Wednesday, September 29, 2010

Bipolar Tips

Bipolar disorder explained

What is Bipolar Disorder?

Bipolar Disorder is the name used to describe a set of 'mood swing' conditions, the most severe form of which used to be called 'manic depression'.

Bipolar Disorder I is the more severe disorder - with individuals being more likely to experience mania , have longer 'highs', be more likely to have psychotic experiences and be more likely to be hospitalized.
Bipolar Disorder II is less severe, with no psychotic experiences, and with episodes tending to last only hours to a few days.
The high moods are called mania or hypomania and the low mood is called depression.
It is important to note that everyone has mood swings from time to time. It is only when these moods become extreme and interfere with personal and professional life that Bipolar Disorder may be present and medical assessment may be warranted.




What is Bipolar Disorder?

Bipolar Disorder is the name used to describe a set of 'mood swing' conditions, the most severe form of which used to be called 'manic depression'.

Bipolar Disorder I is the more severe disorder - with individuals being more likely to experience mania , have longer 'highs', be more likely to have psychotic experiences and be more likely to be hospitalized.
Bipolar Disorder II is less severe, with no psychotic experiences, and with episodes tending to last only hours to a few days.
The high moods are called mania or hypomania and the low mood is called depression.
It is important to note that everyone has mood swings from time to time. It is only when these moods become extreme and interfere with personal and professional life that Bipolar Disorder may be present and medical assessment may be warranted.

Causes of Bipolar Disorder
While we don't yet know exactly what causes Bipolar Disorder, we do know that it appears to have primarily biological underpinnings. However, its onset is often linked to a stressful life event.

And while the causes of Bipolar Disorder are still unknown, there are a number of factors that are believed to play a role, including genetics, brain chemicals, environmental factors and sometimes medical illnesses.
Read about:


  • Genetics

  • Brain chemicals

  • Environmental

  • Medical illness

  • Pregnancy

  • What is the future for someone with Bipolar Disorder?

Genetics

Bipolar Disorder is frequently inherited, with genetic factors accounting for approximately 80% of the cause of the condition.
If one parent has Bipolar Disorder, there is a 10 per cent chance that his or her child will develop the illness. If both parents have Bipolar Disorder the likelihood of their child developing the illness rises to 40 per cent.
However, just because one family member has the illness, it is not necessarily the case that other family members will also develop the illness. Other factors also come into play.

Brain chemicals

A recent theory about the cause of Bipolar Disorder is that it is related to abnormal serotonin chemistry in the brain. Serotonin is one of the neurotransmitters in the brain, and one that strongly affects a person's mood. It is thought that the abnormal serotonin chemistry causes mood swings because of its feedback effect on other brain chemicals. It is unlikely, however, that serotonin is the only neurotransmitter involved.

Environmental

While the onset of Bipolar Disorder may be linked to a stressful life event, it is unlikely that stress itself is a cause of Bipolar Disorder. Notwithstanding this, people who suffer from Bipolar Disorder often find it beneficial to find ways of managing and reducing stress in their lives (as do people without the disorder!).
Again - while not a cause - seasonal factors appear to play a role in the onset of Bipolar Disorder, with onset chance increasing in spring. The rapid increase in hours of bright sunshine is thought to trigger depression and mania by affecting the pineal gland.

Medical illness

Medical illness is not a cause of Bipolar Disorder, but in some instances can cause symptoms that could be confused with mania or hypomania. Some medications and certain illicit stimulant drugs can also cause manic and hypomanic symptoms.

Pregnancy

For women who are genetically or otherwise biologically predisposed to developing Bipolar Disorder, the postnatal period can coincide with a first episode of Bipolar Disorder.

What is the future for someone with Bipolar Disorder?

Like any other medical condition, such as heart disease or diabetes, Bipolar Disorder is an illness that requires careful management.
While there is no known cure for Bipolar Disorder, the good news is that its severity and the frequency of episodes can be reduced or prevented with medication and other supports, such as psychological therapies.
 Treatments of Bipolar Disorder
Bipolar Disorder involves episodes of depression and episodes of mania or hypomania. Therefore its management usually involves two parts:

  • Treating the current episode of mania or depression, and

  • Preventing the long-term recurrence of mania and depression.
In this section we cover the main treatment approaches for Bipolar Disorder.

Key points about treatments


  • Bipolar Disorder is an illness which can require long-term treatment.

  • Everyone is different and therefore the appropriate treatment for a particular individual is a matter for a skilled medical practitioner

  • Physical treatments are necessary for Bipolar Disorder - psychological approaches by themselves are not sufficient but, alongside drug treatments, serve a valuable complementary role.

  • With the right medical management people with Bipolar Disorder can achieve stability and live successful lives.

  • While the great majority of people with Bipolar Disorder will benefit from treatment, it is difficult to know beforehand;

  • which drug regime will be of most benefit to any particular individual, and

  • how long it will take to bring the mood swings under control.

  • Therefore, keeping a Daily Mood Graph can be of fundamental importance to your clinician in assessing the impact of differing treatments on your mood swings over time, and will be of great benefit to you.
 key points about Bipolar Disorder

  • Occasionally people can experience a mixture of both highs and lows at the same time, or switch during the day, giving a mixed picture.


  • A small number of people with Bipolar Disorder (5%) experience only the 'highs', whereas the vast majority of Bipolar sufferers alternate between highs and lows.



