Coping And Reaching Out
Long before Dr. Vogel-Scibilia examined the patient who had bipolar and saw herself reflected back, she had figured out ways of adapting to her seasonal mood swings. Anticipating in winter, she scheduled her most challenging coursework for the fall.
Id do the research, pick the cards, and do the bibliography, she says, so if I had to write the paper Id just have to write the text out. I would try to compensate for things, study stuff in advance.
if youve been the doctor first and then you get sick, you have a hell of a hard time being a patient.
Now a practicing clinical psychiatrist in Beaver, Pennsylvania, she operates an independent mental health clinic and serves as clinical assistant professor at Western Psychiatric Institute, the same hospital where she did her residency and diagnosed herself.
Today, she is president of NAMI at the national level and a consultant for psychopharmacology projects at the National Institute of Mental Health and is a grant reviewer for the federal government.
But at least once a week, she gets a call from a young medical student or resident doctorusually, she says, its a psychiatric resident secretly struggling with mental illness. Some of them offer to fly or drive long distances for a consultation.
You could do a study , but thered be no sample, because nobody would agree to be interviewed. Actually I could just poll my friends. The trouble is it wouldnt be a random sample. It would be the friends of Suzanne.
Types And Causes Of Bipolar Disorder
There are two different types of bipolar disorder. People with bipolar disorder I have severe manic episodes, whereas those with bipolar disorder II experience milder episodes.
Bipolar disorder tends to run in families, and research suggests that certain genes may increase the risk. The condition is usually diagnosed before age 25, although some people experience symptoms for the first time later in life.
Some people with bipolar disorder also have attention deficit hyperactivity disorder, which usually develops before bipolar disorder. Other psychological conditions, including anxiety disorders, may accompany bipolar disorder.
It can be difficult to distinguish between depressive episodes that occur due to regular, or unipolar, depression, and those that occur due to bipolar disorder. NYU Langone is home to nationally renowned psychiatrists who specialize in identifying bipolar disorder. A correct diagnosis is essential to the appropriate management of bipolar disorder. Medications to ease symptoms of unipolar depression can actually trigger manic episodes in people with bipolar disorder.
To diagnose bipolar disorder, a doctor performs a physical exam, asks about your symptoms, and recommends blood testing to determine if another condition, such as hypothyroidism, is causing your symptoms.
If the doctor does not find an underlying cause of your symptoms, he or she performs a psychological evaluation.
Conditions That Can Co
Many people with bipolar disorder also may have other mental health disorders or conditions such as:
- Psychosis. Sometimes people who have severe episodes of mania or depression also have psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the persons extreme mood. For example:
- Someone having psychotic symptoms during a manic episode may falsely believe that he or she is famous, has a lot of money, or has special powers.
- Someone having psychotic symptoms during a depressive episode may believe he or she is financially ruined and penniless or has committed a crime.
Some bipolar disorder symptoms are like those of other illnesses, which can lead to misdiagnosis. For example, some people with bipolar disorder who also have psychotic symptoms can be misdiagnosed with schizophrenia. Some physical health conditions, such as thyroid disease, can mimic the moods and other symptoms of bipolar disorder. Street drugs sometimes can mimic, provoke, or worsen mood symptoms.
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How Does Bipolar Disorder Affect Family And Relationships
Living with bipolar disorder can put an enormous strain on your relationships, especially romantic relationships. Being honest and open about your condition is the best approach to managing your relationship. Whenever you are ready to open up about your illness, these facts will help them understand you better:
One of the best ways to make your relationships work is by adhering to your treatment and following your doctors advice. This helps in keeping your symptoms at bay, allowing you more time to focus on your relationships.
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Bipolar Disorder In The Media
In recent times, a public awareness of bipolar disorder has spread through the internet, radio and television shows such as MTVs True Life: Im Bipolar, and BBCs The Secret Life of the Manic Depressive. The latter was first shown in 2006 and repeated in 2007. It presented the public with an honest portrayal of what it is like to have bipolar disorder.
Can Bipolar Disorder Be Prevented
While theres no guaranteed way to prevent someone from developing bipolar disorder, many people successfully manage it with the right treatment and support. A successful strategy may include medication, therapy and other self-help strategies.
If you have a family history of bipolar disorder, its important to be aware of early warning signs, and for friends and family to be aware of them too. Avoid taking substances that can trigger manic or hypomanic episodes such as:
Other ways to prevent relapses or episodes include learning to manage your stress and getting enough sleep.
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Bipolar Misdiagnosis: Why Does It Happen
Bipolar disorder is frequently misdiagnosed. According to recent medical research, around 20% of people with bipolar disorder may be mistakenly diagnosed with depression. This occurs because the symptoms of bipolar II disorder are similar to those of major depressive disorder, with most people experiencing more depressive episodes than periods of hypomania.
