Bipolar disorder involves periods of elevated or irritable mood (mania), alternating with periods of depression. The “mood swings” between mania and depression can be very abrupt. Bipolar disorder is a serious mental illness. People who have it experience dramatic mood swings. They may go from overly energetic, “high” and/or irritable, to sad and hopeless, and then back again. They often have normal moods in between. The up feeling is called mania. The down feeling is depression.
The elevated moods are clinically referred to as mania or, if milder, hypomania. Extreme manic episodes can sometimes lead to such psychotic symptoms as delusions and hallucinations. The current term “bipolar disorder” is of fairly recent origin and refers to the cycling between high and low episodes (poles). Bipolar disorder can run in families. It usually starts in late adolescence or early adulthood. Untreated, bipolar disorder can result in damaged relationships, poor job or school performance, and even suicide.
Most people will start to see symptoms of Bipolar when they are around 25 years of age. However, there have been people who developed the Bipolar disorder in their early childhoods or some will develop it when they are as old as 40 or 50 years of age. It doesn’t matter what your age, race, ethnic group or social class because men and women can develop Bipolar.
MYTHS AND FACTS ABOUT BIPOLAR DISORDER:
Myth: People with bipolar disorder can’t get better or lead a normal life.
Fact: Many people with bipolar disorder have successful careers, happy family lives, and satisfying relationships. Living with bipolar disorder is challenging. But with treatment, healthy coping skills, and a solid support system, you can live fully while managing your symptoms.
Myth: People with bipolar disorder swing back and forth between mania and depression.
Fact: Some people alternate between extreme episodes of mania and depression, but most are depressed more often than they are manic. Mania may also be so mild that it goes unrecognized. People with bipolar disorder can also go for long stretches without symptoms.
MYTH: Bipolar disorder only affects mood.
Fact: Bipolar disorder also affects your energy level, judgment, memory, concentration, appetite, sleep patterns, sex drive, and self-esteem. Additionally, bipolar disorder has been linked to anxiety, substance abuse, and health problems such as diabetes, heart disease, migraines, and high blood pressure.
MYTH: Aside from taking medication, there is nothing you can do to control bipolar disorder.
Fact: While medication is the foundation of bipolar disorder treatment, therapy and self-help strategies also play important roles. You can help control your symptoms by exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding yourself with supportive people.
EARLY SIGNS OF BIPOLAR:
Perhaps the most likely bipolar symptoms to be overlooked are those known as hypomania. Hypomania is a state in which the person suffering from the condition is showing signs that are completely across the board. They may be exhibiting signs of high levels of energy and being very irritable or moody. They may be reckless in the actions that they perform and may become impulsive in decision making. Often, those suffering from hypomania will find themselves facing mood swings without realizing it. When family and friends ask them about these mood swings, they will brush it off and say that they feel fine. The reason for this is because hypomania actually feels good to them. To them, nothing is wrong.
Bipolar is a complex illness. There are many different symptoms — and several different types — of bipolar disorder. The primary symptoms of the disorder are dramatic and unpredictable mood swings. The various types of bipolar disorder range from mild to severe.
Mania symptoms may include excessive happiness, excitement, irritability, restlessness, increased energy, less need for sleep, racing thoughts, high sex drive, and a tendency to make grand and unattainable plans.
Depression symptoms may include sadness, anxiety, irritability, loss of energy, uncontrollable crying, change in appetite causing weight loss or gain, increased need for sleep, difficulty making decisions, and thoughts of death or suicide.
There are several types of bipolar disorder; all involve episodes of depression and mania to a degree. They include bipolar I, bipolar II, cyclothymic disorder, mixed bipolar, and rapid-cycling bipolar disorder.
A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.
Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time. However, in bipolar II disorder, the “up” moods never reach full-on mania.
In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. About 10% to 20% of people with bipolar disorder have rapid cycling.
In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence.
Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.
The cause of bipolar disorder is not entirely known. Genetic, neurochemical and environmental factors probably interact at many levels to play a role in the onset and progression of bipolar disorder. The current thinking is that this is a predominantly biological disorder that occurs in a specific part of the brain and is due to a malfunction of the neurotransmitters (chemical messengers in the brain). As a biological disorder, it may lie dormant and be activated spontaneously or it may be triggered by stressors in life.
Although, no one is quite sure about the exact causes of bipolar disorder, researchers have found these important clues:
GENETIC FACTORS IN BIPOLAR DISORDER
- Bipolar disorder tends to be familial, meaning that it “runs in families.” About half the people with bipolar disorder have a family member with a mood disorder, such as depression.
- A person who has one parent with bipolar disorder has a 15 to 25 percent chance of having the condition.
- A person who has a non-identical twin with the illness has a 25 percent chance of illness, the same risk as if both parents have bipolar disorder.
- A person who has an identical twin (having exactly the same genetic material) with bipolar disorder has an even greater risk of developing the illness about an eightfold greater risk than a nonidentical twin.
- Studies of adopted twins (where a child whose biological parent had the illness is raised in an adoptive family untouched by the illness) has helped researchers learn more about the genetic causes vs. environmental and life events causes.
NEUROCHEMICAL FACTORS IN BIPOLAR DISORDER
Bipolar disorder is primarily a biological disorder that occurs in a specific area of the brain and is due to the dysfunction of certain neurotransmitters, or chemical messengers, in the brain. These chemicals may involve neurotransmitters like norepinephrine, serotonin and probably many others. As a biological disorder, it may lie dormant and be activated on its own or it may be triggered by external factors such as psychological stress and social circumstances.
ENVIRONMENTAL FACTORS IN BIPOLAR DISORDER
- A life event may trigger a mood episode in a person with a genetic disposition for bipolar disorder.
