When Should I Call My Teens Healthcare Provider
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Feels extreme depression, fear, anxiety, or anger toward him or herself or others
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Feels out of control
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Hears voices that others dont hear
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Sees things that others dont see
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Cant sleep or eat for 3 days in a row
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Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help
Conditions That Can Co
Many people with bipolar disorder also have other mental disorders or conditions such as anxiety disorders, attention-deficit/hyperactivity disorder , misuse of drugs or alcohol, or eating disorders. Sometimes people who have severe manic or depressive episodes also have symptoms of psychosis, such as hallucinations or delusions. The psychotic symptoms tend to match the persons extreme mood. For example, someone having psychotic symptoms during a depressive episode may falsely believe they are financially ruined, while someone having psychotic symptoms during a manic episode may falsely believe they are famous or have special powers.
Looking at symptoms over the course of the illness and the persons family history can help determine whether a person has bipolar disorder along with another disorder.
What Are The Signs Of Bipolar In A Woman
Bipolar disorder is a mental illness that causes severe shifts in a persons mood, energy, activity levels and the ability to carry out day-to-day tasks. A person with bipolar disorder experiences extreme highs and lows that interfere with his or her daily life. Bipolar disorder most commonly begins in a persons late teens or early adulthood. Men and women are equally likely to develop bipolar disorder. Signs of bipolar disorder in a woman often include: Mood swings: People with bipolar disorder experience extreme highs and lows . These mood swings may be sudden and unpredictable. Extreme highs may be characterized by overly good mood, irritability, racing thoughts, decreased need for sleep, risky behavior, and grandiosity. Extreme lows may be characterized by feeling sad, hopeless, helpless, and worthless. People with bipolar disorder may swing from one mood extreme to the other, or they may have periods when their moods are normal..
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Are There Clinical Trials Studying Bipolar Disorder
NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditionsincluding bipolar disorder. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge to help others in the future. Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit the NIMH clinical trials webpage.
Symptoms Of Bipolar I Disorder
Manic Episode
A manic episode is a period of at least one week when a person is extremely high-spirited or irritable most of the day for most days, possesses more energy than usual, and experiences at least three of the following changes in behavior:
- Increased or faster speech
- Uncontrollable racing thoughts or quickly changing ideas or topics when speaking
- Distractibility
- Increased activity
- Increased risky behavior
These behaviors must represent a change from the persons usual behavior and be clear to friends and family. Symptoms must be severe enough to cause dysfunction in work, family, or social activities and responsibilities. Symptoms of a manic episode commonly require a person to receive hospital care to stay safe.
Some people experiencing manic episodes also experience disorganized thinking, false beliefs, and/or hallucinations, known as psychotic features.
Hypomanic Episode
A hypomanic episode is characterized by less severe manic symptoms that need to last only four days in a row rather than a week. Hypomanic symptoms do not lead to the major problems in daily functioning that manic symptoms commonly cause.
Major Depressive Episode
A major depressive episode is a period of at least two weeks in which a person has at least five of the following symptoms :
- Intense sadness or despair
- Frequent thoughts of death or suicide
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Diagnosing Bipolar Disorder In Adults
Bipolar disorder, also known as manicdepressive illness, is a medical condition that causes a person to experience intense mood swings that alternate between depression and mania. These mood swings can last for hours, days, or even weeks.
Mental health specialists at NYU Langone Psychiatry Associates, such as psychiatrists, psychologists, and licensed clinical social workers, can help determine if a person has bipolar disorder and, if so, how best to manage symptoms.
Diagnosing Bipolar Disorder In Older Adults
It was once believed that bipolar disorder burns out over the course of ones life. This belief was likely caused by the prevalence of bipolar disorder diagnoses in teens and young adults. More than half of bipolar disorder cases begin before age 25, according to NAMI.
Numerous studies have debunked the myth that bipolar disorder only affects young people. In recent years, theres been increased research on late onset bipolar disorder . A 2015 report stated that nearly 25 percent of people with bipolar disorder are at least 60 years old.
Most research considers bipolar disorder that begins at 50 years old or later to be LOBD. Between 5 and 10 percent of people with bipolar disorder will be at least 50 when they first show symptoms of mania or hypomania.
