What To Expect After Bipolar Disorder Treatment
Recognizing the symptoms early and treating it promptly is necessary to prevent complications such as suicide, homicide and addictions.
Some lifestyle modifications are important in managing bipolar disorder:
- Treatment compliance is of utmost importance for the patient as well as the caregivers.
- Always follow a routine for sleep and meals.
- Talk to your family and friends and ask for their support.
- Try connecting with other patients and caregivers through social groups.
- Talk to a licensed medical practitioner about your symptoms.
Imaging Studies Of Mania
Data from neurocognitive studies indicate widespread impairments in executive, attentional, and emotional function during the manic phase of bipolar disorder. Functional imaging studies that scanned manic patients at, rest, have indicated changes in blood flow and metabolism, particularly in the orbitofrontal cortex.,- The disadvantage of these resting state studies is that it is not, possible to control for thought content during scanning, and increased activity may relate to aspects of the manic state like flights of ideas. Consequently, recent work has scanned patients while they perform a neuropsychological task, in order to investigate task-related neural activity. For example, Rubinsztein et al scanned a small number of manic patients with positron emission tomography while they performed a variant, of the Cambridge Gamble Task in the scanner . Blocks of a decision-making task were contrasted against blocks of a control task that was matched for visual and motor demands, but, without the requirement, for risk assessment, and decision-making. Compared with demographicallymatched healthy controls, the manic cases showed a dysregulation of medial and ventral prefrontal circuitry during risky decision-making.
Understanding Manic Episodes Of Bipolar Disorder
The way bipolar disorder symptoms manifest, the duration of symptoms, and the overall effect on a person may vary greatly from person to person. The manic symptoms of bipolar disorder may be especially difficult for some people to understand as people may react differently during these episodes. For example, when manic episodes occur, one person may experience mania or hypomania episodes with feelings of frustration or irritability while another may exhibit a decreased need for sleep, accelerated thinking, or hyperactivity.
When manic symptoms of bipolar disorder emerge, its not uncommon for one to experience feelings of creativity, heightened energy, or euphoria. Some people may feel they are destined for greatness or are invincible.
While the overall feeling of increased energy and euphoria may feel good at first, manic episodes can cause a spiral in emotions. For instance, during this phase, some people engage in dangerous or inappropriate behavior. They may become sexually promiscuous, gamble, or go on spending sprees. Some people are easily angered, may start fights or lash out at others, or blame those who criticize their behavior.
Some common symptoms of manic episodes include:
Warning Signs That Indicate Bipolar Mania Episodes
Treatment for Bipolar Disorder
Because bipolar disorder is a chronic, relapsing condition, it requires long-term treatment. This is true even when symptoms are not obvious.
Getting Help for Bipolar Disorder
You Are Not Alone
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What Happens In The Brain With Bipolar Disorder
So, to understand the effects of bipolar disorder on the brain, we must first know what part of the brain is affected by bipolar disorder. Bipolar disorder affects the thinner cortical gray matter in the frontal, temporal, and parietal regions of both brain hemispheres, and also the hippocampus. However, bipolar disorder has the largest effect on the left pars opercularis , left fusiform gyrus , and left rostral middle frontal cortex . But if youre not familiar with the brain, this can all seem confusing. To help, our mental health rehab has broken down how bipolar disorder affects the brain.
Brain Damage From Bipolar Disorder
If you have a broken leg, you can tell people you have a fracture in your left tibia. If you have a bad heart you can let people know you have a weak aortic valve. But what do you say if you have a mood disorder? Most of us settle for the explanation that we have a chemical imbalance, which is about as satisfactory as your mechanic handing you a bill with this one item: “Engine Imbalance.”
Then there is the matter of collateral damage. We know depression can stop the brain it its tracks while mania runs it off the rails, with corresponding deficits in our ability to think and reason, but we are led to believe these are only temporary occurrences, right? Maybe not.
If only a mood disorder were just a mood disorder. A lengthy review article by Carrie Bearden PhD et al of the University of Pennsylvania published in Bipolar Disorders cites “findings of persistent neuropsychological deficits” in long-term bipolar patients, even when tested in symptom-free states. The relationship between these deficits and length of illness led the authors to suggest that “episodes of depression and mania may exact damage to learning and memory systems.”
