What is bipolar disorder?
Bipolar disorder, formerly called manic depression, is a mental disorder characterized by drastic and intense shifts in energy, mood, and activity level. Individuals can be exuberant and euphoric, irritable, severely depressed or explosive. Symptoms can include racing thoughts, impulsive behavior, self-destructive behavior and suicidal behavior. The intensity, nature, and duration of the mood episodes can vary greatly.
Are there different types of bipolar disorder and if so how do they vary?
There are five major types of bipolar disorder. For a diagnosis of Bipolar I, mania must be present for seven days or result in hospitalization. With Bipolar II, patients need to experience both depression and hypomania, a less intense form of mania. Bipolar Not Otherwise Specified (BP-NOS) is a diagnosis used when a person has symptoms of the illness but they do not meet the diagnostic criteria for Bipolar I or Bipolar II. Cyclothymia is a milder form of bipolar disorder that may evolve into Type I or II. A severe form of the disorder is call Rapid-cycling, which occurs when mood swings happen more frequently—four or more major episodes of depression, mania, hypomania or mixed states, all within a year.
Is bipolar disorder hard to diagnose?
Depression is a common condition, but it is also often the initial presenting symptom of bipolar disorder, which makes diagnosing bipolar difficult. Alcoholism and substance abuse issues are common among those with the disorder and may further confuse or mask diagnosis. Periods of hypomania can easily be mistaken for high productivity and wellness. In extreme cases, a full-blown manic episode may result in delusions or psychotic symptoms and may be mistaken for schizophrenia. A person with a history of depressive episodes has a strong risk of suicide. Because of these issues, it is essential for an experienced, knowledgeable, and skillful professional to consider all of these factors carefully and to make a diagnosis based on the criteria in the Diagnostic and Statistical Manual for Mental Disorders, or DSM.
What causes bipolar disorder?
Scientists have not determined a single factor or underlying cause of bipolar disorder. Genetics play a role as the disorder is passed down through the generations, but it is not known or understood why some members of a family will develop the disorder and others will not. In 2013, a genome-wise study revealed a genetic overlap (or common inherited genetic variations) between 5 major mental disorders: bipolar disorder, schizophrenia, depression, ADHD, and autism, with the highest overlap between bipolar disorder and schizophrenia. Experts believe that environmental factors contribute to the development of bipolar disorder and are critical to why some people at risk for the disorder develop it and others do not.
How many people suffer from bipolar disorder?
There are 5.7 million adults diagnosed with bipolar disorder, according to the National Institute of Mental Health.
What are the medications most commonly prescribed in the treatment of bipolar disorder?
Lithium: mood stabilizer with anti-depressant effect that reduces the recurrence of manic and depressive episodes and prevents suicide Side effects: Nausea; headache; fatigue; acne; tremors; long-term use often results in thyroid problems; may affect kidney function; requires monitoring of lithium in blood levels; can cause dehydration; must be monitored; on hot days, special precautions must be taken so that the level of lithium does not rise to a lethal level.
Depakote: mood stabilizer and anticonvulsant that helps prevent and reduce mania and frequency of cycles Side effects: Weight gain; fatigue; acne; hair loss; may cause damage to the liver, heart, pancreas, and kidneys; not advised for women of child-bearing age who may want to become pregnant; may cause birth defects during pregnancy; may increase the risk of polycystic ovary syndrome in women.
Atypical antipsychotics (Seroquel, Abilify, Risperidone, Zyprexa) that bring down and reduce mania and psychotic symptoms Side effects: Weight gain; tremors; tardive dyskinesia; sleepiness; sluggishness; increase the risk of developing type-2 diabetes; cardiac risk factors.
Pregnancy and bipolar medicine
A very small study of 8 women (Northwestern University research) Indicated that the rise in metabolism that pregnancy causes lowers the concentration of lamotrigine (an anticonvulsant like Depakote) in their blood. Some of the women in the study had worsening symptoms of depression. The study seemed to suggest that the dosage should be “optimized,” possibly increased during pregnancy and decreased after birth.
Considering that 4.4 million women in the US have bipolar disorder and most suffer during childbearing years, it’s concerning that so little is known about the effects of the various drugs on the mother and fetus during and after pregnancy.
Is there a cure for bipolar disorder?
Bipolar disorder is a lifelong condition. With the proper treatment and long-term care, people with bipolar disorder can lead full and productive lives. The support of family and other team members are invaluable in helping the individual monitor and recognize moods before they develop into full-blown episodes.
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— Suelain Moy