What Causes Bipolar Disorder In Adults

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.

What Does It Feel Like To Have Bipolar Disorder

There are times when you feel terrific and productive when you are manic, like you can do anything. But you can also feel out of control with racing thoughts and unable to concentrate long enough to accomplish something. When in a depressed episode, you can feel sad, uninterested in anything, and really low like something terrible must have happened but nothing did.

Most Common Triggers For Bipolar Mood Episodes

Spats with your sweetheart, chilly weather, grief a number of scenarios may provoke bipolar mania or depression.

Bipolar disorder is characterized by symptoms including unusual shifts in mood and energy. These mood shifts or episodes last at least a week in the case of mania, and at least two weeks in the case of depression, according to psychiatrist Jeffrey Bennett, MD, an associate professor of psychiatry at the Southern Illinois University School of Medicine in Springfield.

There are several types of bipolar and related disorders. In order to be diagnosed with bipolar I, you must have had at least one manic episode that may have been preceded or followed by hypomanic or depressive episodes. In the case of bipolar II, you must have had at least one major depressive episode and at least one hypomanic episode, but never experienced a manic episode.

Both mania and hypomania share the same symptoms, which include feeling unusually upbeat, euphoric, or irritable, with increased energy, mood elevation, a decreased need for sleep, racing thoughts, trouble concentrating, and poor judgment. In cases of mania, these symptoms are severe enough to be causing significant problems in your day-to-day life.

For example, you might be unable to go to work or school, or you may be compulsively spending money. Hypomania is considered a less severe form of mania. In cases of hypomania, your daily functioning isn’t significantly impacted. For example, you are able to work and socialize.

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Recognizing The Signs Of Bipolar Disorder

Bipolar disorder is marked by dramatic shifts in mood, energy, and activity levels, and typically causes people to swing between intense episodes of mania and depression.

Recognizing the signs of bipolar disorder.

Bipolar disorder is a treatable serious mental illness. It can affect a persons thoughts, feelings, mood and overall functioning. Formerly known as manic-depression, bipolar disorder is marked by dramatic shifts in mood, energy, and activity levels. People with this disorder typically swing between intense episodes of mania and depression.

Social Impact And Prejudice

Research confirms that the social, as well as the more clinical, effects of bipolar disorder can be different for females.

A 2014 review concluded that females are more likely than males to face:

• stigma and isolation
• a loss of self-determination and a sense of a lack of control
• a lack of understanding from healthcare professionals and others
• pressure to appear normal or face consequences such as losing custody over children

Economic factors also influenced the experience of bipolar disorder among the study participants. Those who reported having a safe place to live and help with childcare and family responsibilities tended to manage better.

Participants with less privileged socioeconomic backgrounds and participants from marginalized groups, including Black Americans, were more likely to face abuse and experience other risk factors for psychosis. These participants were also more likely to work full-time and have full responsibility for caring for their families. A lack of support and safe living conditions, abuse, and other factors can increase the risk of severe symptoms of bipolar disorder and make the symptoms harder to manage.

Menstruation, pregnancy, and menopause can influence how bipolar disorder affects females.

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How Is Bipolar Disorder In Elderly Identified

One of the main reasons bipolar disorder is often misdiagnosed later in life is because the symptoms can be slightly different from common bipolar disorder symptoms. For one thing, seniors experience depression but are less likely to exhibit the classic signs of mania. Instead of the energy, elation and hyper confidence experienced by younger patients, patients over 50 are more likely to experience the following:

• Confusion
• Difficulty solving problems
• Loss of perception and judgment

In older patients, the symptoms can be sudden and very severe, and often cycle faster than in younger people with the disease. Often seniors report experiencing both the high and low moods associated with bipolar disorder symptoms simultaneously.

The Role Of Mitochondria

Experts also believe mitochondria which you may remember from science class as the cells that generate energy, aka the powerhouse of the cell may have something to do with the development of mood disorders.

When cells dont produce or metabolize energy as they typically would, the resulting imbalances in brain energy could lead to the changes in mood and behavior often seen with bipolar disorder.

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Antidepressants Corticosteroids And Other Medication

Can antidepressants make you manic?

The treatment of bipolar disorder can trigger episodes of mania by further setting off unstable moods and behaviors. Many psychiatrists say they’ve seen patients enter a manic phase after starting antidepressants and some feel uncomfortable prescribing them to bipolar patients.