An article by FC Murphy PhD and BJ Sahakian PhD of Cambridge University in the British Journal of Psychiatry draws a similar conclusion: “The balance of evidence … supports a hypothesis of residual cognitive impairments.”
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Imaging Studies Of Bipolar Depression
The limited number of imaging studies in bipolar depression have also highlighted changes in prefrontal and subcortical activity A resting state positron-emission tomography study in a notably large group of patients with bipolar depression reported decreases in prefrontal cortical metabolism, and increases in subcortical metabolism, compared with healthy controls. Both of these effects were correlated with depressive severity on the Hamilton scale. Using cognitive activation designs, decreased activation in the prefrontal cortex has also been reported, where attentional or executive tasks have been employed. In addition, resting state activation in the subgenual cingulate region was positively correlated with target detection performance on a CPT performed outside the scanner. Decreased blood flow in medial prefrontal cortex was also reported during a sad mood induction in remitted and depressed patients with type 1 bipolar disorder, although this study did not, include a healthy comparison group.
Determination Of Changes In The Brain In Bipolar Disorder By Imaging Methods And Its Reflections In Nursing Care
Özlem Katan1 and Gülah Acar2
1Assistant Professor, Akdeniz University, Antalya, Turkey
2Research Assistant, Akdeniz University, Antalya, Turkey
*Corresponding author: Özlem KATAN, Assistant Professor, Akdeniz University, Antalya, Turkey, Tel: +90505-2598348, E-mail:
Received: July 21, 2017 | Accepted: September 21, 2017 | Published: September 23, 2017
Citation: Katan Ö, Acar G Determination of Changes in the Brain in Bipolar Disorder by Imaging Methods and its Reflections in Nursing Care. Int Arch Nurs Health Care 3:082. doi.org/10.23937/2469-5823/1510082
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Frequently Asked Questions About Bipolar Disorder
Bipolar disorder, formerly known as manic-depressive illness, is a brain and behavior disorder characterized by severe shifts in a person’s mood and energy, making it difficult for the person to function. More than 5.7 million American adults or 2.6 percent of the population age 18 or older in any given year have bipolar disorder. The condition typically starts in late adolescence or early adulthood, although it can show up in children and in older adults. People often live with the disorder without having it properly diagnosed and treated.
Bipolar disorder causes repeated mood swings, or episodes, that can make someone feel very high or very low . The cyclic episodes are punctuated by normal moods.
Mania Episode Signs and Symptoms:
- Increased energy, activity, restlessness
- Racing thoughts, fast talking, jumping between ideas
- Sleeplessness
- Abuse of drugs, such as cocaine, alcohol and sleeping medications
- Provocative, intrusive or aggressive behavior
- Denial that anything is wrong
Depressive Episode Signs:
- Sad, anxious or empty-feeling mood
- Feelings of hopelessness and pessimism
- Feelings of guilt, worthlessness and helplessness
- Loss of interest or pleasure in activities once enjoyed, including sex
- Difficulty concentrating, remembering or making decisions
- Restlessness and irritability
- Sleeplessness or sleeping too much
- Change in appetite, unintended weight loss or gain
- Bodily symptoms not caused by physical illness or injury
- Thoughts of death or suicide
Subcortical And Medial Temporal Activation
In addition to studies of prefrontal cortex, functional abnormalities in striatum and other subcortical structures have been reported in bipolar disorder. Specifically, compared with healthy subjects, Baxter et al observed decreased caudate metabolism in depressed bipolar patients. However, after adjusting for hemispheric metabolism, which was also decreased in depression, the specific regional specificity in the striatum was less clear. OConnell et al reported increased blood flow in the basal ganglia, with right-sided flow greater than left, in bipolar patients during mania. Blumberg et al partially replicated this finding as they observed increased blood flow in the left head of the caudate in manic compared with healthy subjects. These latter investigators also compared a group of bipolar adolescents with healthy controls and found increased signal in the thalamus and putamen. However, the mood state of patients in this latter study was not described. Together, these findings suggested that state-dependent changes in activation occurred in striatum during the course of bipolar disorder that mirrored those in the prefrontal cortex.
