How Does Bipolar Disorder Affect Caregivers And Families
Caring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a childs mood episodes and other problemssuch as short tempers and risky behaviorscan challenge any caregiver.
It is important that caregivers take care of themselves, too. Find someone you can talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.
Interpersonal And Social Rhythm Therapy
Substantial evidence exists that mood instability in bipolar disorder is related to changes in circadian rhythms . The relation between sleep and mood disturbances seem to be bidirectional. Polymorphisms in CLOCK genes are related to circadian mood fluctuations and recurrences in bipolar disorder. In one promising animal model, mice with mutations in CLOCK genes behaved in ways that resembled manic behaviour in people these behaviours were reversed upon treatment with lithium.
What Are The Types Of Bipolar Disorder
There are three main types of bipolar disorder:
- Bipolar I disorder involves manic episodes that last at least 7 days or manic symptoms so severe that you need immediate hospital care. Depressive episodes are also common. Those often last at least two weeks. This type of bipolar disorder can also involve mixed episodes.
- Bipolar II disorder involves depressive episodes. But instead of full-blown manic episodes, there are episodes of hypomania. Hypomania is a less severe version of mania.
- Cyclothymic disorder, or cyclothymia, also involves hypomanic and depressive symptoms. But they are not as intense or as long-lasting as hypomanic or depressive episodes. The symptoms usually last for at least two years in adults and for one year in children and teenagers.
With any of these types, having four or more episodes of mania or depression in a year is called “rapid cycling.”
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Question : If I Think I Might Have Bipolar Disorder What Should I Do
While it seems pretty obvious you should tell a doctor of your thought you should also tell as many friends and family members as you can because their support, guidance and words of wisdom will help you much more in the early days than you might think. You need to get diagnosed as soon as you can and sadly with the current state of most mental health that might mean you will have to do your own research for the area you live in, then go from there. The key thing to remember is to keep talking to people about your thoughts and problems.
Question : How Do I Know If I Am Bipolar
This might sound like a simple question, but it really isnt as straight forward as you might think as there are many other mental health illnesses that feature the same signs. The most basic of diagnosing you can do is to ask yourself how intense these mood swings are and how long do they last? If you do show signs of suffering Bipolar disorder the answers might be VERY intense and they last days or weeks at a time. While this is no guarantee at all that you do indeed have Bipolar disorder it is the main signs to be aware of.
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Top Mood Stabilizers For Bipolar Disorder
None of them are perfect, but a few rise to the top, according to recent guidelines.
RESEARCH UPDATE
Ive been pouring over textbooks and treatment guidelines, and these four mood stabilizers keep rising to the top.1-6 None of them are perfect, but each has a unique role in bipolar disorder:
- Lithium
- Lurasidone
- Lamotrigine
Lithium and quetiapine top the lists for all three phases of the illness: mania, depression, and the maintenance phase. Lurasidone and lamotrigine are either untested or ineffective in mania, but they are essential tools for bipolar depression.
Lithium
Lithium stands out for its preventative effects in bipolar disorder, but it also has important benefits outside of the manic-depressive symptom lists. It is the only mood stabilizer that significantly reduces the risk of suicide, and it reduces mortality in other ways as well. Although lithium is often avoided out of concerns of toxicity, it actually lowers the risk of cancer, heart disease, stroke, and viral illnesses.7 All of those occur at higher frequency in bipolar disorder. Vascular disease is the leading cause of death in bipolar disorder,8 and viral illnesses are both a consequence and cause of bipolar symptoms.9
Quetiapine
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What Role Does Environment And Lifestyle Play In Bipolar Disorder
Along with a genetic link to bipolar disorder, research shows that children of bipolar parents are often surrounded by significant environmental stressors. That may include living with a parent who has a tendency toward mood swings, alcohol or substance abuse, financial and sexual indiscretions, and hospitalizations. Although most children of a bipolar parent will not develop bipolar disorder, some children of bipolar parents may develop a different psychiatric disorder such as ADHD, major depression, schizophrenia, or substance abuse.
Environmental stressors also play a role in triggering bipolar episodes in those who are genetically predisposed. For example, children growing up in bipolar families may live with a parent who lacks control of moods or emotions. Some children may live with constant verbal or even physical abuse if the bipolar parent is not medicated or is using alcohol or drugs.
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Brain Structure And Gray Matter
Some evidence suggests people with bipolar disorder have less gray matter in certain parts of the brain, including the temporal and frontal lobes.
These brain areas help regulate emotions and control inhibitions. A lower volume of gray matter may help explain why emotion regulation and impulse control become difficult during mood episodes.
Gray matter contains cells that help process signals and sensory information.
Research has also linked the hippocampus, a part of the brain implicated for learning, memory, mood, and impulse control, to mood disorders. If you have bipolar disorder, your hippocampus may have a lower total volume or a slightly altered shape.
These brain differences may not necessarily cause bipolar disorder though. Still, they offer insight on how the condition might progress and affect brain function.
Family history can certainly increase the likelihood of developing bipolar disorder, but many people with a genetic risk never develop the condition.
Various factors from your surrounding environment offer another point of connection to consider. These might include:
- personal experiences
- external stress triggers
- alcohol or substance use
Research shows that childhood trauma is a risk factor for bipolar disorder, and is associated with more severe symptoms.
This is because strong emotional distress in childhood might affect your ability to regulate your emotions as an adult. Childhood trauma can include:
Other possible environmental factors might include:
What Can I Expect After Treatment
For most people, a good treatment program can stabilize severe moods and provide effective symptom relief. Treatment that is continual has proven more effective in preventing relapses. Those who also have a substance abuse problem may need more specialized treatment.
