Thursday, June 16, 2022

Is Bipolar Disorder A Mental Illness

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What Can I Do About It

Mental Health: Living with Bipolar Disorder

Some common treatments for bipolar disorder, used on their own or in combination, include:

Medication: There are many different types of effective medication for bipolar disorder, and different kinds work in different ways. Medication can help keep your mood more stable. Mania can make you feel so good that you stop taking your medications. This is very dangerous because symptoms that return after stopping treatment are often much harder to treat properly. Talk to your doctor to find out if medication is right for you and if so, how to use it properly.

Counselling: There are two types of counselling that work best for people with bipolar disorder.

  • Cognitive-behavioural therapy : A health professional who uses this approach can teach you skills to help change your view of the world around you. They do this by coaching you to break the negative patterns of depression or the destructive patterns of mania including the thoughts and actions that can keep the moods going.
  • Interpersonal therapy : Often when you are depressed or in mania, your relationships with other people suffer. A health professional who uses IPT can teach you skills to improve how you interact with other people.

Living With Bipolar Disorder

Treatment can help you manage mood episodes and cope with the symptoms they cause.

Creating a care team can help you get the most out of treatment. Your team might involve:

  • your primary doctor
  • a psychiatrist who manages your medications
  • a therapist or counselor who provides talk therapy
  • other professionals or specialists, such as a sleep specialist, acupuncturist, or massage therapist
  • a bipolar disorder support group, or community of other people also living with bipolar disorder

You may need to try a few treatments before you find one that leads to improvement. Some medications work well for some people but not others. In a similar vein, some people find CBT very helpful, while others may see little improvement.

Its always best to be open with your care team about what works and what doesnt. If something doesnt help or makes you feel even worse, dont hold back from letting them know. Your mental health matters, and your care team should always support you in finding the most helpful approach.

A little self-compassion can go a long way, too. Keep in mind that bipolar disorder, like any other mental health condition, didnt happen by choice. Its not caused by anything you did or didnt do.

Its OK to feel frustrated when treatment doesnt seem to work. Try to have patience and treat yourself kindly as you explore new approaches.

Brain Structure And Function

Researchers are learning that the brain structure and function of people with bipolar disorder may be different from the brain structure and function of people who do not have bipolar disorder or other psychiatric disorders. Learning about the nature of these brain changes helps doctors better understand bipolar disorder and may in the future help predict which types of treatment will work best for a person with bipolar disorder. At this time, diagnosis is based on symptoms rather than brain imaging or other diagnostic tests.

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Information For Family Carers And Friends

How can I get support?

You can speak to your GP. You should be given your own assessment through NHS mental health services to work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.

These are some other options for you:

  • Join a carers service
  • Join a carers support group
  • Ask your local authority for a carers assessment
  • Read about the condition
  • Apply for welfare benefits for carers

Rethink Mental Illness run carers support groups in some areas. You can also search for groups on the Carers Trust website:

How can I support the person I care for?

You might find it easier to support someone with bipolar disorder if you understand their symptoms, treatment and self-management skills.

You should be aware of what you can do if you are worried about their mental state. It can be helpful to know contact information for their mental health team or GP.

You could find out from your relative if they have a crisis plan. You could help your relative to make a crisis plan if they dont have one.

As a carer you should be involved in decisions about care planning. But you dont have a legal right to this. The medical team should encourage the person that you care for to allow information to be shared with you.

You can find out more information about:

Bipolar Disorder Due To Another Medical Or Substance Abuse Disorder

TMH Speaks... Bipolar Disorder

Some bipolar disorders dont have a specific pattern or dont match the three categories of disorders listed above and yet, they still align with the criteria for abnormal mood changes. For example, a person may experience mild depressive or hypomanic symptoms that last less than the specified amount for cyclothymia. Additionally, a person might experience depressive episodes, but have symptoms of mood elevation that are too mild or brief to be diagnosed as mania or hypomania.

These instances can be determined to be characteristic of bipolar disorder, but arent classified under the aforementioned types of bipolar disorder.

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Common Signs & Symptoms Of Depression

  • Feeling very sad or hopeless
  • Feeling lonely or isolating themselves from others
  • Eating too much or too little
  • Having little energy and no interest in usual activities
  • Sleeping too much

Teens and young adults with bipolar disorder symptoms may think and talk about self-harm or suicide. If someone you know is expressing these thoughts, seek help immediately.

Bipolar Disorder In Women And During Pregnancy

Women and people with bipolar II disorder are significantly more likely to experience periods of rapid cycling than men with the same condition. Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness.

