts
back to top
|
What Kinds of Medication Are Used for Bipolar Disorder?
•Mood stabilizers. These medications are prescribed to help stabilize manic symptoms, prevent future episodes and reduce suicide risk. The most well-known of these is lithium, which is effective in 60 to 80 percent of manic and hypomanic episodes. Anticonvulsant (or anti-seizure) medications also have mood stabilizing effects. These include valproate (Depakote), carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurotin) and topiramate (Topamax).
Every medication has its own set of potentially serious side effects. For instance, Lamictal can cause Stevens-Johnson syndrome, a potentially fatal skin disease, though this is rare and is entirely avoidable by careful, slow dose titration.
•Atypical antipsychotics. The newest medications, atypical antipsychotics were originally developed to treat psychosis (a symptom of schizophrenia). Like the mood stabilizers above, atypical antipsychotics help to control mood swings. These seven medications are commonly prescribed for bipolar: aripiprazole (Abilify), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), clozapine (Clozaril) and olanzapine/fluoxetine (Symbyax).
Contrary to popular belief, these medications aren’t without significant side effects, including rapid weight gain, high cholesterol and risk for diabetes, which occurs most commonly with olanzapine and clozapine. In some cases, atypical antipsychotics have been associated with a life-threatening condition known as diabetic ketoacidosis (DKA).
In June 2004, the U.S. Food and Drug Administration (FDA) requested that all companies who manufacture atypical antipsychotics include a warning about the elevated risk for hyperglycemia and diabetes (see here ).
In addition, several organizations, including the American Diabetes Association and American Psychiatric Association, have published recommendations for doctors on how to treat patients taking these medications. For more information, read the press release at the American Diabetes Association website.
•Calcium-channel blockers. Used to treat angina and high blood pressure, these medications — including verapamil (Calan, Isoptin, Verelan) and nimodipine (Nimotop) — also have mood stabilizing effects. They have fewer side effects than other bipolar drugs but aren’t as effective.
•Combination therapy. When one medication isn’t working, a doctor might prescribe two mood stabilizers or a mood stabilizer along with an adjunctive medication to treat symptoms such as anxiety, hyperactivity, insomnia and psychosis. For example, Xanax (alprazolam), a fast-acting benzodiazepine, typically is taken for two weeks before mood-stabilizing medication starts to work. Antidepressants might be prescribed for patients who are in a depressive phase, but research suggests they aren’t effective, can trigger mania and exacerbate episodes long term.
|
|
TeresahRN
26676 posts
back to top
|
Psychotherapy
Psychotherapy is a crucial component of long-term bipolar disorder management. Even when your mood swings are under control, it’s still important to stay in treatment.
Several different psychotherapeutic methods have proved to be effective in treating bipolar disorder.
•Cognitive behavioral therapy (CBT) helps individuals develop strategies to cope with their symptoms, change negative thinking and behavior, monitor their moods and predict their mood to try to prevent a relapse.
•Interpersonal and social rhythm therapy is a combination of interpersonal therapy and CBT. This newer treatment focuses on circadian rhythms to help clients establish and maintain routines and build healthier relationships.
•Psychoeducation teaches individuals about their disorder and treatment and gives them the tools to manage it and anticipate mood swings. Psychoeducation also is valuable for family members.
|
|
TeresahRN
26676 posts
back to top
|
How Else Can I Manage Bipolar Disorder?
•Take your medication.
•See a therapist regularly.
•Learn more about bipolar disorder and its treatment
•Participate in online communities or in-person support groups
•Adopt healthy habits, including exercising, practicing stress management techniques, eating healthy, avoiding alcohol and drugs, getting seven to eight hours of sleep and avoiding any potential triggers.
|
|
TeresahRN
26676 posts
back to top
|
What is Dissociative Identity Disorder?
According to Wikipedia, “Dissociative identity disorder (DID), also known as multiple personality disorder (MPD), is a mental disorder characterized by at least two distinct and relatively enduring identities or dissociated personality states that alternately control a person’s behavior, and is accompanied by memory impairment for important information not explained by ordinary forgetfulness.”And according to WebMD, “Dissociative identity disorder is an effect of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse.” As a result of the catalyzing trauma and the schizophrenic-like behavior, DID is commonly seen alongside other diagnoses; comorbidity.
There is some controversy over whether or not this disorder exists. But it seems that the majority of opinion is that it does. According to WebMD, “Other types of dissociative disorders defined in the DSM-IV, the main psychiatry manual used to classify mental illnesses, include dissociative amnesia, dissociative fugue, and depersonalization disorder.” DID seems to relate in many ways to these other dissociative disorders, giving it some foundation for legitimacy.