Last reviewed by a Cleveland Clinic medical professional on 01/27/2018.
References
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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.
Ten Of The Most Common Questions About Bipolar Disorder Answered
Before I start, I just want to say that I dont suffer from Bipolar disorder and I am not a therapist or psychologist in any way. What I am is deeply interested in spreading awareness about mental health and hopefully bring you information that might be valuable to someone. These ten questions I have answered are ten of the most commonly asked questions about Bipolar disorder and I have kept the answers in terms most of us can understand rather than medical bibble-babble
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Common Causes And Illnesses
Mental illness is one of the leading causes of homelessness. This article explores the common illnesses and treatments availible to the homeless community.
Mental illness and homelessness are two of sides of the same coin. Where there is a large number of mentally ill individuals in a country, there is usually a large percentage of people homeless as well. According to Brain and Behavior, roughly 25% of homeless people are mentally ill.
What Risks And Complications Can Bipolar Disorder Cause
There can be complications and risks for people who live with bipolar disorder. But these risks can be lessened with the right support and treatment.
What about suicide and self-harm?
You might have an illness where you experience psychosis, such as schizophrenia or bipolar disorder. Your risk of suicide is estimated to be between 5% and 6% higher than the general population.
You are more likely to try to take your own life if you have a history of attempted suicide and depression. It is important that you get the right treatment for your symptoms of depression and have an up to date crisis plan.
There is also research that suggests you are 30% – 40% more likely to self-harm if you live with bipolar disorder.
What about financial risk?
If you have mania or hypomania you may struggle to manage your finances. You may spend lots of money without thinking about the effect that it may have on your life.
You could make a Lasting Power of Attorney. This is a legal process. This means that you pick someone that you trust to manage your finances if you lack mental capacity to manage them by yourself.
You can work with your carer and mental health team. You can form an action plan. This can say what they can do if you have a period of mania or hypomania and you start to make poor financial decisions.
What about physical health risk?
What about alcohol and drugs risk?
If you want advice or help with alcohol or drug use contact your GP.
What about driving risk?
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Is Bipolar Disorder Genetic
Many studies of bipolar patients and their relatives have shown that bipolar disorder sometimes runs in families. Perhaps the most convincing data come from twin studies. In studies of identical twins, scientists report that if one identical twin has bipolar disorder, the other twin has a greater chance of developing bipolar disorder than another sibling in the family. Researchers conclude that the lifetime chance of an identical twin to also develop bipolar disorder is about 40% to 70%.
In more studies at Johns Hopkins University, researchers interviewed all first-degree relatives of patients with bipolar I and bipolar II disorder and concluded that bipolar II disorder was the most common affective disorder in both family sets. The researchers found that 40% of the 47 first-degree relatives of the bipolar II patients also had bipolar II disorder 22% of the 219 first-degree relatives of the bipolar I patients had bipolar II disorder. However, among patients with bipolar II, researchers found only one relative with bipolar I disorder. They concluded that bipolar II is the most prevalent diagnosis of relatives in both bipolar I and bipolar II families.
Are Bipolar Symptoms Different For Each Person
Symptoms can vary widely for each patient diagnosed with bipolar disorder. Thats why its important to work closely with a psychiatrist or psychologist to put a long-term treatment plan in place which suits the patients individual needs.
Many patients will enjoy long periods of wellness between episodes of depression or mania. The depression or mania can last for prolonged periods. Some encounter many episodes of bipolar depression or mania throughout their lives. Others experience only a few episodes. Some patients may experience symptoms that change quickly.
Rapid cycling is when a patient experiences four or more episodes of mania or depression within a single year. Mood swings can switch from high to low and then back within a matter of days- sometimes within hours. This experience can leave a patient feeling out of control. Rapid cycling sometimes happens when an individual is not closely following a treatment plan.
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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
What Are The Different Types Of Bipolar Disorder
Mental health professionals distinguish between 2 main types of bipolar disorder:
- Bipolar I This is characterised by extreme, long-lasting highs as well as depressive episodes, and may include psychosis .
- Bipolar II This is characterised by highs that are less extreme that only last or a few hours or days, as well as depressive episodes, and periods of normal mood.
Other types of bipolar disorder include cyclothymic disorder and substance-induced bipolar disorder .
CHECK YOUR SYMPTOMS Try the Black Dog Institutes self-test to see if you have symptoms that may indicate bipolar disorder.
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Treatment For Bipolar Disorder
If you spot the symptoms of bipolar disorder in yourself or someone else, dont wait to get help. Ignoring the problem wont make it go away in fact, it will almost certainly get worse. Living with untreated bipolar disorder can lead to problems in everything from your career to your relationships to your health. But bipolar disorder is highly treatable, so diagnosing the problem and starting treatment as early as possible can help prevent these complications.
If youre reluctant to seek treatment because you like the way you feel when youre manic, remember that the energy and euphoria come with a price. Mania and hypomania often turn destructive, hurting you and the people around you.
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.
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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.
You can find out more information about:
The Stress Of A Bad Breakup Or Failed Marriage
A number of people with bipolar disorder especially those with a history of severe manic episodes have failed marriages. If youre going through a divorce, working with your therapist through what is often a drawn-out and extremely stressful process can help.
You might consider a durable power of attorney that allows someone else to make major decisions for you, such as financial ones, when you are going through an episode of depression or mania in relation to or during a breakup.
In fact, assigning a durable power of attorney could be useful for anyone who might be experiencing an episode of bipolar disorder.
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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.