Who Is At Risk From Developing A Mental Disorder
At any one time, a diverse set of individual, family, community, and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances including poverty, violence,disability, and inequality are at higher risk. Protective and risk factors include individual psychological and biological factors, such as emotional skills as well as genetics. Many of the risk and protective factors are influencedthrough changes in brain structure and/or function.
Living With Bipolar Disorder
Teens normally face ups and downs with school, family, work, and friends. Dealing with bipolar disorder at the same time is a very difficult challenge. One 16-year-old reader who was diagnosed with bipolar disorder at 14 wrote to us about the experience:
I had mood swings that were the worst anyone could have ever seen. My poor parents thought I hated them, but really I was sick and didnt even realize it. But now I am on medications for my disorder and I live a pretty normal life. My family and friends support me, and they, along with my therapist, have helped me get to the point where I am today. I just want other teens to know that even though it is hard at times to be bipolar, things will get better.
If youve been diagnosed with bipolar disorder, taking your medications as prescribed, reporting any changes in how you feel or function, and participating in therapy will be key to living a successful life. In addition to treatment, making a few lifestyle changes, such as reducing stress, eating well, and getting enough sleep and exercise can help someone who is living with the condition. And many teens find it helps to join a support network such as a local support group for people with bipolar disorder.
When Should I Go To The Emergency Room For Bipolar Disorder
If youre experiencing any of these situations, its essential to call 911 or get to the nearest emergency room:
- Thoughts of death or suicide.
- Thoughts or plans of hurting yourself or others.
- Experiencing hallucinations and delusions.
- Symptoms of lithium toxicity , such as severe nausea and vomiting, severe hand tremors, confusion and vision changes.
A note from Cleveland Clinic
Bipolar disorder is a lifelong illness. But long-term, ongoing treatment, such as medication and talk therapy, can help manage your symptoms and enable you to live a healthy, purposeful life. Its important to see your healthcare team regularly to monitor your treatment plan and symptoms. Know that your healthcare providers and loved ones are there to support you.
Last reviewed by a Cleveland Clinic medical professional on 04/12/2022.
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Causes Of Bipolar 1 And Bipolar 2
Scientists dont know exactly what causes bipolar 1 or 2. They think several factors may contribute to both disorders, including:
If you have a parent or sibling with bipolar disorder, you have a greater chance of developing it. However, many people with a family history of bipolar never develop it themselves. There are even cases of identical twins where one twin has bipolar and the other doesnt.
A stressful event can trigger a manic or depressive episode. If youre going through an event like a difficult divorce, having financial problems, or an illness, it can play a role in developing bipolar disorder.
Brain structure and function
Researchers have discovered subtle differences in the average size or activation of certain brain structures. You cant tell if someone has bipolar by looking at brain scans, though.
Summary And Future Directions
This review concludes that personality, temperament, life stress, and family discord are important influences on the course of BD, alone and in interaction with each other. Patients with comorbid personality disorders are more treatment-refractory and generally have poorer outcomes of their bipolar disorder. Temperamental attributes that are related to subsyndromal manic symptoms, such as hyperthymia, cyclothymia, and positive affectivity predict the onset of more severe manic symptoms. BD patients are highly sensitive to reward, and excessive goal pursuit after goal-attainment life events may be one pathway to mania. Negative life events and neuroticism are more closely associated with depressive recurrences than manic recurrences. High levels of intrafamilial criticism and other dimensions of family functioning are most consistently associated with depressive symptoms and recurrences.
The course of BD is characterized by a multifinality of outcomes, which can include recovery, remission, relapse, recurrence, ongoing symptoms, or psychosocial impairments . It is rare for psychosocial studies to distinguish recovery from remission or recurrence from relapse . These distinctions could help determine whether psychosocial predictors are equally relevant to the short-term and long-term course of the disorder.
