Bipolar Disorder

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Bipolar Disorder, (also known as bipolar affective disorder, manic-depressive disorder, or manic depression) is a type of mood disorder causes dramatic changes or extremes of mood, energy, activity levels which interfere with the ability to carry out daily tasks. It is characterized by episodes of mania that may alternate with episodes of major depression.

What is a Manic Episode?

 When a person is experiencing mania or having a manic episode, he/she is feeling usually "high", euphoric, or irritable. Some outward behavioral signs that may indicate a person is in a manic state is 

  • Needing little sleep yet having great amounts of energy
  • Talking so fast that others can not follow his/her thinking
  • Having racing thoughts (many thoughts are "racing" fast in his/her head to the point of not being able to keep up with them)
  • Being easily distracted the his/her attention switches to numerous topics within a few minutes
  • Having an inflated feeling of power, greatness, or importance
  • Exhibiting reckless behavior without concern for the consequences.

Hypomania is another condition similar to mania. Hypomania is a milder form of mania with similar but less severe symptoms and less impairment in functioning.

What is a Depressive Episode?

The symptoms of depression that patients experience are similar to major depression. These symptoms are present for at least 2 weeks and have cause significant impairment in functioning. Manic episodes can last for several weeks and even months.

  • Feeling sad, blue, or down in the dumps or loss of joy or interest in things they normally enjoy

Plus at least four of the following: 

  • Significant change in sleep pattern
  • Loss of appetite or eating too much
  • Problems concentrating or making decisions
  • Feeling slowed down or feeling too agitated to sit still
  • Feeling worthless or guilty or having very low self-esteem
  • Loss of energy or feeling tired all of the time
  • Thoughts of suicide or death

Usually an individual will experience a time period of mania and then the mania may subside for a while before experiencing a depressive state or vise versa. Bipolar disorder usually begins in adolescence or early adulthood, although it can sometimes start in early childhood or as late as the 40’s or 50’s. In the United States, over 1.2% of the adult population has bipolar disorder (more than 2.2 million people).

What is a Mixed Episode?

A mixed episode is when an individual experiences symptoms of both mania and depression at the same time or alternating frequently during the day. He/she may feel excitable or agitated as in mania but also feel irritable and depressed, instead of feeling on top of the world.

What Causes Bipolar Disorder?

There is no single, proven cause of bipolar disorder, but research strongly suggests that it is often an inherited problem related to a lack of stability in the transmission of nerve impulses in the brain. This instability of nerve transmissions causes people with bipolar disorder to be more vulnerable to emotional and physical stresses. For example, is there is an upsetting life experience or event, the normal brain mechanisms for restoring cam functioning do not always work properly.

There are also theories that bipolar disorder has a genetic link that predisposes individuals to this disorder. This is not saying that if one of your parents have bipolar then you will have bipolar disorder. Just as other medical conditions, such as heart disease, the person might inherit a tendency to have high blood pressure or cholesterol which makes them more susceptible to heart disease.

Types of Bipolar Disorder

Bipolar disorder type I-

Characterized by one or more manic or mixed episodes usually accompanied by depressive episodes.

Bipolar disorder type II-

Characterized by one or more depressive episodes accompanied by at least one hypomanic episode.

Treatments for Bipolar Disorder

There are three main components for treating bipolar disorder.

Medication

The two most widely used types of medication for bipolar are mood stabilizers and antidepressants. Mood stabilizers are used to improve symptoms during acute manic, hypomanic, and mixed episodes and are used as preventive medicine to maintain a stable mood. However, not everyone responds to medications in the same way, and at times, multiple types of medication must be assessed. Medications used to treat bipolar disorder often include mood-stabilizing medications and some second-generation antipsychotics. For the most timely information on use and side effects, visit the U.S. Food and Drug Administration (FDA) at www.fda.gov.

Psychotherapy

Psychotherapy and self-care interventions are essential components in the treatment of bipolar disorder. Most useful psychotherapies generally focus on understanding the illness, learning how to cope and changing ineffective patterns of thinking. Psychotherapy can help individuals learn to identify negative behavioral patterns which can be contributing to the disorder and learn more healthy lifestyles to prevent a full-blown mania or depressive episode. Cognitive behavioral therapy (CBT) is one popular example.

Family-focused therapy

Family-focused therapy involves family members or friends in supportive roles. They participate by learning about the illness, and in developing and supporting a recovery. It is important that the individual who is diagnosed with Bipolar Disorder and family members learn how to best manage this disorder and prevent its complications. The help of family members and/or friends can give the individual significant support on identifying symptoms of mania and depression as the individual is sometimes "blinded" by the disorder.  

For more information please refer to the following resources:

www.bpkids.org

www.mentalhealth.com/dis/p20-md02.html

www.nimh.nih.gov

www.mentalhelp.net

Books

Bipolar Disorder: A Guide for Patients and Families. By Francis Mark Mondimore, M.D.

Bipolar Disorders: A Guide to Helping Children and Adolescents. By: Mitzi Waltz.

Surviving Manic Depression: A Mannual on Bipolar Disorder for Patients, Families, and Providers By E. Fuller Torrey, M.D. and Michael B. Knable