Pregnancy and the postpartum period can exacerbate bipolar disorder symptoms. The body goes through so many hormonal changes and women who already have an underlying bipolar disorder can have their symptoms exacerbated by these changes, explains Dr. Narasimhan. Crazy enough, sometimes women who dont have bipolar disorders can develop one in the postpartum period. Called postpartum bipolar onset, the mood disorder may resolve itself after the postpartum period or it can sometimes remain.

The general consensus is that when theres severe mental illness, and someone gets pregnant, its not the time to take them off medication, Dr. Narasimhan says. That said, you have to have an honest discussion and know which medications have some risk during pregnancy and which can affect the fetus, she says. Oftentimes the risk of not being on medication is worse than the risk of stopping the medication. Dr. Narasimhan also says she has plenty of patients who dont want to take their medication during pregnancy, and for these patients, they weigh the risks and benefits carefully.

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Whats Going On In The Brain

Up until recently, researchers hadnt been able to distinguish a person with bipolars brain from a person without the disorder on a scan. But science is making some tracks. A 2019 study that looked at the brains of people with bipolar and those with depression on functional MRI scans correctly differentiated their brains about 80% of the time.

The findings suggest differences in the amygdala, the emotion center of the brain, of people with bipolar when they process emotions like sadness, anger, fear, and joy, and could become a marker to help identify bipolar disorder on brain scans. Likewise, bipolar affects brain biochemistry and neurotransmitters in the brain that produce chemical variations such as oxytocin, GABA, dopamine, and serotonin. These chemicals may be unbalanced in the brains of people with bipolar disorders. But as of yet, researchers arent clear on how too little GABA or too many oxytocin-active neurons play a role in the disorder or whether measuring them can help.

Where Do I Go From Here

Living with Mental Illness: Bipolar Disorder

The best first step is always to talk to your doctor. They can help you decide which, if any of the above treatments would be best for you. If you think you have bipolar disorder, its important to see a doctor first to rule out other explanations for your symptoms. If you go to your doctor when youre depressed, its important to also mention if you have other moods as well. This is because some treatments like antidepressants that are very helpful for depression can actually trigger a manic episode if youve had one before. So its important to give your doctor the full picture of how youre feeling, even if the mania distresses you less. This will help them prescribe the best treatments to prevent both depression and mania. In addition to talking to your family doctor, check out the resources below for more information on bipolar disorder:

Other helpful resources, available in English only, are:

Mood Disorders Association of BCVisit www.mdabc.net or call 604-873-0103 or 1-855-282-7979 for resources and information on mood disorders. Youll also find more information on support groups around the province.

Canadian Mental Health Association, BC DivisionVisit www.cmha.bc.ca or call 1-800-555-8222 or 604-688-3234 for information and community resources on mental health or any mental illness.

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Can It Be Prevented

Once you begin to experience mood episodes, you can take steps to help reduce the severity of those episodes and lower your chances of experiencing additional mood episodes. But you cant always prevent mood episodes entirely or keep the condition from developing in the first place.

Future research may reveal more about the specific causes of bipolar disorder and give researchers more insight into potential ways of preventing the condition.

Who Does It Affect

More than 2% of the population will have bipolar disorder at some point in their lives. About 1% of people have experienced bipolar disorder in the past year. Unlike other causes of depression, men and women seem to experience bipolar I in equal numbers. Bipolar II, however, is more likely to affect women. Both types of bipolar affect people of all ages, but tend to appear first in young adulthood, and the risk decreases slightly with age. Bipolar disorder looks quite different in children than it does in adults. Bipolar disorder does seem to run in families. Having a close relative who has bipolar disorder or another mood disorder increases your risk of having bipolar disorder.

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Complications Of Bipolar Disorder

Having bipolar disorder can increase your risk for other conditions. According to the National Institute of Mental Health, this includes thyroid disease, migraine, heart disease, diabetes, and obesity.

Other conditions such as anxiety disorder, post-traumatic stress disorder, attention deficit disorder, and substances abuse disorders also tend to co-occur with bipolar disorder, which can make treatment challenging.

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This post was edited and updated on June 24, 2013, to address comments received from readers. I thank them for their input.

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DSM-IVs criteria for a manic episode are given below:

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week .

D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

Note

The manic episode is an important part of the DSM system because it acts as the basis for a diagnosis of Bipolar Disorder. DSM lists several variations of Bipolar Disorder, each with its own specific criteria, but in general, if a person has had a manic or hypomanic episode, he has bipolar disorder.

Lets take a look at criterion A. This criterion calls for a distinct period of abnormally and persistently elevated expansive or irritable mood, lasting at least a week The DSM defines elevated mood as: an exaggerated feeling of well-being or euphoria or elation. Expansive mood is defined as a lack of restraint in expressing ones feelings, frequently with an over-evaluation of ones significance or importance. Finally irritable mood is defined as being easily annoyed and provoked to anger.

