What Is The Meaning Of Bipolar Disease

Developmental Perspectives On Bipolar Disorder

In the past 10 years, there has been a notable increase in research focused on how to evaluate and treat BD in childhood and adolescence. That BD can occur in childhood has been known for some time and is not controversial. In contrast, how frequently it occurs and whether its presentation is consistent with adult presentations are matters of considerable debate.

In community samples, between 0% and 2.0% of adolescents meet diagnostic criteria for BD I disorder, and between 0.1% and 0.6% meet criteria for BD II disorder . As one would expect, prevalence estimates of BD spectrum disorders are higher in pediatric psychiatric facilities, with estimates from 6.0%â6.9% .

There is broad agreement that early-onset BD disorder, when carefully diagnosed, is associated with a wide array of dysfunctions. In a four-year follow-up of prepubertal and early adolescent children with DSM-IV BD I mania or mixed disorder , the average duration of manic episodes was 79 weeks, and only 36% recovered fully within one year. At four-year follow-up, 64% had a recurrence of mania . Other outcomes include high rates of hospitalization, suicidal behavior, psychosis, reckless behavior, aggression, and substance abuse; psychiatric, medical, and educational service utilization; severe family conflicts; significant caregiver burden; and chronic psychosocial impairment .

How It Affects Daily Life

When itâs not under control, bipolar disorder can cause problems in many areas of life, including your job, relationships, sleep, health, and money. It can lead to risky behavior. It can be stressful for the people who care about you and arenât sure how to help or may not understand whatâs going on.

Racism Discrimination And Mental Health

Since its inception, America has struggled with its handling of matters related torace, ethnicity, and immigration. The histories of each racial and ethnic minoritygroup attest to long periods of legalized discrimination – and more subtle forms ofdiscrimination – within U.S. borders . Ancestors of many of today’s African Americans were forciblybrought to the United States as slaves. The Indian Removal Act of 1830 forcedAmerican Indians off their land and onto reservations in remote areas of the countrythat lacked natural resources and economic opportunities. The Chinese Exclusion Actof 1882 barred immigration from China to the U.S. and denied citizenship to ChineseAmericans until it was repealed in 1952. Over 100,000 Japanese Americans wereunconstitutionally incarcerated during World War II, yet none was ever shown to bedisloyal. Many Mexican Americans, Puerto Ricans, and Pacific Islanders became U.S.citizens through conquest, not choice. Although racial and ethnic minorities cannotlay claim to being the sole recipients of maltreatment in the United States, legallysanctioned discrimination and exclusion of racial and ethnic minorities have beenthe rule, rather than the exception, for much of the history of this country. Eachof the later chapters of this Supplement describes some of the key historical eventsthat helped shape the contemporary mental health status of each group.

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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.

What Does A Person With Bipolar Disorder Experience

Bipolar disorder does not have a set pattern and differs from individual to individual. Patients may feel a particular emotion several times before switching to another state.

Symptoms of mania are:

• Patients may feel that they are on the top of the world
• Highly irritable

• Phenothiazine antipsychotics: Chlorpromazine

When medication therapy is ineffective, electroconvulsive therapy might be considered.;During electroconvulsive therapy, an electric current is passed through the brain to treat the disorder. In some, talk therapy has proven to be beneficial in treating mood episodes. Another part of treatment is psychoeducation where patients and their families are educated regarding symptoms and importance of medication compliance.

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Mechanisms Of Drug Action

observed that most of the effective pharmacological treatments for BD affect levels of dopamine and serotonin. Current research on the action mechanisms of mood stabilizers centers upon signal-transduction pathways responsible for communicating chemical signals from the postsynaptic receptors to the cell nucleus and nearby cells. Lithium and valproate both inhibit protein kinase C . Lithium also inhibits calcium, glutamate, and G-proteins, all components of the intracellular signaling cascade . There is increasing evidence that lithium and the selective serotonin reuptake inhibitors have neuroprotective effects in preventing apoptosis .

Anticonvulsants are believed to have âantikindlingâ effects via diminishing excitation and enhancing inhibition in the mesolimbic system and other brain circuits responsible for affect regulation . Lamotrigine and carbamazepine reduce the outflow, the presynaptic release, or the postsynaptic uptake of excitatory amino acids such as glutamate.

Antidepressants alleviate depression primarily through serotonergic, dopaminergic, and noradrenergic mechanisms. They may also reduce the output of glucocorticoids, which, if overproduced, can lead to the destruction of cells in the hippocampus .

What Is Bipolar Disorder

Bipolar disorder is a chronic or episodic mental disorder. It can cause unusual, often extreme and fluctuating changes in mood, energy, activity, and concentration or focus. Bipolar disorder sometimes is called manic-depressive disorder or manic depression, which are older terms.

Everyone goes through normal ups and downs, but bipolar disorder is different. The range of mood changes can be extreme. In manic episodes, someone might feel very happy, irritable, or up, and there is a marked increase in activity level. In depressive episodes, someone might feel sad, indifferent, or hopeless, in combination with a very low activity level. Some people have hypomanic episodes, which are like manic episodes, but less severe and troublesome.