Another important part of DID is the complexity of each separate identity. It is not uncommon for each identity to have its own gender, age, occupation and other details. Commonly called “alters”, these multiple personalities can even stretch as far as different species; animals. The person who has DID fully takes on the role of each identity. And each identity has its own memories. So it is possible for a therapist to actually be able to interact with the unique character as is each personality.
One of the biggest problems with DID is the loss of memory of what happens when the core person slips into a character or alter. A common metaphor used is as if the linear magnetic tape in a cassette has blank or erased spaces. It would affect the listening experience with silence. The same is true for the memory of someone with dissociative identity disorder. The patient is only able to recall broken pieces of memory with much of it missing.
DID is a complex disorder that deeply impacts the lives of those who have it. From memory loss to split personalities, dissociative identity disorder is chronic. I can see how, with trauma being the cause, patients with DID would have bipolar disorder as well. Do you have both DID and bipolar disorder?
|
|
TeresahRN
26676 posts
back to top
|
Sensory Processing Disorder
Like any other community, the medical community has division within it. One of these areas is in the area of diagnosing “sensory experience”. It is being reported by a growing number of people that as common as 1 in 20 children are experiencing extra-normal sensitivity to sensory stimuli.
Even further, within this medical community there is division in what to call this phenomenon, with two names being debated. One is “Sensory Processing Disorder” and the other is “Sensory Integration Dysfunction”. According to Wikipedia, the experience was originally called “Sensory Integration Dysfunction” but is now the subject of a movement to change the name to “Sensory Processing Disorder”. For the purposes of this article, we will refer to this experience as “Sensory Processing Disorder” or SPD.
|
|
TeresahRN
26676 posts
back to top
|
According to Wikipedia, “Sensory processing disorder or SPD is a neurological disorder causing difficulties with taking in, processing, and responding to sensory information about the environment and from within one’s own body.” The origins of SPD come from an occupational therapist and psychology named Anna Jean Ayres. Although Ayer’s ideas remain controversial, they are increasingly receiving attention from medical professionals and organizations. One of the more prominent organizations is the “Sensory Processing Disorder Foundation”.
Their mission is “To improve the lives of children with Sensory Processing Disorder (SPD) and their families by conducting research, educating caregivers, pediatric professionals, and educators, and empowering scientists throughout the world to study the diagnosis and treatment of SPD.” In the short term it seems that one of their main goals is to achieve “diagnostic recognition” for the disorder. And while they were not able to accomplish having SPD included in DSM-5, they are continuing to advocate for it’s official declaration as a diagnosis.
It is said that the intensity of the experience varies from one person to the next. Another way to describe SPD is to say that a person has a “hypersensitivity” to sensory stimuli. It is as if what is normal for Jane Doe is difficult to near impossible for someone with SPD. Examples include flickering lights, Velcro, shuffling and other seemingly benign events.
The individual who experiences SPD often has odd behaviors that spawn as coping mechanisms for a level of confusion and frustration with the inner and outer Worlds.
This seems to imply that there is a growing community of people who are recognizing the symptoms as being common enough to warrant a unique classification. I was unable to find information about the comorbidity rate of SPD, yet the emerging interest in this as a primary diagnosis is increasing. I think this is something we will be hearing more about in the future.
|
|
TeresahRN
26676 posts
back to top
|
There is No Cure for Bipolar Disorder
Few days ago, I asked my readers one question. „If there were a cure for a bipolar disorder, would you use it?“ After 47 answers there was majority of people with same answer. 44 of 47 people would cure their bipolar disorder if cure were available. This is clearly showing what is going on in the world of the people with bipolar disorder. Why would all those people wanted to cure their disorder? I think that people don’t want to suffer any more.
There is no cure for bipolar disorder but with the right treatment it can be managed and stabilized. Like a diabetes, bipolar disorder is serious lifelong disease. One thing I need to say is that I do not share opinion with a majority of people who answered my question. If I knew that there is cure for bipolar disorder, I would not use it. Why? Because over the years I found a way to stabilize my disorder and now I see more advantages to having bipolar disorder than curing it. But I understand that is not true for everyone.
What I found interesting is that majority of people want to completely cure their disorder. I used to think that too, especially when I was in pain. But we know there is no cure for bipolar disorder. So what should we do?