What’s more, unlike full-blown mania, hypomania is easy dismissed as someone being “normal” or seeming more productive and sociable than usual. Some people misunderstand the symptoms of bipolar disorder and think they can’t possibly have the condition because their mood changes don’t follow a regular pattern.
Bipolar disorder doesnt always present as we see it in movies and on television. If you think youre experiencing symptoms of bipolar disorder, such as episodes of depression and mania or hypomania, you must consult your doctor, who will refer you for help and treatment.
Reflect On Your Symptoms
To help better understand your symptoms and pinpoint patterns in your behavior and mood, consider these questions:
- When do you first remember experiencing intense mood changes?
- How long do these changes typically last?
- What happens when you feel this way?
- How do you behave during an episode?
- What does your daily life look like during these times?
- What symptoms are you currently experiencing? When did they start?
- When do your symptoms tend to worsen?
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Psychiatry Can Help You
There is no cure for bipolar disorder. Still, there are ways to manage the effects of this challenging condition. A psychiatrist near you can determine the nature of your condition. The doctor will then customize care for you. The science of psychiatry will use a multi-faceted approach to help you achieve a good quality of life. You can once again feel well and have the peace of mind that you have been searching for.
Get more information about Evolve Psychiatry in Massapequa at .
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What Does Onset Of Bipolar Disorder Look Like
In some patients, the first sign of bipolar disorder is what appears to be a major depressive episode. Others experience full-blown mania or hypomania a less extreme form of mania. Still others experience a confusing combination of symptoms called a mixed episode, which has elements of both depression and mania.
Here is a closer look at what a first episode might look like:
Depression: When the first episode of bipolar disorder is depression, symptoms can develop slowly, reports Michael Strober, PhD, who is Distinguished Professor of Psychiatry, and Senior Consultant to the Youth Mood Disorders Treatment and Research Program at the David Geffen School of Medicine at UCLA. Bipolar depression usually includes not only the sadness or irritability we associate with depression, but delusions of failure, exaggerated feelings of guilt, mental confusion and profound physical slowness.
Despite these differences, Dr. Strober notes that symptoms of bipolar depression are often misdiagnosed as major depressive disorder early on, because alternating periods of mania may not appear until months or years later.
Mania: Unlike the gradual descent into depression, when the initial episode is mania the onset can be like a thunderclap, says Wendy Nash, MD, a child and adolescent psychiatrist. An initial manic episode might be characterized by grandiose thinking, risk-taking, accelerated speech and thought, and euphoria or irritability.
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Do Other Illnesses Mimic Symptoms Of Bipolar Disorder
Mood swings and impulsive behavior can sometimes reflect psychiatric problems other than bipolar disorder, including:
- Substance use disorders
- Attention deficit hyperactivity disorder
- Certain anxiety disorders such as post-traumatic stress disorder
Psychosis can occur not only in bipolar disorder but other conditions such as schizophrenia or schizoaffective disorder. In addition, people with bipolar disorder often have additional psychiatric problems such as anxiety disorders , and social anxiety disorder), substance use disorders, or personality disorders that may complicate an illness presentation and require independent treatment.
Some non-psychiatric illnesses, such as thyroid disease, lupus, HIV, syphilis, and other infections, may have signs and symptoms that mimic those of bipolar disorder. This can pose further challenges in making a diagnosis and determining the treatment.
What Will My Doctor Ask Me
To make a diagnosis of bipolar disorder, your doctor will ask you about:
- How many symptoms you experience
- Which types of mood episodes you experience
- How long your mood episodes last for
- How many mood episodes you’ve had
- How often your mood episodes occur
- How your symptoms impact your life
- Your family history
They may also:
- Ask you to keep a diary of your moods to help you both identify patterns and triggers.
- Check up on your physical health. For example, some conditions like thyroid problems can cause mania-like symptoms.
Only a mental health professional like a psychiatrist can give you a bipolar disorder diagnosis not your GP.
However, if you’re experiencing bipolar moods and symptoms, discussing it with your GP can be a good first step. They can refer you to a psychiatrist, who will be able to assess you.
For more information see our pages on seeking help for a mental health problem.
Once properly diagnosed, I knew the cause. I understood that I was someone with an illness. I was not a failure, not a bad person.
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How Is Bipolar Disorder Diagnosed
How is bipolar disorder diagnosed? This is one of the first questions most people ask when theyre showing bipolar symptoms. Unlike with other, more common, mental health conditions like depression and anxiety, you cannot walk into your doctors office and leave with a bipolar disorder diagnosis.