    • Some people may only have one episode of mania once a decade, while others may have daily mood swings. For each individual the pattern is quite distinct.

    • People with Bipolar Disorder experience normal moods in between their swings.

    • Women and men develop Bipolar I Disorder at equal rates while the rate of Bipolar II is somewhat higher in females.

    • Bipolar Disorder can commence in childhood, but onset is commoner in the teens or early 20s. Some people develop their first episode in mid-to-late adulthood. Many people go for years before it is accurately diagnosed or treated (see How to tell if you have Bipolar Disorder)

    • Women with Bipolar Disorder have a very high chance of a significant mood disturbance both during pregnancy and in the post-partum period - most commonly in the first four weeks. (Most will have a depressive episode, a significant proportion will have highs, and 10% will have mixed highs and lows.)

    • With the right treatment, the vast majority of people with Bipolar Disorder are able, to varying extents, to live normal and productive lives.

    • Some people with Bipolar Disorder can become suicidal. It is very important that talk of suicide be taken seriously and for such people to be treated immediately by a mental health professional or other appropriate person.
     FAQ about Bipolar Disorder
    1.     What is Bipolar Disorder?
    2.     What are the signs of Bipolar Disorder?


    1. What is Bipolar Disorder?

    Bipolar Disorder is the name now given to what used to be called manic depression and other related disorders, with milder versions called Bipolar II.
    The term describes the exaggerated swings of mood from one extreme to the other that are characteristic of the illness. People with this illness suffer recurrent episodes of high, or elevated, mood (mania or hypomania) and of depression. A very small percentage of sufferers of Bipolar Disorder only experience the 'highs'. Most experience both the highs and the lows.

    2. What are the signs of Bipolar Disorder?

    Bipolar Disorder can be difficult to diagnose. The chief feature that distinguishes it from depression is the mania , or elevated mood that its sufferers also experience periodically. However, the degree of mania experienced differs from one person to the next.
    Mild mania, or hypomania, which is characteristic of Bipolar II Disorder, can go unnoticed for some time by anyone other than the person concerned.
    A person experiencing hypomania or mania would usually be in very high spirits, feel terrific, enthusiastic, confident and invincible. However, others have a different experience and instead become irritable and aggressive. The person's mind would be working much faster than usual, with both ideas and speech being more rapid. They tend to require less sleep and may stay up late to do housework or to begin a new project.
    However, mania (in particular) affects a person's judgement, so that the person is likely to have unrealistic perspectives and beliefs about their own abilities, and this can cause serious problems for him or her and/or family members. For instance, people may engage in reckless spending sprees, gambling, or in sexual activity they would not normally engage in, without thinking of the consequences.  

    3. How is Bipolar Disorder treated?

    Bipolar Disorder is usually treated with a combination of mood stabilisers and atypical antipsychotics to treat the mania, and antidepressants to treat the depression, with maintenance (aimed at preventing recurrence) usually relying on a mood stabiliser (or sometimes an antidepressant) alone.
    Psychological therapies by themselves are ineffective and inappropriate, but can be a useful adjunct to the physical treatment.

    4. Will I have to stay on medication forever?

    Bipolar Disorder is an illness which usually requires long-term medication. Most people who have had one manic episode will go on to have further illness. Without medication, relapse is likely. Long-term stability is usually a key objective for people with Bipolar Disorder, and correct medication is central to long-term stability.

    5. Can Bipolar Disorder be cured?

    There is presently no known cure for Bipolar Disorder. However, with the help of skilled medical management, the person with Bipolar Disorder is able to lead a stable and productive life, and may, over time, be able to reduce the level of their medication.

    6. What should I do if I'm (or someone close to me is) feeling suicidal?

    See the list of emergency contact numbers (and add the numbers of your GP and your local Community Mental Health Service) and keep a copy handy somewhere. Don't hesitate to call one of them if in need of help.
    Recognise that having suicidal thoughts is one of the features of depression, and seek help, either from your GP or another mental health professional such as a psychologist or a counsellor. Make sure you tell them you have been having suicidal thoughts.
    If you have already received treatment for depression, and you are having suicidal thoughts, contact the person who has been giving you the treatment, or a close friend who you trust, and tell them you are feeling suicidal.
    If someone close to you is suicidal or unsafe, talk to them about it and encourage them to seek help. Help the person to develop an action plan, involving him or her and trusted close friends or family members, to keep him or her safe in times of emergency. Take away risks (e.g. remove guns or other dangerous weapons and hold the keys of the car if the depressed person is angry, out of control and wanting to drive off into the night).

    7. Where can I get help for Bipolar Disorder?

    Bipolar Disorder usually requires diagnosis and treatment by a psychiatrist.
    However, if you have not previously sought help for Bipolar Disorder, as a first step, you should see your General Practitioner. He or she will either conduct an assessment of you to find out if you have Bipolar Disorder, or refer you to a psychiatrist who will conduct the assessment.
    The psychiatrist will develop a management plan in consultation with you and possibly also your General Practitioner. Depending on the nature of your illness, ongoing management may be done by the psychiatrist, or by your General Practitioner in consultation with your psychiatrist.
    If you have recurring episodes of mania, you may need to see a mood disorders specialist.

    Ask a Doctor Now.

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