Not so long ago, health professionals did not know much about bipolar disorder, and as a result of that there was not so many treatments. But today that is not a case. Todays problem is that so many people are diagnosed with this terrible disorder and treatments are not accessible to everyone. They are not accessible to those who need them the most. Majority of people today is suffering, when they should be treating their disorder so they can become stable.
So what would be a good solution for this problem? I think that treatments for bipolar disorder should be free for everyone. How to achieve this? We need to work on developing our community so more people can have access to the information.
If people who are suffering would have more information about treatments, they would see that is possible to feel better and that they can manage their disorder on their own. And that is most important thing for success.
As we know there is more people who are suffering than people who are stable. And that is a huge problem. From my experience I know how hard can it be to deal with the pain. But there is a solution. We can educate ourselves about treatments that can help us. Because there is no cure this is the best thing we have
|
|
TeresahRN
26676 posts
back to top
|
More About Bipolar Disorder
Bipolar disorder is a mood disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out every day tasks. Symptoms of bipolar disorder are severe. They are different from the normal moods that people experience from time to time in their lives. Bipolar disorder often develops in a person’s late teens or early adult years. Bipolar disorder symptoms can result in damaged relationships, poor work or school performance, and even suicide. Bipolar disorder has treatment options, and people with this illness can lead a full and productive life.
People with bipolar disorder experience unusually intense emotional states that occur in increments of time often referred to as “episodes.” An overly happy or overexcited state is a manic episode, and an extremely sad or low activity state is a depressive episode. Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. Sometimes symptoms are so extreme that the person cannot function normally in society.
Those who suffer with bipolar disorder may feel happy or depressed for an unknown reason, sleep very little or too much, start new projects or tasks or abandon tasks and work they were committed to do, lose interest in activities they enjoy, act on impulses involving high-risk (i.e. spending more money than they normally would, without thinking of the consequences), have racing thoughts or a feeling of slowing down, their abilities to think clearly are affected, they speak faster than normal or do not want to communicate with others, they will eat more or less than normal, and become irritable and restless.
There is no cure for bipolar disorder because of this treatments for bipolar disorder are often long-term and often last the person’s lifetime. The most effective treatment is a combination of psychotherapy (or talk therapy) and medication. Typical medications include mood stabilizing medications such as anticonvulsants (approved to treat seizures but work well with people with bipolar disease), Lithium, Valproic acid, Depakote, Lamictal, Neurontin, Topamax, Trileptal are examples of anticonvulsants. Other medications used are atypical antipsychotics such as Zyprexa, Olanzapine, Abilify, Seroquel, Risperdal, and Geodon. Most people diagnosed with bipolar disorder are also prescribed some sort of antidepressant as well, such as Prozac, Paxil, Zoloft, Wellbutrin, among others. Girls and young women taking valproic acid for treatment should see their doctors regularly for monitoring because the drug may increase levels of the male hormone testosterone and may lead to polycystic ovary syndrome.
|
|
TeresahRN
26676 posts
back to top
|
Bipolar Disorder in Women
Bipolar disorder occurs with similar frequency in men and women but there are some differences between the sexes in the way the condition is experienced. For instance, a woman is likely to have more symptoms of depression than mania. Female hormones and reproductive factors may influence the condition and its treatment.
Research have found that in women, hormones may play a role in the development and severity of bipolar disorder. Studies suggests that late-onset bipolar disorder may be associated with menopause. Among women who have the disorder, almost one in five reported severe emotional disturbances during the transition into menopause. Studies have also looked at the association between bipolar disorder and premenstrual symptoms. These studies suggest that women with mood disorders, including bipolar disorder, experience more severe symptoms of premenstrual syndrome (PMS). Other research has shown that women whose disorders are treated appropriately have less fluctuation in mood over the course of the menstrual cycle.
The greatest evidence of a hormonal association with bipolar disorder is found during pregnancy and the postpartum period. Women with bipolar disorder that are pregnant or have recently given birth are more likely than other women to be admitted to the hospital for their bipolar disorder, and they are twice as likely to have a recurrence of symptoms.
|
|
TeresahRN
26676 posts
back to top
|
What is Life Like for Bipolar Sufferers?
Life for a bipolar sufferer can be very mixed, with dramatic mood swings between the extreme highs, and the extreme lows. This is why people commonly call it maniac depression. They are referring to the maniac part of the disorder, which is the highs, and then the depression being the feeling low part of the disorder.