Beyond Treatment: Things You Can Do
Regular Exercise: Regular aerobic exercise, such as jogging, brisk walking, swimming, or bicycling, helps with depression and anxiety, promotes better sleep, and is healthy for your heart and brain. There is also some evidence that anaerobic exercise such as weightlifting, yoga, and Pilates can be helpful. Check with your health care provider before you start a new exercise regimen.
Keeping a Life Chart: Even with proper treatment, mood changes can occur. Treatment is more effective when a patient and health care provider work together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help patients and health care providers track and treat bipolar disorder over time. Patients can easily share data collected via smartphone apps including self-reports, self- ratings, and activity data with their health care providers and therapists.
Bipolar Disorder Statistics By Age
- The average age of onset is 25 years old.
- People ages 18 to 29 years old had the highest rates of bipolar disorder followed by 30- to 44-year-olds as of 2001-2003.
- People 60 and older had the lowest rates of bipolar disorder as of 2001-2003.
- Only 2.9% of adolescents had bipolar disorder as of 2001-2004, the majority of which had severe impairment.
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What Are The Symptoms Of Bipolar Disorder In A Teen
Teens with bipolar disorder often have abnormal mood swings. They shift between depression and mania. These episodes often last 1 or 2 weeks. But symptoms may be different for each teen.
Symptoms of depression may include:
Lasting feelings of sadness
Heightened energy level
Uncharacteristically poor judgment
Seeing or hearing things that are not there , or believing things that are not true
Symptoms of bipolar disorder, especially in a teen, may look like other problems. Make sure your teen sees his or her healthcare provider for a diagnosis.
How Is Bipolar Disorder Treated In A Teen
Treatment will depend on your teens symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment can often help a teen with bipolar disorder get better. But it will take time. Treatment may include one or more of the following:
Mood-stabilizing medicines or antidepressants
Is Anger A Side Effect Of Medication Used To Treat Bipolar Disorder
Prescription medication is one of the primary ways doctors treat bipolar disorder. Doctors often prescribe a variety of medications for the disorder. Mood stabilizers such as are usually part of the mix.
Lithium can help treat symptoms of bipolar disorder. It can also improve the brain chemical imbalances believed to be responsible for the disorder in the first place.
Although there are anecdotal reports of people experiencing increased episodes of irritability and anger after taking lithium, they arent considered side effects of the medication.
Side effects of mood stabilizers such as lithium include:
Changes in emotions are often the result of your body learning to adjust to the new chemicals. Thats why its important that you continue to take your medication as prescribed by your doctor.
Even if new symptoms crop up, dont stop taking your medication without first discussing it with your doctor. If you do, it may cause an unexpected shift in your emotions and increase your risk of side effects.
Everyone gets upset from time to time. Anger can be a normal, healthy reaction to something thats happened in your life.
However, anger thats uncontrollable or prevents you from interacting with another person is a problem.
If you think this strong emotion is preventing you from having a healthy relationship with friends, loved ones, and colleagues, it may be time to see a doctor.
Here are some signs that irritability or anger may be affecting your life:
Can Lifestyle Habits Increase The Risk Of Bipolar Disorder
Lack of sleep increases the risk of having an episode of mania in someone with bipolar disorder. In addition, antidepressants, particularly when taken as the only medication, may also trigger a switch into a manic state.
Excessive use of alcohol or drugs can also trigger bipolar symptoms. Research has shown that about 50% of bipolar sufferers have a substance abuse or alcohol problem. Sufferers often use alcohol or drugs in an effort to reduce unpleasant feelings during low mood periods, or as part of the recklessness and impulsivity associated with manic highs.
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Family Factors In Childhood
The family has a risk or protective role early in the course of the disorder, depending on when BD is diagnosed, whether the parents themselves have mood disorders, how conflicts are resolved, and whether the family is intact. One study found that adolescent BD patients who were undergoing family treatment and medication had more persistent mood symptoms over 2 years up if their parents were high-EE than low-EE . Low maternal warmth based on the self-reports of children and their mothers – was associated with a shorter time to recurrence in a 4-year follow-up of pediatric and early adolescent BD patients .