Most of the time, bipolar disorder develops or starts during late adolescence or early adulthood. Occasionally, bipolar symptoms can appear in children. Although the symptoms come and go, bipolar disorder usually requires lifetime treatment and does not go away on its own. Bipolar disorder can be an important factor in suicide, job loss, and family discord, but proper treatment leads to better outcomes.

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Poverty Marginal Neighborhoods And Community Violence

Poverty disproportionately affects racial and ethnic minorities. The overall rateof poverty in the United States, 12 percent in 1999, masks great variation.While 8 percent of whites are poor, rates are much higher among racial andethnic minorities: 11 percent of Asian Americans and Pacific Islanders, 23percent of Hispanic Americans, 24 percent of African Americans, and 26 percentof American Indians and Alaska Natives . Measured another way, the per capita income forracial and ethnic minority groups is much lower than that for whites.

Table 2-2: Per Capita Income by Ethnicity in 1999.

gives Per CapitaIncome averages by ethnicity in 1999.

For centuries, it has been known that people living in poverty, whatever theirrace or ethnicity, have the poorest overall health ; ; . It comes as no surprise then that poverty isalso linked to poorer mental health . Studies have consistently shown that people in the loweststrata of income, education, and occupation are about two to three times more likely than those in the highest stratato have a mental disorder ; ;. They alsoare more likely to have higher levels of psychological distress .

Who Experiences Bipolar Disorder

Bipolar disorder usually begins in older teens and young adults, with at least half of all cases appearing before age 25. Children and adolescents, however, can develop this disease in more severe forms and often in combination with attention deficit hyperactivity disorder . Some studies have indicated that bipolar depression is genetically inherited, occurring more commonly within families.

While bipolar disorder occurs equally in women and men, women are more likely to meet criteria for bipolar II disorder. Women with bipolar disorder may switch moods more quickly this is called “rapid cycling.” Varying levels of sex hormones and activity of the thyroid gland in the neck, together with the tendency to be prescribed antidepressants, may contribute to the more rapid cycling seen in women. Women may also experience more periods of depression than men.

An estimated 60 percent of all people with bipolar disorder have drug or alcohol dependence. It has also been shown to occur frequently in people with seasonal depression and certain anxiety disorders, like post-traumatic stress disorder .

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Get Involved With Treatment

Ask if you can be involved with your partners treatment, which may include occasionally going to the psychiatrist together. Being a part of your partners treatment has multiple benefits, including:

• Gaining a better understanding of the illness.
• Providing additional insight for the psychiatrist.
• Learning to spot signs of impending episodes.
• Alerting the psychiatrist about mood changes.

Even if your partner hasnt signed off on you exchanging information with their psychiatrist, you can still report worrisome signs . This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalized.

Progression Of The Bipolar Disorder

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With treatment, the outcome, in general, is good. Without treatment, on the other hand, the outcome is almost always very negative, with constant relapses and serious family, occupational, and social consequences.

Generally, although there are exceptions, the illness develops imperceptibly during adolescence, a stage already known for its proclivity to emotional instability, and reaches its splendour in adult age, in the form of a depressive or even a hypomanic/manic phase.

Very often, the first episode is preceded by a stressing environmental situation. However, from then on, the illness becomes independent of the environmental and psychological circumstances, as such that the biological mood regulator mechanisms seem to enter into a permanent fluctuation, which leads the individuals to lose the point of reference of their usual mood state.

Each relapse makes the individual more vulnerable to stress, as such that, some patients, can begin to present with so-called rapid cycling, which is the uninterrupted succession of depression and euphoria .

Bipolar disorder is only slightly more common in women than in men, but rapid cycling is a lot more common in female patients. However, rapid cycling can be reversed with suitable treatment.

Consequences of bipolar disorder

Treatment is the determining factor in order to prevent the main complications of the disorder, in which one of the most serious is suicide.

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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.

How Common Are Comorbid Bipolar Disorders And Eating Disorders

Someone with comorbid disorders has two disorders at the same time. Studies vary widely when it comes to figuring out how common comorbid bipolar disorder and eating disorders are, mostly because of the different ways researchers identify eating and bipolar disorders.

Studies have found that anywhere from 5.3-31% of individuals on the bipolar spectrum have a co-occurring eating disorder.