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What Is A Person With Bipolar Disorder Like
Bipolar disorder is a serious, persistent mental illness characterized by changes in mood, energy, and the ability to function. People with bipolar disorder frequently display extreme, intense, and disturbing emotional states known as mood episodes. Extreme happiness or excitement and melancholy are typical symptoms of mood episodes. People with bipolar disorder can also have normal moods occasionally.
Bipolar disorder is classified into:
- Bipolar I: Characterized by alternating severe depression and intense mania
- Bipolar II: It involves severe depression but a less intense mania
- Cyclothymic disorder: A less severe form of mania and depression
Bipolar Psychosis And The Brain
Its impossible to separate the physical brain from the neurochemicals in the brain, but there are actually structural differences in the brain of people who experience psychosis. There can be a chronic shut down of the frontal lobes and there is a particular part of the limbic system called the where the dopamine system is especially hyperactive. Antipsychotic medications work by blocking dopamine in this area. The limbic system, the emotional part of the brain, is also central to the causes and ultimately treatment of bipolar psychosis. Brain research into this area is vital as new medications and other treatments are based on new research. In other words, if we do find out exactly where psychosis resides in the brain and specifically what chemicals are affected, medications can be much more targeted.
APA ReferenceFast, J. . What Causes Psychosis? Psychosis and the Brain, HealthyPlace. Retrieved on 2021, October 16 from https://www.healthyplace.com/bipolar-disorder/psychosis/what-causes-psychosis-psychosis-and-the-brain
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What Are The Signs And Symptoms
A person with bipolar disorder will go through episodes of mania and at other times experience episodes of depression . These arent the normal periods of happiness and sadness that everyone experiences from time to time. Instead, the episodes are intense or severe mood swings, like a pendulum that keeps arcing higher and higher.
Symptoms of mania include:
- anger, worry, and anxiety
- thoughts of death or suicide
In adults, episodes of mania or depression usually last for weeks or months, although they can be shorter in length. In children and adolescents, though, these episodes can be much shorter, and a kid or teen can even go back and forth between mania and depression throughout the day.
Episodes of mania or depression may happen irregularly and follow an unpredictable pattern or they may be linked, with a manic episode always following a period of depression, or vice versa. Sometimes episodes have a seasonal pattern. Mania in the spring, for example, may be followed by depression in the winter.
Between episodes, someone with bipolar disorder usually returns to normal functioning. For some people, though, there is little or no break period between their cycles. These mood swing cycles can change slowly or rapidly, with rapid cycling between mania and depression being much more common in women, children, and adolescents.
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How Is Bipolar Disorder Diagnosed
To diagnose bipolar disorder, a doctor or other health care provider may:
- Complete a full physical exam.
- Order medical testing to rule out other illnesses.
- Refer the person for an evaluation by a psychiatrist.
A psychiatrist or other mental health professional diagnoses bipolar disorder based on the symptoms, lifetime course, and experiences of the individual. Some people have bipolar disorder for years before it is diagnosed. This may be because:
- Bipolar disorder has symptoms in common with several other mental health disorders. A doctor may think the person has a different disorder, such as schizophrenia or depression.
- Family and friends may notice the symptoms, but not realize that the symptoms are part of a more significant problem.
- People with bipolar disorder often have other health conditions, which can make it hard for doctors to diagnose bipolar disorder.
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Underlying Mechanism For Cell Loss
Activation of the HPA axis appears to play a critical role in mediatinghippocampal atrophy, as was already discussed. In addition to directly causingneuronal atrophy, stress and glucocorticoids also appear to reduce cellularresilience, thereby making certain neurons more vulnerable to other insults,such as ischemia, hypoglycemia, and excitatory aminoacid toxicity.
Who Has Bipolar Disorder
Nearly 6 million adults in America are affected by bipolar disorder, which can also affect children and adolescents. The onset of the disorder most commonly begins in young adulthood , but it can also start in childhood or as late as in a persons 50s.