It can be difficult to correctly diagnose bipolar disorder symptoms in older adults. The symptoms are often confused with other conditions. Symptoms such as psychosis, sleep disturbance, and aggressiveness can be confused with dementia or depressive disorder, according to an article in Primary Psychiatry. The article also suggests that late onset manic episodes can be more closely associated with stroke, dementia, or hyperthyroidism.
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What Is Disruptive Mood Dysregulation Disorder
If a child is prone to severe irritability with explosive outbursts, but the behavior is not episodic, its possible that he may fit the criteria for the new diagnosis, disruptive mood dysregulation disorder, or DMDD. DMDD was added to the list of diagnoses in DSM-5 when it was published in 2013, to identify children with severe mood dysregulation who would previously have been diagnosed with pediatric bipolar disorder. The problem was that children who fit this description often did not go on to develop adult bipolar disorder.
Children with DMDD are prone to outbursts that are out of proportion to the trigger, and are irritable in between outbursts, but this behavior differs from bipolar mania in that it does not alternate with periods of depression or normal mood.
If a child fits the criteria for DMDD, he may still have ADHD, in fact Dr. Carlson estimates that about 75 to 80 percent of children in clinical samples do have ADHD, and treating the ADHD that underpins the explosive behavior may be the most important opportunity to help them. However, emotion dysregulation may be a severe problem with its own burdens leading to emergency room visits and psychiatric hospitalizations. Many children do not respond either to ADHD medications or to mood stabilizing medications. Finding appropriate interventions for these children, Dr. Carlson adds, is a high priority.
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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What The Research Says
A recent study looked at 114 people with bipolar disorder and stable moods. All of the study participants were being treated with mood stabilizers as opposed to antipsychotics or antidepressants.
The researchers found that people who took the anticonvulsants valproate or lamotrigine had better sexual function scores than people who took lithium or a combination of lithium and benzodiazepines.
In comparison with people who took anticonvulsants alone:
- People who took lithium or a combination of lithium and benzodiazepines had worse sexual desire.
- People who took lithium had worse sexual arousal.
- People who took a combination of lithium and anticonvulsants, or lithium and benzodiazepines had .
When To Seek Help
Children and adolescents with bipolar disorder experience severe mood and behavior changes that are extreme and represent a major change from their typical mood and behavior. It might be difficult to know when the symptoms are severe enough to warrant evaluation and, potentially, diagnosis, so consider these three basic factors: functioning, feeling, and family.
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Does Bipolar Disorder Affect Religion And Spirituality
Many individuals with bipolar disorder experience hyper-religiosity during mania. Fifteen to 22 percent of those with bipolar mania in the U.S. experience religious delusions, such as thinking that demons are watching them or that they are Christ reborn.
The complex phenomenon of spirituality involves networks of multiple brain regions. Parts of the parietal lobe are associated with feelings of spiritual transcendence, parts of the temporal and frontal cortices are involved in the storage and retrieval of religious beliefs in memory, and still other parts of the frontal lobe and limbic structures are responsible for rational and emotional aspects of religious beliefs. Dopamine levels in those with bipolar disorder may play a role in elevating religious and spiritual experiences.
What Should I Do Before I See The Doctor About Bipolar Disorder
Before meeting with your doctor to clarify a diagnosis, itâs helpful to write down the symptoms you notice that may reflect depression, hypomania, or mania. Particular attention should focus not just on mood but also changes in sleep, energy, thinking, speech, and behavior. It is also useful to get an in-depth family history from relatives before meeting with your doctor. A family history can be very helpful in supporting a suspected diagnosis and prescribing appropriate treatments.
In addition, consider bringing your spouse or a close friend with you to the doctorâs visit. Oftentimes, a family member or friend may be more aware of a personâs unusual behaviors and be able to describe these in detail to the doctor. Before your visit, think about and record the following:
- Your mental and physical health concerns
- Symptoms youâve noticed
- Causes of stress in your life
- Questions you may have about bipolar disorder
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Bipolar Disorder In Young Children
Diagnosing bipolar disorder in young children is difficult, because many of the symptoms are similar to those of attention deficit hyperactivity disorder or conduct disorders — or even just normal, childhood behavior. One problem is that medications used for ADHD are often stimulants, which can potentially trigger mania in children with bipolar disorder.
Young children in a manic phase might be more irritable than adults they may be more likely to have psychotic symptoms, hearing and seeing things that aren’t real. During a depressive episode, they might be more likely to complain of physical symptoms, like aches and pains.
