What is Bi-Polar Disorder? It is a mental condition that is characterized by the unusual mood swings from deep depressive lows to manic highs. This disorder is caused by chemical imbalances in the brain and affect how individuals feel and act in their personal and professional lives. The disorder usually develops in late adolescence and young adulthood and cannot be cured, although it can be managed. Approximately one percent of the general population has received a bipolar disorder diagnosis, and ten percent of those with depression are actually diagnosed with bipolar disorder. The Phases of Bipolar Disorder:
Manic Phase During the manic phase of a bipolar episode, the individual will experience inflated feelings of self-esteem with grandiose delusions. They will talk non-stop, expressing a rapid flight of ideas and seem to require no sleep or rest. Goal-oriented behaviors will increase to the point of obsession and pleasure seeking behaviors will be out of control (excessive shopping, foolish investments, sexual activity, and risk taking). The individual will also be easily distracted and will fixate on seemingly irrelevant external factors. Depressive Phase Depressive symptoms of bipolar disorder include a deep feeling of emptiness and a diminished capacity to find interest in day to day activities or those that formerly brought pleasure (sports, hobbies, or other once consuming passions). There may be changes in weight (increase or decrease), fatigue, difficulty concentrating, recurrent thoughts of death, and insomnia. What Causes Bipolar Disorder Without question, individuals who have a family history of bipolar disorder are at a heightened risk of suffering from the problem themselves. Research indicates, however, that heredity works in concert with environmental factors. There are examples, for instance, of identical twins in which only one individual presents as bipolar. In a chemical sense, it is thought that an imbalance in the brain causes the symptoms, but there is no medical bipolar test. Drug use, particularly that of cocaine and methamphetamine, can trigger bipolar attacks in individuals who have no previously exhibited symptoms of the disorder. Severe emotional stress or traumatic events are also recognized triggers, but most people never know why their bipolar disorder starts. In rare cases even viral infections have been found to start an episode. Not all individuals who experience mood swings have bipolar disorder. Head trauma, a thyroid imbalance, epilepsy, diabetes, and prescriptions that interfere with serotonin and norepinephrine levels can cause similar symptoms. Drug abuse, schizophrenia, attention deficit hyperactivity disorder, and panic disorder can all be mistaken for bipolar disorder. How Is Bipolar Disorder Diagnosed? The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) lists two profiles for diagnosing bipolar disorder, Bipolar I and Bipolar II. In instances of Bipolar I there are alternating, full-blown manic and depressive episodes. Bipolar II is less severe and more common. In this case the episodes range from hypomania through to depression. Hypomania is a state in which there are combinations of elevated mood, irritability or crankiness, racing thoughts, hypersexual urges and behavior, extreme religiosity, and pressured speech. What Are The Complications? Many writers, artists, and musicians see bipolar disorder symptoms as a two-edged sword. Some of their best and most creative work, they say, occurs during manic episodes. When they seek to level their mood swings, particularly with medication, their talent and creativity, as they perceive it, diminishes or disappears. Therefore, many individuals with bipolar disorder are reluctant to seek treatment, preferring instead to self-medicate with alcohol and illegal drugs. This situation creates a unique treatment dilemma for health care professionals. The bottom line would seem to be that if an individual does not present a danger to themselves or to others they should be allowed to regulate their health - mental and physical - as they see fit. However, a bipolar individual who chooses not to seek help would do well to have a strong support system of friends and family in case they sink to levels where they cannot accurately judge their own condition and safety. Can Bipolar Disorder Be Prevented? Unfortunately bipolar disorder cannot be prevented. Although there are several options that can help to take the edge off the disorder: Medication In selecting medications as treatment for bipolar disorder physicians are attempting to balance out the need for mood stabilizers during manic phases with that for antidepressants on the "down" side. If the depression becomes severe to the point of actual psychosis, antipsychotic drugs may also be used. Unfortunately, in some cases both antidepressants and antipsychotic medications will actually have the unwanted effect of causing mania and panic attacks. Each individual will react differently to various prescriptions and it may take some time to arrive at the correct medication or medications, as well as the correct dosage. People with bipolar disorder are notorious for discontinuing their medications when the desired effect is not immediate. Others actually enjoy the manic phase of their illness and do not want to lose the "high." Others, when they do see improvement, erroneously consider themselves to be cured. Psychotherapy While talking about bipolar disorder will go no further toward "curing" the condition than drugs, it can help to address and minimize the disruption that plagues and often destroys the life of the bipolar sufferer. Such therapy may also be useful in helping patients to see the need for their medication and to stick with their prescription therapy regimen. Without question, bipolar disorder is an isolating illness and those who grapple with its effects require a support system. Electroconvulsive Therapy In extremely severe bipolar cases electroconvulsive or "shock" therapy may be the last resort when no other therapies have proved helpful. Although effective, doctors are increasingly reluctant to take this route due to the severe side effects. In the immediate wake of the treatment the patient will experience considerable confusion and memory loss. These issues usually resolve over a period of time, but studies indicate that more than a third of patients who have undergone electroconvulsive therapy have significant and permanent memory loss. When Should A Person Seek Medical Advice? As soon as an individual begins to experience extreme cycles of euphoria and black depression medical advice should be sought. The sooner treatment for bipolar disorder begins the more effective it tends to be. Bipolar disorder in children as young as six years of age has been detected. Children who laugh hysterically and display infectious happiness for no reason, who seem to need no sleep, entertain grandiose ideas, and then cycle into deep depression should be carefully observed and evaluated by a professional as soon as possible. Bipolar disorder treatment involves a life-long program of treatment, both prescription and therapy based. The good news is that individuals who stick with their medication and work to develop coping techniques can live a life relatively free of bipolar disorder symptoms.
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Author Zarar Bajwa, MD, is a licensed medical doctor Archives
June 2015
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