Bipolar Disorder:
Bipolar disorder, also known as manic-depressive illness,
is a brain disorder that causes unusual shifts in a person's
mood, energy, and ability to function. Different from
the normal ups and downs that everyone goes through, the
symptoms of bipolar disorder are severe. They can result
in damaged relationships, poor job or school performance,
and even suicide. But there is good news: bipolar disorder
can be treated, and people with this illness can lead
full and productive lives. More than 2 million American
adults, 1 or about 1 percent of the population age 18
and older in any given year, 2 have bipolar disorder.
Bipolar disorder typically develops in late adolescence
or early adulthood. However, some people have their first
symptoms during childhood, and some develop them late
in life. It is often not recognized as an illness, and
people may suffer for years before it is properly diagnosed
and treated. Like diabetes or heart disease, bipolar disorder
is a long-term illness that must be carefully managed
throughout a person's life.
Signs and symptoms of mania
(or a manic episode) include:
- Increased energy, activity, and restlessness
- Excessively "high," overly
good, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast,
jumping from one idea to another
- Distractibility, can't concentrate
well
- Little sleep needed
- Unrealistic beliefs in one's abilities
and powers
- Poor judgment
- Spending sprees
- A lasting period of behavior that is
different from usual
- Increased sexual drive
- Abuse of drugs, particularly cocaine,
alcohol, and sleeping medications
- Provocative, intrusive, or aggressive
behavior
- Denial that anything is wrong
A manic episode is diagnosed if elevated mood occurs
with 3 or more of the other symptoms most of the day,
nearly every day, for 1 week or longer. If the mood is
irritable, 4 additional symptoms must be present.
Signs and symptoms of depression
(or a depressive episode) include:
- Lasting sad, anxious, or empty mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in activities once enjoyed,
including sex
- Decreased energy, a feeling of fatigue or of being
"slowed down"
- Difficulty concentrating, remembering, making decisions
- Restlessness or irritability
- Sleeping too much, or can't sleep
- Change in appetite and/or unintended weight loss or
gain
- Chronic pain or other persistent bodily symptoms that
are not caused by physical illness or injury
- Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if 5
or more of these symptoms last most of the day, nearly
every day, for a period of 2 weeks or longer. Some people
with bipolar disorder become suicidal. Risk for suicide
appears to be higher earlier in the course of the illness.
Therefore, recognizing bipolar disorder early and learning
how best to manage it may decrease the risk of death by
suicide. Findings from gene research suggest that bipolar
disorder, like other mental illnesses, does not occur
because of a single gene. It appears likely that many
different genes act together, and in combination with
other factors of the person or the person's environment,
to cause bipolar disorder. Finding these genes, each of
which contributes only a small amount toward the vulnerability
to bipolar disorder, has been extremely difficult. But
scientists expect that the advanced research tools now
being used will lead to these discoveries and to new and
better treatments for bipolar disorder. Brain-imaging
studies are helping scientists learn what goes wrong in
the brain to produce bipolar disorder and other mental
illnesses. New brain-imaging techniques allow researchers
to take pictures of the living brain at work, to examine
its structure and activity, without the need for surgery
or other invasive procedures. These techniques include
magnetic resonance imaging (MRI), positron emission tomography
(PET), and functional magnetic resonance imaging (fMRI).
There is evidence from imaging studies that the brains
of people with bipolar disorder may differ from the brains
of healthy individuals. As the differences are more clearly
identified and defined through research, scientists will
gain a better understanding of the underlying causes of
the illness, and eventually may be able to predict which
types of treatment will work most effectively.
Treatment:
- Lithium, the first mood-stabilizing medication approved
by the U.S. Food and Drug Administration (FDA) for treatment
of mania, is often very effective in controlling mania
and preventing the recurrence of both manic and depressive
episodes.
- Anticonvulsant medications, such as valproate (Depakote®)
or carbamazepine (Tegretol®), also can have mood-stabilizing
effects and may be especially useful for difficult-to-treat
bipolar episodes. Valproate was FDA-approved in 1995
for treatment of mania.
- Newer anticonvulsant medications, including lamotrigine
(Lamictal®), gabapentin (Neurontin®), and topiramate
(Topamax®), are being studied to determine how well
they work in stabilizing mood cycles.
- Anticonvulsant medications may be combined with lithium,
or with each other, for maximum effect.
- Children and adolescents with bipolar disorder generally
are treated with lithium, but valproate and carbamazepine
also are used. Researchers are evaluating the safety
and efficacy of these and other psychotropic medications
in children and adolescents. There is some evidence
that valproate may lead to adverse hormone changes in
teenage girls and polycystic ovary syndrome in women
who began taking the medication before age 20.14 Therefore,
young female patients taking valproate should be monitored
carefully by a physician.
- Women with bipolar disorder who wish to conceive,
or who become pregnant, face special challenges due
to the possible harmful effects of existing mood stabilizing
medications on the developing fetus and the nursing
infant.15 Therefore, the benefits and risks of all available
treatment options should be discussed with a clinician
skilled in this area. New treatments with reduced risks
during pregnancy and lactation are under study.
Source: www.nimh.nih.gov/publicat/bipolar.cfm
Call
us anytime, 24 hours a day, seven days a week for a free
assessment. One of the owners will always answer the calls
directly and be able to provide you or a family member with
the guidance you need. We give people their lives back everday!
1-800-559-9503
|