One of the most notable differences is that bipolar disorder in children cycles much more quickly. While manic and depressive periods may be separated by weeks, months, or years in adults, they can happen within a single day in children.
What Is Bipolar Disorder In Teens
Bipolar disorder is a type of depression.
There are 3 main types of depression:
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Major depression
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Bipolar disorder
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Persistent depressive disorder
A teen with bipolar disorder often has extreme mood swings. These mood swings go beyond the days normal ups and downs. A teen may have times of great elation, happiness, elevated mood, or irritability. This is called mania. These episodes are countered by periods of major depression. That is why this disorder has two poles or symptoms.
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What Is Bipolar Disorder
Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Sometimes children with bipolar disorder feel very happy or up and are much more energetic and active than usual. This is called a manic episode. Sometimes children with bipolar disorder feel very sad or down and are much less active than usual. This is called a depressive episode.
Bipolar disorder, which used to be called manic-depressive illness or manic depression, is not the same as the normal ups and downs every child goes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms can make it hard for young people to perform well in school or to get along with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide.
Most people are diagnosed with bipolar disorder in adolescence or adulthood, but the symptoms can appear earlier in childhood. Bipolar disorder is often episodic, but it usually lasts a lifetime.
With treatment, children and teens with bipolar disorder can manage their symptoms and lead successful lives.
Signs And Symptoms Of Bipolar Disorder
Bipolar disorder can look very different in different people. The symptoms vary widely in their pattern, severity, and frequency. Some people are more prone to either mania or depression, while others alternate equally between the two types of episodes. Some have frequent mood disruptions, while others experience only a few over a lifetime.
There are four types of mood episodes in bipolar disorder: mania, hypomania, depression, and mixed episodes. Each type of bipolar disorder mood episode has a unique set of symptoms.
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A Focus On First Episode Psychotic Mania
Prof Philippe Conus, Lausanne University, Switzerland, concluded the session with a perspective on the impact of age of onset on the first episode of psychotic mania. At the Early Psychosis Prevention & Intervention Centre , 87 patients with first episode psychotic mania were followed for 12 months. The age of entry to the EPPIC was looked at as one of the predictors of outcome. Using the onset age cut-off of 21 years, it was found that age was not correlated with outcome characteristics.
The impact of sexual abuse featured again in the symposium as it was noted that sexual trauma played a greater role in later age of onset of any mood disorder. Prof Conus proposed that early onset bipolar disorder is more biologically driven, i.e. genetics play a bigger role whereas later onset disease is more often triggered by life events, such as abuse.
What Should I Know About Clinical Trials
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit the NIMH Clinical Trials webpage.
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Webinars For Youth With Bipolar Disorder
Webinars are online presentations that are about an hour long. We have a live webinar almost every week with experts on different areas of bipolar disorder. Each webinar is recorded and posted to our website. The webinars go in depth on specific topics and are designed to help you learn more about different treatment options, developing research trends, or everyday tips for managing symptoms. A wide variety of topics are covered, here are some examples that are especially useful for youth:
Childhood Bipolar Disorder with Dr. Thomas Jensen
Childhood Onset of Bipolar Disorders: An Excess in the US and What to Do About It
Risk and Vulnerability for Mood Disorders in Teens with Dr. Carrie Bearden
Suicide Risk & Prevention in Pediatric Bipolar Disorder: The Role of the Family
How Does Bipolar Disorder Affect People
At times, people with bipolar disorder go through depression. Other times, they go through manic moods. They may have normal moods in between.
When they go through depression, people with bipolar will:
- have a sad or irritable mood that lasts for at least 2 weeks
Added to that, they may:
- feel hopeless or worthless
- use poor judgment, do things they shouldnt do
- try risky behaviors
- think of themselves in inflated ways or think they have superpowers
Going through these two types of extreme moods is hard on a person. Bipolar moods can make it harder to get along well with others. It can be a challenge to succeed at goals.
Bipolar can cloud peoples judgment and lead them to take unsafe risks. It can cause problems they didnt expect and didnt intend. Some people might be more likely to self-harm or try suicide. They may drink alcohol or use drugs.
Thats why it matters to get the right diagnosis and treatment for bipolar moods. It can help reverse or prevent problems like these.
Moods dont have to run a persons life. With treatment, people with bipolar can learn to manage their moods and symptoms. This helps them feel and do better in things that matter to them.
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