Age is not a factor in people suffering from bipolar. It can be something that you experience slightly, which builds slowly over time, yet for others it can be an overwhelming, and very sudden diagnosis of the disorder which affects them.
Someone with bipolar can suffer the disorder in a number of ways. These are mostly in the form of mood swings, and they happen win a variety of cycles for people. These cycles are the length of time which the person’s mood swings through. This can be from only a few hours, to in some weeks for people.
A typical bipolar sufferer will also have to battle with the frequency which they have these dramatic mood swings, which can be upto many times a day. Some people will also feel that the intensity changes for them too, which can result in difficult social situations for the person diagnosed with the illness.
There are many known treatments for bipolar, yet there is no known cure. Most people respond well to the medication, which although won’t stop the person experiencing the dramatic mood swings, will help them be not quite as extreme, as what they may have suffered in the past.
Firstly you should consult with your doctor, who will help provide you with the support you will need medically. However, you should also surround yourself with a network of good friends and family who will also be able to care for you, and listen to you if you have any difficulties.
With the new advances in genes and genetic technology and medicine, it is hoped that we are coming closer to discovering a cure that will help people who suffer from bipolar. Although we may not be quite there yet, we are advancing in the actual diagnosis of the condition, with more people who are suffering finally being recognized.
Since mental illness and bipolar are experienced by many people then its a good idea to be able to recognize this from the symptoms that people have.
These include:
•A very high mood, which might seem excessively elevated.
•You will hear that the way they speak will be higher pitched, and much more animated than usual.
•You will find that they are easily irate if you say something out of place, or something they don’t agree with, and they will react quite angrily.
•They will be very easily distracted, and their attention will seem to shift from one subject to another vigorously.
•They will sleep much less, and wake very quickly on occasion with a real sense of urgency.
•Their behavior will be much more cavalier, and risky in many respects.
Similarly, their behavior when they experience the lows of their disorder, will include symptoms such as:
•Their motivation to join in regular social interaction will be greatly reduced, and they will also reduce the amount of time that they spend on essential activities.
•They will be sad all the time about their life in general, and will even have regular crying spells.
•They will sleep for an extended period longer than normal.
•Their energy, and motivation levels will be reduced dramatically.
•They will have thoughts of suicide, and death.
•They will reduce or even stop eating completely, and this will result in dramatic weight loss.
|
|
TeresahRN
26676 posts
back to top
|
Why I Smoke Marijuana
Why do you smoke marijuana? I know the answer for a lot of you is because it works, you’ve never felt more yourself than certain moments when you medicated or stoned essentially. The reason why I bring this up is because I want to see if my experience with marijuana is similar to yours. So I will describe my experience with marijuana and hopefully you can relate to this.
Before I smoke, it’s a cloud of confusion, like a haze or a fog. It’s definitely hypomanic and the energy is highly electric. That’s one of the reasons why I smoke cannabis Indica which is a down stabilizer. Meaning it brings you from a higher state to lower state and soothes or reduces that frenetic energy that comes with mania. But that is a subject for another post.
Marijuana really does reduce the impact of mood swings. I believe this has a lot to the CB1 receptors inside your brain and the increase performance of serotonin, but the experience of it is incredible; it’s very centering. That’s a good way to describe it, sort of a centering along your middle that enables you to just exist right here and now.
Marijuana also helps me connect my mind and body in a way that creates a sort of union or piece. Most of the time I feel like I don’t even belong in my body or that I can’t be my body. Much of that has to do with OCD and ADD but a lot of it has to do with bipolar disorder as well. And the marijuana sort of reduces the friction between the two and makes them step into the same beat.
One of the most important things marijuana does for me is it brings my mind to a state where I can actually think. Marijuana gives me a certain sort of headspace. That headspace I recycle right back into working for me. Ultimately the lucidity or the clearheadedness that I experience when I’m smoking pot is irreplaceable and critical to my success as a person with bipolar disorder.
Another way the marijuana helps me is through spirituality, without a doubt marijuana is a sacrament. I personally find it brings me closer to God, Spirit or source. It enables me to process and communicate in a form of prayer that I can’t do without it.
Another benefit from smoking marijuana is processing trauma. This is very typical of a psychedelic like LSD and marijuana, as the substances are mine manifesting. They bring a higher order to your mind and a clear conscience in which you can process that which you’ve been avoiding. This has been critical for me. I could not have done this without agents to help process my traumas. Because that’s what so much of my bipolar was wrapped up in; unprocessed trauma. I think that’s true for a lot of people bipolar disorder.
|