Men and women are equally likely to develop the disorder, which tends to run in families. People with a parent or sibling with the condition are more likely to develop it. This indicates there may be a genetic factor involved. However, its important to know that having a family member with the condition does not mean that you will get it too. In addition, remember that your genetics are not your destiny. A growing body of evidence shows that your lifestyle habits can either turn on or turn off your genes.
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Can The Brain Recover From Bipolar Disorder
There is no cure for bipolar disorder, and changes to the brain can be permanent.
However, treatments for bipolar disorder, such as lithium, may have a normalizing effect on the brain. The author of a concluded that the use of lithium or mood stabilizers is associated with increases in gray matter volume.
Brain Imaging In Bipolar Disorder
Structural and functional brain imaging studies in bipolar disorder lend direct, support to the indications of prefrontal cortical pathophysiology from studies of neurocognition. Classic studies of patients with secondary mood disturbance as a consequence of organic pathology like stroke or tumor reported increased prevalence of depressed mood following damage to the left, frontal cortex and the left, basal ganglia., Cases of secondary mania arc unsurprisingly less common than poststroke depression, but, are reported to show the reverse pattern of laterality, associated with right-lateralized damage to the frontal cortex and basal ganglia. These data highlight the connectivity between the frontal cortex and basal ganglia, and this frontostriatal circuitry is thought, to support, many aspects of attentional, executive and emotional function. Neurological patients with basal ganglia pathology also show elevated levels of depression, compared with other patient, groups with disorders matched for level of disability
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What Are The Core Symptoms
Because bipolar disorder involves both manic episodes and depressive episodes that shift in a cyclical pattern, people with the condition typically experience a broad range of symptoms. Manic episodes are characterized by many things, including decreased need for sleep, grandiose ideas or racing thoughts. Depressive episodes are characterized by loss of interest in usually pleasurable activities to even thoughts of death or suicide. See below for more details about these two types of episodes.
Glycogen Synthase Kinase: A Common Target For Mood Stabilizers
Lithium and VPA regulate the activity of a crucial kinase that functionsas an intermediary in numerous intracellular signaling pathways, the enzymeglycogen synthase kinase-3 , suggesting the importance of this enzymein BD research . While lithium inhibits GSK-3 a constitutively activeand a highly conserved enzyme in evolution by direct competition with magnesiumfor a binding site, the precise mechanisms by which VPA exerts its actionis still uncertain . Other signals deactivating GSK-3 arise from insulinstimulation, developmental signals, and numerous growth factors . Thus, growth factors may bring about many of their neurotrophic/neuroprotectiveeffects, at least in part, by GSK-3 inhibition. Rapidly increasing evidencesuggests that GSK-3 also plays important roles in regulating neuroplasticityand cellular resilience. GSK-3 phosphorylates and thereby inactivates -transcription factors and cytoskeletal proteins . Furthermore, changes in GSK-3 mediate MAP-1B phosphorylation, associated with the loss and/or unbundling of stable axonalmicrotubules. Finally, GSK-3β inhibition results in the accumulationof synapsin I, a protein involved in synaptic vesicle docking and release,at growth cone-like areas.
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What Happens In The Manic Phase Of Bipolar Disorder
Are you or someone you know affected by mood swings that seem extreme or out of the ordinary? Do those changes in mood affect your ability to stay focused or complete tasks? While occasional changes in mood are normal, when those changes occur often, or without obvious reason, they may be a reason for concern. For some, these could be signs of a mental health disorder known as bipolar disorder. Because not everyone who has bipolar disorder has been properly diagnosed or is receiving treatment, it is important to understand the symptoms and know when to seek help.
Brain Cells And Depression/bipolar Disorder
Professor Wayne Drevets explains that specific glial cells known as oligodendrocytes may be decreased in the brains of individuals who have bipolar disorder or major depressive disorder.
brain cells, glial, glia, oligodendrocyte, bipolar disorder, major depressive disorder, depression, wayne, drevets
- ID: 2087
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