Bipolar disorder is complex, and it shares traits with other conditions such as major depressive disorder and borderline personality disorder. Misdiagnosing bipolar disorder, and consequently mistreating bipolar disorder, can be dangerous, so how do you know you’ve got the right diagnosis? Find out how bipolar disorder is diagnosed and who is qualified to make the call.
A Story Of Misdiagnosis
“Home from a weeks vacation in Costa Rica, I was at the office of my general practitioner to get a prescription for a different medication for my depression. I told the doctor that I had spent my vacation entirely in my hotel room ‘maniacally writing.’ While my wife went to the beach, explored neighborhoods, and visited my family who lived there, I just wrote. And wrote. And wrote. I wrote so much that I came home with seven chapters of what would become my first book.
“I needed a new prescription because my first prescription for depression, Prozac, had made me irritable. I also could not concentrate, couldn’t sleep, and my language was coarse. These symptoms had been taken by the doctor to indicate a deeper depression, and so she had originally increased the dosage. But a new problem, a side effect of diarrhea, pushed me to noncompliance. I quit taking the medication, and went to Costa Rica during the period needed to wash it out of my system before getting a different medication.
“But now, at this appointment, my use of the word ‘maniacally’ caused my doctor to pause. Antidepressants can cause people with bipolar disorder to ‘flip’ into mania or hypomania. So she screened me by asking just one question, ‘Are you manic?’
“I answered, ‘No. I’m not manic, I’m excited!’ With that, she gave me the next antidepressant.
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Coping With Bipolar Disorder
Living with bipolar disorder can be challenging, but there are ways to help make it easier for yourself, a friend, or a loved one.
- Get treatment and stick with itrecovery takes time and its not easy. But treatment is the best way to start feeling better.
- Keep medical and therapy appointments, and talk with the provider about treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping, and make sure to get enough sleep and exercise.
- Learn to recognize your mood swings.
- Ask for help when trying to stick with your treatment.
- Be patient improvement takes time. Social support helps.
Remember, bipolar disorder is a lifelong illness, but long-term, ongoing treatment can help control symptoms and enable you to live a healthy life.
What Are The Signs Of Mania Or Hypomania
In a manic episode, for at least a week a person must feel either so euphoric or so irritable that there is significant impairment of social or occupational function. In addition, if the mood is euphoric, he or she must have at least three of the following symptoms. If the mood is irritable, at least four of the symptoms must be present:
- Increased energy, activity and restlessness
- Racing thoughts, talking very fast and jumping from one idea to another
- Inability to concentrate, very easily distracted
- Little need for sleep
- Having an inflated feeling of power or importance, or an unrealistic belief in ones abilities and powers
- Showing poor judgment, such as going on spending sprees or taking part in inappropriate sexual activity
- Abusing drugs, particularly cocaine, alcohol and sleep medications
- Exhibiting aggressive behavior
- Denying that anything is wrong
The symptoms of hypomania are similar to those of mania, but they are less severe and often of shorter duration. Hypomania causes little or no functional impairment and does not result in hospitalization.
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Types Of Bipolar Test
These are some that a Doctor can perform to examine if you have Bipolar Disorder:
This is one of the bipolar disorder test. This blood test is used to rule out other illnesses that can trigger bipolar disorder. Its also used to determine if the patient has any thyroid issues. . It may screen for anemia as well as various illnesses. You can also test vitamins and calcium using these tests.
Tests for a variety of diseases and disorders are also done, including MRA to look for organ abnormalities. Blood tests, thyroid function tests, hormone levels.
The doctor will now inquire about your symptoms, treatments used. He or she can also ask about other medications youre taking. He or she will enquire any other relevant information to diagnose Bipolar Disorder. These are some of the screening exams that can help:
Some Other Tests
How To Get Help
About 2.6% of the U.S. population have a diagnosis of bipolar disorder. It usually comes on at about age 25, but it can happen earlier. There are different types, too. Symptoms can happen — or not happen — along a wide spectrum.
A âlife chartâ is a good way to track your moods and help your doctor diagnose whether you have bipolar disorder. Youâll record details about your moods, sleep patterns, and events in your life. If youâre on a manic swing, you might feel âupâ and capable, but a look at the big picture will show you how a âdownâ will follow. The info also will give your doctor a window into your day-to-day — even hour-to-hour — life to decide how best to proceed with treatment if needed.
Special phone apps can help you keep up, too. There are quite a few available to help you track your moods, medications, sleep patterns, and more. One even analyzes how you type on your phone: your rhythm and speed, mistakes, corrections, and other dynamics, but not your content. It then uses this data to gauge your mood and predict bipolar episodes. Just remember that these apps donât take the place of following a treatment plan under your doctorâs care.
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