Mother/child relationships in childhood-onset bipolar disorder are characterized by less warmth, greater tension, greater conflict, and more hostility than mother/child relationships in healthy control or ADHD children . When pediatric BD is accompanied by ADHD or other externalizing disorders, families have greater conflict, lower cohesion scores, and greater use of power assertion in parenting strategies . Frequent behavioral outbursts in the child in the absence of well-defined episodes increases the chance that parents attribute the childs problems to personality or willful opposition, which may increase criticism .
Bipolar Disorder With Impairment Among Adults
- Of adults with bipolar disorder in the past year, degree of impairment ranged from moderate to serious, as shown in Figure 2. Impairment was determined by scores on the Sheehan Disability Scale.
- An estimated 82.9% of people with bipolar disorder had serious impairment, the highest percent serious impairment among mood disorders.3
- An estimated 17.1% had moderate impairment.
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What Can Children And Teens Expect From Treatment
With treatment, children and teens with bipolar disorder can get better over time. Treatment is more effective when health care providers, parents, and young people work together.
Sometimes a childs symptoms may change, or disappear and then come back. When this happens, your childs health care provider may recommend changes to the treatment plan. Treatment can take time, but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.
Your childs health care provider may recommend keeping a daily life chart or mood chart to track your childs moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.
Bipolar Disorder From A Global Perspective
Bipolar disorder is far from a condition that only affects Americans individuals from every country in the world may find themselves facing symptoms of bipolar disorder.
As of 2017, an estimated 46 million individuals worldwide have bipolar disorder. Incidence worldwide is a little higher in women than in men, at a rate of 52% to 48%. Based on population share, Brazil, Australia and Finland have the highest rates of bipolar disorder diagnoses. Many Asian countries have a lower incidence rate in China, around .4% of the citizens will be diagnosed with bipolar disorder. However, this does not take into account potential roadblocks in diagnoses in some countries, biases against mental illness may obscure true incidence rates.
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Young Adults May Outgrow Bipolar Disorder
- University of Missouri-Columbia
- Bipolar disorder, or manic-depression, causes severe and unusual shifts in mood and energy, affecting a persons ability to perform everyday tasks. With symptoms often starting in early adulthood, bipolar disorder has been thought of traditionally as a lifelong disorder. Now, researchers have found evidence that nearly half of those diagnosed between the ages of 18 and 25 may outgrow the disorder by the time they reach 30.
Bipolar disorder, or manic-depression, causes severe and unusual shifts in mood and energy, affecting a persons ability to perform everyday tasks. With symptoms often starting in early adulthood, bipolar disorder has been thought of traditionally as a lifelong disorder. Now, University of Missouri researchers have found evidence that nearly half of those diagnosed between the ages of 18 and 25 may outgrow the disorder by the time they reach 30.
Using two large nationally representative studies, we found that there was a strikingly high peak prevalence of bipolar disorders in emerging adulthood, said David Cicero, doctoral student in the Department of Psychological Sciences in the College of Arts and Science
and lead author of the paper. During the third decade of life, the prevalence of the disorder appears to resolve substantially, suggesting patients become less symptomatic and may have a greater chance of recovery.
Psychosocial Interventions And Personality Attributes
A few studies have examined whether personality attributes moderate the impact of adjunctive psychotherapy on BD. Lam Wright, & Sham found that a sense of hyperpositive self among BD patients dynamism, persuasiveness, and productiveness was associated with a poorer response to CBT. These attributes may map on to high risk behaviors such as medication nonadherence, expansive goal-setting, or impulsive risk taking, but may be especially difficult to change using standard cognitive restructuring techniques.