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Medications For Bipolar Disorder

Certain medications help with managing symptoms of bipolar disorder. Psychopharmaceuticals, for example, are used to help balance mood and can be used immediately after diagnosis. Some treatment plans may target sleep and anxiety, while others may seek to treat depressive episodes. This process may take some time, and a person might need to try several different medications before finding the ones that work best. Before starting a medication, it is important to:

• Understand the risks and benefits of the medication
• Report side effects to your doctor right away
• Tell the doctor about any other prescription drugs, over-the-counter medications, or supplements being taken;

Once prescribed, the medication shouldnt be stopped without first consulting a health care provider first. Medications for bipolar disorder are meant to be taken consistently, as prescribed, even once a person starts feeling better. If an individual stops taking a prescribed medication, it may actually lead to a worsening of bipolar symptoms.;

Depending on a persons situation and unique needs, in addition to medications, symptoms of bipolar disorder can be managed with the following treatment options:;;

What Are Bipolar Disorder Medications And Other Treatments Are There Any Home Remedies Or Alternative Treatments For Bipolar Disorder

Many people, whether they suffer from bipolar disorder or any medical or other mental illness, understandably wonder how they might help themselves to have the best outcome of treatment. While there is no cure for bipolar disorder, medications and psychotherapies remain mainstays of treatment of this illness. Also, lifestyle improvements can be important complementary measures to care for this population. For example, aerobic exercise has been found to help alleviate some of the thinking problems, like memory and ability to pay attention, that are associated with bipolar disorder and other mental health problems. While some home remedies or alternative/over-the-counter treatments like St. John’s wort have been found to help mild depression, they may induce a manic episode. There remains insufficient evidence that such treatments successfully treat manic symptoms. Although alternative medicine treatments for bipolar disorder like St. John’s wort or ginkgo biloba are not recognized as standard care for bipolar disorder, as many as one-third of some patient groups being treated for this disorder report using them.

Medications that treat bipolar disorder

Psychotherapies

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When Someone Is Manic

During this phase, people feel super-charged and think they can do anything. Their self-esteem soars out of control and itâs hard for them to sit still. They talk more, are easily distracted, their thoughts race, and they donât sleep enough. It often leads to reckless behavior, such as spending sprees, cheating, fast driving, and substance abuse. Three or more of these symptoms nearly every day for a week accompanied by feelings of intense excitement may signal a manic episode.

Bipolar Disorder Vs Manic Depression

A critical point in distinguishing bipolar disorder from major depressive disorder is whether the person has had a manic episode. For someone to be diagnosed with bipolar disorder, they must have had a manic episode lasting for at least one week or a hypomanic episode lasting for at least four days.

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Symptoms Presentation And Meaning

The symptoms of mental disorders are found worldwide. They cluster into discretedisorders that are real and disabling . As noted in, mental disorders aredefined in the Diagnostic and Statistical Manual of MentalDisorders. Schizophrenia, bipolar disorder, panicdisorder, obsessive compulsive disorder, depression, and other disorders havesimilar and recognizable symptoms throughout the world . Culture-boundsyndromes, which appear to be distinctive to certain ethnic groups, are theexception to this general statement. Research has not yet determined whetherculture-bound syndromes are distinct from established mental disorders, are variants of them, or whetherboth mental disorders and culture-bound syndromes reflectdifferent ways in which the cultural and social environment interacts with genesto shape illness .

The Bipolar Disorder Spectrum

There is much disagreement about where to draw the boundaries of the bipolar spectrum, but some investigators include subsyndromal manic episodes, manic or hypomanic episodes triggered by antidepressants, or agitated depression . When broader definitions of BD are included, lifetime prevalence rates from 6.4% to 10% are reported . A reanalysis of the Epidemiological Catchment Area database indicated that 6.4% of the general population met criteria for the BD spectrum . There are data to support the spectrum concept. Notably, patients with subsyndromal forms of BD are more likely to have family histories of BD than people without subsyndromal symptoms and have high rates of suicide, marital disruption, and psychiatric service utilization .

Various self-report instruments have been designed to identify persons with or at risk for BD spectrum disorders. The General Behavior Inventory , a 79-item questionnaire, assesses lifetime experiences of depressive and manic symptoms. High scores during adolescence are associated with psychosocial impairment in adulthood , and a youth version discriminated early-onset BD from attention deficit disorders . The Hypomanic Personality Scale robustly predicted the onset of bipolar spectrum disorders in a 13-year follow-up of college students .

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How Can I Help A Loved One

When someone you love is diagnosed with depression or bipolar disorder, you may wonder how you can really help. You can offer support in different ways: you can offer emotional support or practical support to help make the journey less daunting. You can also help a loved one watch for signs of relapse or other difficulties, which is an important part in maintaining wellness.

People who experience an episode of depression may have thoughts of ending their life. This is a sign that a loved one needs extra support. If you believe that a loved one is in danger, dont hesitate to call 911 or your local crisis line.

Here are some tips for supporting someone you love:

• Learn more about the illness and listen to your loved one so you have a better understanding of their experiences.
• Someone who experiences an episode of depression may want to spend time alone or act out in frustration, and this can hurt other peoples feelings. These are just symptomsit isnt about you.
• Ask your loved one how you can help. Think about practical help with day-to-day tasks, too.
• Make sure your expectations are realistic. Recovery takes time and effort. It means a lot when you recognize your loved ones work towards wellness, regardless of the outcome.
• Make your own boundaries, and talk about behaviour you arent willing to deal with.
• Seek support for yourself and think about joining a support group for loved ones. If family members are affected by a loved ones illness, consider family counselling.