I will discuss psychotic features in later posts on the topic of schizophrenia.

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Treatments For Bipolar Disorder

The high and low phases of bipolar disorder are often so extreme that they interfere with everyday life.

But there are several options for treating bipolar disorder that can make a difference.

They aim to control the effects of an episode and help someone with bipolar disorder live life as normally as possible.

The following treatment options are available:

  • medicine to prevent episodes of mania and depression these are known as mood stabilisers, and you take them every day on a long-term basis
  • medicine to treat the main symptoms of depression and mania when they happen
  • learning to recognise the triggers and signs of an episode of depression or mania
  • psychological treatment such as talking therapy, which can help you deal with depression, and provides advice about how to improve your relationships
  • lifestyle advice such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, as well as advice on improving your diet and getting more sleep

It’s thought using a combination of different treatment methods is the best way to control bipolar disorder.

Help and advice for people with a long-term condition or their carers is also available from charities, support groups and associations.

This includes self-help and learning to deal with the practical aspects of a long-term condition.

What Causes Bipolar Disorder

The cause of bipolar disorder isnt clear. Research suggests that a combination of different things can make it more likely that you will develop bipolar disorder.

Genetic factors

There is a 13% chance you will develop bipolar disorder if someone in your immediate family, like a parent, brother or sister has bipolar disorder.

This risk is higher if both of your parents have the condition or if your twin has the condition.

Researchers havent found the exact genes that cause bipolar disorder. But different genes have been linked to the development of bipolar disorder.

Brain chemical imbalance

Different chemicals in your brain affect your mood and behaviour. Too much or too little of these chemicals could lead to you developing mania or depression.

Environmental factors

Stressful life events can trigger symptoms of bipolar disorder. Such as childhood abuse or the loss of a loved one. They can increase your chances of developing depressive episodes.

You can find more information about Does mental illness run in families? by clicking here.

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Ways To Manage And Treat The Condition

Fluctuations in mood can significantly impact a persons quality of life and productivity, especially when the condition is untreated. While there is no cure for bipolar disorder, treatment can help manage symptoms.

Treatment for bipolar disorder consists of medication, therapy, or a combination of the two.

Bipolar As A Cause Of Death

Mental Health Minute: Bipolar Disorder in Adults

As I recently remarked on a piece on bipolar depression and exercise, people with bipolar disorder have a higher risk of obesity, cardiovascular disease, diabetes and metabolic syndrome . But if a person with bipolar died of cardiovascular disease, the cause of death would never be bipolar even though its bipolar that may have been the causational factor .With suicide its even clearer. One symptom of bipolar disorder is suicidal ideation and/or suicide attempt and we know that 25-50% of people with bipolar disorder will, in fact, attempt suicide . Whats more, current data suggests 11% will die of suicide. Thats more than 1-in-10. And yet, still, bipolar is never listed as a cause of death.

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What Are The Causes Of Bipolar Disorder

There is no single cause of bipolar disorder. Researchers are studying how a few factors may lead to it in some people.

For example, sometimes it can simply be a matter of genetics, meaning you have it because it runs in your family. The way your brain develops may also play a role, but scientists arenât exactly sure how or why.

Dont Make Assumptions About Someone Based On Their Diagnosis

Keep in mind that all mental illnesses, including bipolar disorder, have a range of potential symptoms and severities. In other words, the way one person experiences mental illness may be different from the way someone else with a similar diagnosis experiences it. Dont assume that because one person experiences their disorder one way such as having a history of outbursts that this will be the case for everyone with the disorder.

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Are There Different Types Of Bipolar Disorder

There are a few types of bipolar disorder, including:

Bipolar I disorder: With this type, you have extreme erratic behavior, with manic âupâ periods that last at least a week or are so severe that you need medical care. There are also usually extreme âdownâ periods that last at least 2 weeks.

Bipolar II disorder: With this type, you also have erratic highs and lows, but it isnât as extreme as bipolar I.

Cyclothymic disorder: This type involves periods of manic and depressive behavior that last at least 2 years in adults or 1 year in children and teens. The symptoms arenât as intense as bipolar disorder I or bipolar disorder II.

“Unspecified” or “other specified” bipolar disorder is now used to describe conditions in which a person has only a few of the mood and energy symptoms that define a manic or hypomanic episode, or the symptoms may not last long enough to be considered as clear-cut “episodes.”

Rapid cycling is not a type of bipolar disorder, but a term used to describe the course of illness in people with bipolar I or II disorder. It applies when mood episodes occur four or more times over a 1-year period. Women are more likely to have this type of illness course than men, and it can come and go at any time in the course of bipolar disorder. Rapid cycling is driven largely by depression and carries an increased risk for suicidal thoughts or behaviors.

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