Bipolar Disorder
Bipolar disorder, or manic depression, is a very severe mental illness. It is distinguished from any other form of clinical depression by the presence of manic (euphoric) episodes, followed by depression. Some six million Americans suffer from bipolar disorder, usually beginning in adolescence.
The good news is that with regular treatment, those suffering from this brain disorder can look forward to leading normal lives. However, with its symptoms often mimicking other mood disorders, the major obstacle to combating manic depression is proper diagnosis.
What are the Symptoms of Bipolar Disorder?
Sufferers of bipolar disorder are most easily distinguished by their extreme changes in mood. Symptoms are generally broken down into the two mood phases that constitute bipolar disorder: mania and depression.
Symptoms of mania include:
- Exaggerated sense of optimism, confidence or "good mood"
- Racing speech, accompanied by racing and possibly delusional thoughts
- Lack of concentration
- Lack of need for sleep
- Increased sexual desire
- Poor judgment and impulsive or reckless behavior
- Extreme irritability
- Denial of a problem
Symptoms of depression include:
- Prolonged periods of sadness, anxiety or crying
- Sense of worthlessness, hopelessness or indifference
- Loss of interest in social and other activities that were formerly enjoyed (including sex)
- Decreased energy, lethargy
- Lack of concentration, indecisiveness
- Sleeping too much or too little
- Unexplained, chronic pain
- Changes in appetite; weight loss or gain
- Thoughts of death or suicide
If you have experienced five or more of these symptoms for most of the day, every day, for two weeks, then you could be suffering from manic depression.
The problem is that manic depression can sometimes lead to drug and alcohol abuse, poor work or school performance, or strained relationships. This sometimes causes doctors to attribute the symptoms of bipolar disorder to these circumstances. Also, some people may feel enhanced by their manic mood, and therefore only seek treatment for their depression. Unfortunately, treatments usually prescribed for depression can actually exacerbate symptoms of manic depression.
What are the Risk Factors for Developing Bipolar Disorder?
The greatest determinant for developing bipolar disorder is genetics. Some 10-15% of those who have a close relative (sibling, child or parent) with bipolar disorder also have a form of mood disorder. However, hormones, chemical triggers in the brain, and major life events can also influence the onset of manic depression.
Manic depression tends to develop late in adolescence, although it can also occur in adults and even children. However, bipolar disorder in children is usually accompanied by different symptoms than in adults; their manic and depression stages, for example, tend to occur in much more frequent intervals, and may even overlap. Also, their manic mood is more likely to consist of periods of irritability and aggressiveness than euphoria. This sometimes causes bipolar disorder to be misdiagnosed as Attention Deficit Hyperactivity Disorder (ADHD) or other types of behavioral disorders.
What Treatment Options are Available?
Bipolar disorder is a very serious mental illness that cannot be treated without medical supervision. Left untreated, bipolar disorder carries a 15% risk of suicide. In fact, among 15-24 year olds, bipolar disorder is the third leading cause of death.
Treatment of manic depression usually involves a combination of psychotherapy, mood stabilizers, antidepressants, and antipsychotic medication.
Since antidepressants alone may aggravate bipolar symptoms, they are typically prescribed in combination with mood stabilizers. The two most common forms of mood stabilizers are Lithium and anticonvulsant medications (such as valproate and carbamazepine).
It is important, however, to discuss the side effects of these medications in detail with your doctor. Some of the more common side effects include: weight gain, anxiety, nausea, hair loss, difficulty with movement and dry mouth. Certain antipsychotic drugs may also increase your risk for developing diabetes, high blood pressure and obesity. Also, women who are breastfeeding, pregnant or wish to become pregnant should be aware that certain medications might cause harmful side effects to the fetus and nursing infant.
The goal of psychotherapy (or talk therapy) is to detect triggers for bipolar episodes so that they may be avoided altogether. Through discussion of your symptoms, education about the disease and the introduction of coping strategies, psychotherapy can be instrumental in helping you to get more control over your life and mental health.
ECT or Herbs
For those who do not experience success with either medication or psychotherapy, or for those who demonstrate suicidal tendencies, electroconvulsive therapy (ECT) may be an option. Although this therapy has been very successful, the risks associated with prolonged use of the treatment are not yet fully understood.
Certain herbal remedies such as omega-3 fatty acids, St. John’s Wort and S-Adenosyl-L-Methionine (SAM-e) are also commonly recommended for those suffering from depression, although studies have yet to confirm their effectiveness. It is important to remember that herbal supplements are not as rigorously tested as prescription medications, and that some may even contain dangerous chemicals. Also, some of these supplements may interfere with prescribed medications. Therefore, it is important to talk to your doctor before taking any form of medication.
Finally, it is worth emphasizing that at the present time there is no cure for bipolar disorder. It is considered a life-long illness. Consequently, it is imperative that treatment be maintained even in the absence of symptoms so you can avoid recurrence and remain in control of your life.
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