What should you do about bipolar depression? Until more research is available on long-term safety, Keming Gao, MD, PhD, a professor of psychiatry at Case Western Reserve School of Medicine in Cleveland, suggests the following: For bipolar I depression, antidepressants should only be used with a mood stabilizer or stabilizers after symptoms haven’t responded to FDA-approved treatment options .

Dr. Gao says that while some recent studies suggest that using an antidepressant alone is as effective as lithium taken alone for some bipolar II patients , they should never be used alone for bipolar I depression, and patients and doctors should consider discontinuing use of antidepressants once symptoms have responded.

Other drugs that have been linked to manic symptoms include corticosteroids, thyroid medication, and appetite suppressants.

Whats A Person With Bipolar Like

When someone is managing their bipolar disorder well, they likely wont appear any different from anyone else. If theyre in a manic episode you might notice they talk fast, switch topics continually, have grandiose plans or ideas, or take risks. When in a depressed episode they may have trouble getting out of bed, show a lack of interest in activities they used to love, not engage in conversation, have difficulty socializing or interacting with others, or have suicidal thoughts.

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The Brain And Bipolar Disorder

Experts believe bipolar disorder is partly caused by an underlying problem with specific brain circuits and the functioning of brain chemicals called neurotransmitters.

Three brain chemicals — norepinephrine , serotonin, and dopamine — are involved in both brain and bodily functions. Norepinephrine and serotonin have been consistently linked to psychiatric mood disorders such as depression and bipolar disorder. Nerve pathways within areas of the brain that regulate pleasure and emotional reward are regulated by dopamine. Disruption of circuits that communicate using dopamine in other brain areas appears connected to psychosis and schizophrenia, a severe mental disorder characterized by distortions in reality and illogical thought patterns and behaviors.

The brain chemical serotonin is connected to many body functions such as sleep, wakefulness, eating, sexual activity, impulsivity, learning, and memory. Researchers believe that abnormal functioning of brain circuits that involve serotonin as a chemical messenger contribute to mood disorders .

Symptoms Of Depressive Episodes

Depressive episodes can also emerge without warning. Some of the triggers for these depressive periods include lack of sleep, excessive stress, or a negative life event, but often there is no known cause for the depression. The depressive episodes must be carefully monitored, as there is an increased risk of suicidal behavior during these phases.

Symptoms include:

• Feelings of despair and hopelessness
• Intense fatigue
• Loss of interest in activities once enjoyed
• Chronic pain with no known medical cause
• Trouble concentrating
• Suicidal thoughts

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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:

• Rethink Mental Illness: www.rethink.org/about-us/our-support-groups
• Carers Trust: www.carers.org/search/network-partners

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.

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What Are The Symptoms Of Bipolar Disorder

The symptoms of bipolar disorder can vary. An individual with bipolar disorder may have manic episodes, depressive episodes, or mixed episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are intense and happen along with changes in behavior, energy levels, or activity levels that are noticeable to others.

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Changes In Sleep Patterns Or Lack Of Sleep

A change in your sleep pattern is a hallmark symptom of bipolar disorder but it can also be a trigger.

Shift workers, people who work long hours, and students who are short on sleep are all at risk for having a recurrence of a mood episode related to a lack of sleep. “In addition, travel beyond one’s time zone can be another trigger for a mood episode,” says Bennett.

Interpersonal and social rhythms therapy is one of the most effective preventions, Bennett says. This treatment approach, available in group as well as individual sessions, helps you develop an orderly life schedule of sleep, diet, and exercise habits, to make you more effective at managing bipolar disorder.

Other forms of therapy, including psychoeducation and cognitive-behavioral therapy , can also be helpful in managing the illness.

What Are Your Treatment Options

Treatment will depend on which type of bipolar disorder you have, and what your symptoms are. Most of the time, youll need medication to manage your symptoms, along with therapy. Medications that may be used include:

Antidepressants Antipsychotics Mood stabilizers Anti-anxiety medications

Sometimes traditional medication therapy isnt enough. At Boston MindCare, our doctors offer a unique treatment option when nothing else has worked. Ketamine infusion therapy can help the symptoms of depressive episodes associated with bipolar disorder. It works by inhibiting glutamate in your brain to stabilize your mood.

