Bipolar Disorder Symptoms and Treatments
By Joan Whetzel
Bipolar disorder, sometimes referred to as manic-depressive disorder, consists of wide mood swings from the depression lows (sadness, hopelessness, loss of interest) to manic highs (euphoria, full of energy). The swings may occur in high frequency (a few times a day) or be extremely spread out (a few times a year or less). Some patients even suffer both the manic and depression symptoms together. However, while this long-term condition has no cure, it's symptoms can be managed.
What Is Bipolar Disorder?
Bipolar sufferers experience moods that swing between manic euphoria and depression that are more extreme than the average garden-variety ups and downs, and are severe enough that they have difficulty performing their daily tasks. Between episodes of mania or depression, many of those suffering from the disease are frequently free of symptoms, while some continue to have symptoms that never quite clear away completely. In fact the disease, left unchecked, can reak havoc on relationships, contribute to poor academic and work performance, lead to legal problems, and even lead to suicide. Symptoms of the disorder begin showing up in the late teens and early 20s, with at least 50% of all cases beginning before the age of 25 years. Some sufferers don't begin showing symptoms until later in life, though. The disease lasts forever, meaning it cannot be cured, only treated.
The "Diagnostic and Statistical Manual of Mental Disorders" (DSM) lists 4 types of bipolar disorder.
1. Bipolar I Disorder has manic or mixed manic and depressive episodes that last about 7 days, and depressive symptoms lasting about 14 days, or by manic symptoms that are severe enough to require immediate hospitalization.
2. Bipolar II Disorder demonstrates a pattern of alternating depressive and hypermanic episodes, without full blown manic episodes or mixed episodes.
3. Bipolar Disorder Not Otherwise Specified demonstrates symptoms of the disorder that don't meet the criteria for Bipolar I or Bipolar 2 Disorders. Either the person doesn't have enough of the symptoms, or the symptoms don't last long enough, but the person is still suffering symptoms that are clearly out of their normal behavior patterns.
4. Cyclothymic Disorder is a mild form of the disease, alternating between hypermanic and mild depressive states for at least 2 years.
Symptoms tend to become worse over time if left untreated or if receiving a correct diagnosis is delayed. People suffering from bipolar disorder often suffer from one or more of these other conditions as well:
1. Substance abuse.
2. Anxiety Disorders like PTSD or social phobia.
4. Thyroid disease.
5. Migraine headaches.
6. Heart disease.
8. Other illnesses that can make a correct diagnosis more complicated.
Causes, Incidence, and Risk Factors
The disease usually begins between the ages of 15 and 25, with men and women affected equally. The exact cause is unclear, though it does tend to run in families, and episodes generally have an event that triggers them. Tirggers often include:
· life changing events, like childbirth.
· medications (e.g. antidepressants, steroids).
· sleepless periods.
· recreational drug use.
Other contributing factors include:
1. Biology: Sufferers may have physical changes in their brains.
2. Neurotransmitters: Sufferers may have a brain chemistry imbalance.
3. Hormones: Sufferers may have a hormonal imbalance.
4. Inherited Traits: It is more common in people who have blood relatives with the disease.
5. Environmental factors: Sufferers may also suffer from stress, abuse, significant loss, or some other traumatic experience.
The main purpose of bipolar disorder treatment is to stabilize the mood swings so that the patient doesn't move between the two extremes (to make the episodes less frequent and severe), to avoid hospitalization, to help the patient function as normally as possible between episodes, and to prevent self-injury. Treatments for bipolar disorder fall into one of 4 categories: medication, psychotherapy, hospitalization and other treatments.
1. Medications are aimed at stabilizing the mood swings, though not everyone responds to medications in the same manner. The medications may need to be switched out until the best regime for each patient is found. The different types of medications include mood stabilizers, atypical antipsychotic medications, and antidepressants.
2. Psychotherapy - also referred to as "talk therapy" provides support, education and guidance to those suffering from the disease and to their families. It includes Family-focused therapy, group therapy, cognitive behavior therapy, interpersonal therapy, rhythm therapy, and pscycho-education.
3. Hospitalization provides a safe, calm, and stable environment designed to help patients in the throes of an extreme episode, come back to a state of balance and to bring symptoms under control.
4. Other Treatments include those that are not used as frequently and only if need dictates their use. These treatments may include: electroconvulsive therapy (ECT) or electric shock therapy and sleeping medications.
The medications can help the patients control their bipolar symptoms. Yet, patients often need support from a psychiatric professional as well as from family and friends, especially when it comes to making sure they take their medication properly. Taking the prescribed medication in the proper dosages is important, but it is even more important that they don't stop taking their medications once the moods have evened out, once they start feeling better. Bipolar disorder is an un-curable disease with a long-term treatment plan.
Complications of Bipolar Disorder
Having bipolar disorder that is undiagnosed or untreated, or where the patient decides to go off his or her meds or not to take the medications as prescribed, can have the following complications:
· alcohol abuse.
· drug abuse.
· relationship, work, or financial problems
· suicidal ideation.
· attempted or successful suicide.
· legal problems.
· isolation and loneliness.
· difficulty performing well at school or at work.
· frequent absences.
The Bipolar Patient's Family
The most important thing any family member or friend can do is to make sure the person suffering from the symptoms mentioned gets the correct diagnosis and begins a treatment regimen. Other assistance that family and friends can provide include:
1. Providing emotional support and understanding.
2. Having patience and giving encouragement.
3. Educating themselves on bipolar disorder so that they have an idea of what the patient is going through.
4. Listening to and talking to their friend or relative.
5. Recognizing the triggers that bring on the patient's manic or depressive episodes.
6. Helping their friend or family member find positive distractions (such as walks or outings) to help prevent episodes, or cut them off at the turn.
7. Don't ignore comments about or referring to self harming by their friend or family member.
8. Get help from support groups to help them cope with the behaviors of their friend or family member.
9. Take a break whenever possible and find ways to take care of themselves so that they are better able to cope with the behaviors of their friend or family member.
When to Call for Emergency Help
There may come a time when a friend or family member - or even the bipolar patient himself or herself - becomes aware that the situation is getting out of hand, and that outside help is needed urgently. Don't be afraid to call for help if:
· The patient begins exhibiting thoughts of suicide or death.
· The patient appears to have attempted suicide or has harmed himself or herself in some way.
· The patient is experiencing severe depressive or manic symptoms that are out of control.
· The bipolar patient is experiencing new symptoms or old, resolved symptoms that have returned
National Institute for Mental Health. Bipolar Disorder.
National Center for Biotechnology Information, US National Library of Medicine. Bipolar Disorder.
Mayo Clinic. Bipolar Disorder.
WebMD. Bipolar Disorder Help Center.