A small open trial examined the impact of interpersonal and social rhythm therapy on bipolar I patients who had comorbid borderline personality disorder . Only 25% of the comorbid BD patients stabilized within a 2-year time frame when treated with IPSRT, whereas 74% of the BD patients without borderline personality disorder stabilized. Patients with comorbid presentations also required more adjunctive antipsychotic medications and were more likely to drop out of treatment. One study found that structured group psychoeducation could be administered successfully to bipolar patients with comorbid axis II disorders . Thus, dysfunctional personality traits may moderate the effectiveness of manual-based psychosocial interventions. Nonetheless, structured interventions can be adapted to the needs of these more complicated patients.
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Women And Bipolar Disorder
- Women and people with bipolar II disorder are significantly more likely to experience periods of rapid cycling than men with the same condition. . Depression, anxiety and perceived stress in women with and without PCOS: A community-based study. Psychological Medicine, 49)
- Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness.
Toxicity And Side Effect Management
Medical comorbidities are quite prevalent in patients with bipolar disorder because of the adverse effects of treatment with mood stabilizers, anticonvulsants, antipsychotics, genetic vulnerability, and lifestyle factors . Keeping in mind the burden of these comorbidities and adverse effects of pharmacotherapy, regular monitoring of weight, glycemia, dyslipidemia, blood pressure, and liver function is necessary for patients with bipolar affective disorder.
Blood concentrations of lithium and valproate, when taken by the patient, should be regularly monitored to ensure they are within the therapeutic range. In addition, renal and thyroid function testing is necessary because treatment with lithium is known to be associated with tubulointerstitial nephropathy, hypothyroidism, and nephrogenic diabetes insipidus. For patients receiving valproate, the hepatic function should be monitored, and, in women, cases of polycystic ovary disease are known with valproate therapy.
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How Bipolar Behavior Effects Family Friends
As the illness becomes more serious, degraded performance shades into incapacity. Thus the depressive will linger in bed, begin to be routinely late for work, be unable to make decisions or handle the workload on the job, and eventually will be perceived as an unsatisfactory employee. Likewise the manic will make quick but bad decisions based on little or no knowledge or data, will take serious risks with business assets, become insubordinate or otherwise disrupt the normal chain of command, and will be perceived as unreliable, though energetic, and therefore an unacceptable risk.
The loss of a permanent, well-paying job is one of the worst things that can happen to someone with mental illness. First, it means a direct loss of income, perhaps the main source of income in the family. Second, it may mean the loss of medical insurance, which may be badly needed in the weeks and months ahead. Third, it means an unsatisfactory performance rating in ones personnel file, which may come back to haunt the victim again and again as he/she tries to find further employment. Fourth, it is a serious blow to the self-esteem of a depressive, whereas a manic may not even consider the loss worth notice.
APA ReferenceTracy, N. . Effects of Bipolar Disorder on Family and Friends, HealthyPlace. Retrieved on 2022, January 12 from https://www.healthyplace.com/bipolar-disorder/bipolar-support/effects-of-bipolar-disorder-on-family-and-friends
Getting Diagnosed And Getting Treated
While bipolar disorder is generally a life-long illness, treatment helps most people manage their symptoms. You may still have lingering symptoms and relapses, but you can enjoy a good and productive life. Because there is no blood test or brain scan that can diagnose bipolar disorder, you need to let your doctor know if you have any of the symptoms. You may be at increased risk of bipolar disorder if you have a family history of the disease.
Symptoms to report include:
Periods of depression when you may be very tired, have no energy, be unable to think straight, feel helpless, or have thoughts of death or suicide
Periods of mania when you may not need sleep, talk very fast, be very restless, have unrealistic ideas, and engage in reckless behaviors
Periods of mania or that last for at least seven days
Periods of mania or depression that are a major change from your normal behavior, most likely affecting your work and social life
Shifting back and forth between periods of feeling low, sad and helpless and feeling high, unstoppable and energetic
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