Like many of the other medications used to treat this disorder, ketamine comes with some side effects, so its important to talk to our doctors to see if this treatment is right for you.

You dont need to deal with bipolar disorder on your own. If youre looking for help, call our office at 701-207-9841 or book an appointment online today.

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Bipolar Behavior Hypersexuality And Related Conditions

A meta-analysis published in the December 2016 Journal of Affective Disorders found a high prevalence of comorbidity between substance abuse disorders and bipolar disorder meaning that a person is experiencing some form of both conditions simultaneously.

The study found substance abuse disorders to be quite common in patients with bipolar disorder. The disorders with the highest prevalence in conjunction with bipolar disorder were alcohol use , followed by cannabis use .

Stimulants in particular can be problematic: The study authors point out that if stimulants are being used or abused, they could mimic symptoms of mania. In addition, alcohol and cannabis use can be linked to poor judgment, which may further contribute to hypersexual behavior. Since addictions often feed off one another, this can lead to cycles of unhealthy behaviors.

Bipolar Disorder And Relationships

When it comes to managing a relationship while you live with bipolar disorder, honesty is the best policy. Bipolar disorder can have an impact on any relationship in your life, perhaps especially on a romantic relationship. So, its important to be open about your condition.

Theres no right or wrong time to tell someone you have bipolar disorder. Be open and honest as soon as youre ready. Consider sharing these facts to help your partner better understand the condition:

• when you were diagnosed
• what to expect during your depressive phases
• what to expect during your manic phases
• how you typically treat your moods
• how they can be helpful to you

One of the best ways to support and make a relationship successful is to stick with your treatment. Treatment helps you reduce symptoms and scale back the severity of your changes in mood. With these aspects of the disorder under control, you can focus more on your relationship.

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Brain Chemistry And Biology

Bipolar disorder also has a neurological component.

Neurotransmitters are chemical messengers in the brain. They help relay messages between nerve cells throughout the body. These chemicals play an essential role in healthy brain function. Some of them even help regulate mood and behavior.

Older links three main neurotransmitters to bipolar disorder:

• serotonin
• dopamine
• norepinephrine

Imbalances of these brain chemicals may prompt manic, depressive, or hypomanic mood episodes. This is particularly the case when environmental triggers or other factors come into play.

Bipolar Disorder In Teens

Angst-filled behavior is nothing new to the average parent of a teenager. The shifts in hormones, plus the life changes that come with puberty, can make even the most well-behaved teen seem a little upset or overly emotional from time to time. However, some teenage changes in mood may be the result of a more serious condition, such as bipolar disorder.

A bipolar disorder diagnosis is most common during the late teens and early adult years. For teenagers, the more common symptoms of a manic episode include:

• being very happy
• taking part in risky behaviors
• abusing substances
• thinking about sex more than usual
• becoming overly sexual or sexually active
• having trouble sleeping but not showing signs of fatigue or being tired
• having a very short temper
• having trouble staying focused, or being easily distracted

For teenagers, the more common symptoms of a depressive episode include:

• sleeping a lot or too little
• eating too much or too little
• feeling very sad and showing little excitability
• withdrawing from activities and friends
• thinking about death and suicide

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Natural Selection And Evolution

Mutations alter an organism’s genotype and occasionally this causes different phenotypes to appear. Most mutations have little effect on an organism’s phenotype, health, or reproductive . Mutations that do have an effect are usually detrimental, but occasionally some can be beneficial. Studies in the fly suggest that if a mutation changes a protein produced by a gene, about 70 percent of these mutations will be harmful with the remainder being either neutral or weakly beneficial.

studies the distribution of genetic differences within populations and how these distributions change over time. Changes in the in a population are mainly influenced by , where a given allele provides a selective or reproductive advantage to the organism, as well as other factors such as , , , and .

Over many generations, the genomes of organisms can change significantly, resulting in . In the process called , selection for beneficial mutations can cause a species to evolve into forms better able to survive in their environment. New species are formed through the process of , often caused by geographical separations that prevent populations from exchanging genes with each other.

Organisms were chosen, in part, for convenienceâshort generation times and easy made some organisms popular genetics research tools. Widely used model organisms include the gut bacterium , the plant , baker’s yeast , the nematode , the common fruit fly , and the common house mouse .