- Even without clear genetic factors, altered health habits, alcohol or drug abuse, or hormonal problems can trigger an episode.
- Among those at risk for the illness, bipolar disorder is appearing at increasingly early ages. This apparent increase in earlier occurrences may be due to under diagnosis of the disorder in the past. This change in the age of onset may be a result of social and environmental factors that are not yet understood.
- Although substance abuse is not considered a cause of bipolar disorder, it can worsen the illness by interfering with recovery. Use of alcohol or tranquilizers may induce a more severe depressive phase.
PHYSCHOLOGICAL EFFECT ON INDIVIDUAL, FAMILY AND SOCIETY:
EFFECT ON INDIVIDUAL:
It can effect an individual like the individual can’t get along with others or have good relationship with people. It makes harder for an individual to keep responsibilities, achieve their goals and make decisions. They may feel guilty about events occurred years ago or about issues that didn’t cause. They sometimes hear a voice that they are hopeless. Bipolar disorder patients may loss self-esteem during their depressive stage and have anxiety with low mood and sometimes become hyperactive, they can drink too much alcohol or abuse drugs and get into a risky situation, like a risk of suicide. Suicidal thoughts can become worse when patients use alcohol or drugs.
EFFECTS ON FAMILY:
Siblings may experience jealousy if too much attention is devoted to the ill member and not enough to themselves. To deal with feelings of resentment and guilt, siblings spend more time away from the family. When the ill member is a parent who cannot meet the emotional needs of his or her spouse, a child may assume the role of confidante with the well parent and may sacrifice some of his or her own personal development as an independent individual.
In severe cases of manic-depressive illness, families typically find that their social network starts shrinking in size for several reasons. The family is often embarrassed by the varied symptoms of an ill relative whether these symptoms have to do with poor self-care skills or belligerent behaviour. Visitors may feel awkward about what to say or how to help the family. Usually they say nothing at all and soon both family and friends find themselves participating in a conspiracy of silence. Eventually, it becomes easier to avoid each other.
Families go through a range of emotions in response to the unpredictability of the bipolar mood phases. They will sometimes be loving, patient and understanding. They will also be angry that their lives are so severely disrupted. Most families put a lot of energy into keeping the secret—maintaining a positive public face—so no one else knows about the constant turmoil and conflict. This just adds to the mounting pressure. They will struggle with their own bouts of depression and anxiety as a result of the unrelenting stress. Their time is filled with worry about what’s going to happen next.. They sometimes feel guilty that they aren’t able to help. They are forced to face behaviors and situations that are unfathomable.
EFFECT ON SOCIETY:
impairment in daily living activities, affect familial relationship and job performance and even impair the bipolar sufferer to such an extent that physical health is affected. However, in some cases of bipolar order, the outcome may be positive and lead to such an extent that physical health is affected. However, in some cases of bipolar disorder, the outcome may be positive and lead to such a degree of creativity so as to allow the individual to make a significant impact on the world around them. Bipolar disorder crosses all genders , races , creeds and colors with examples of individuals whom made an impact on society through the exhibition of their bipolar symptoms. These symptoms often lead to absenteeism from work, loss of employment
ROLE OF INDIVIDUAL, FAMILY FRIEND, GOVERNMENT, AND SOCIETY TO REMOVE THE BIPOLAR DISORDER:
ROLE OF INDIVIDUAL:
It may be very hard to take that first step to help yourself. It may take time, but you can get better with treatment.
To help yourself:
- Talk to your doctor about treatment options and progress
- Keep a regular routine, such as eating meals at the same time every day and going to sleep at the same time every night
- Try to get enough sleep
- Stay on your medication
- Learn about warning signs signaling a shift into depression or mania
- Expect your symptoms to improve gradually, not immediately.
ROLE OF FAMILY:
A family that has a member who may have bipolar disorder should try their best to get that person the help that they need. Consult an counselor who would be more than happy to answer any questions and give any suggestions or advice. If it is believed that this person really is suffering from bipolar disorder, than the best thing for the family to do is to get that person into counseling. Many individuals will not go in to see a counselor because they are embarrassed or they don’t want to appear weak to others. Improve the overall atmosphere in the household and keep the happiness and joy in life around.
People with bipolar disorder do better when they have support from family members.
Open and honest communication is essential to coping with bipolar disorder in the family. Share your concerns in a loving way, ask the person how he or she is feeling, and make an effort to truly listen—even if you disagree with your loved one or don’t relate to what’s being said.: Stress makes bipolar disorder worse, so try to find ways to reduce stress in your family member’s life. Ask how you can help and volunteer to take over some of the person’s responsibilities if needed. Establishing and enforcing a daily routine— with regular times for getting up, having meals, and going to bed—can also reduce family stress. Things you can do to support a loved one’s bipolar disorder treatment:
- Find qualified doctors and therapists
- Set up appointments and going along
- Offer your insight to the doctor
- Monitor your loved one’s moods
- Learn about the person’s medications
- Track treatment progress
- Watch for signs of relapse
- Alert the doctor to problems
In this way u can remove bipolar disorder from family.
ROLE OF FRIEND:
To help a friend or relative, you can:
- Offer emotional support, understanding, patience, and encouragement
- Learn about bipolar disorder so you can understand what your friend or relative is experiencing
- Talk to your friend or relative and listen carefully
- Listen to feelings your friend be understanding about situations that may trigger bipolar symptoms
- Invite your friend out for positive distractions, such as walks, outings, and other activities
- Remind your friend, with time and treatment, he or she can get better.
Never ignore comments about your friend or harming himself or herself. Always report such comments to his or her therapist or doctor. In this way u can help your friend and remove a bipolar disorder.
ROLE OF GOVERNMENT:
Government should develop health centres to give treatment to bipolar patient. They should start some vocational centres to enhance their skills and give employment and job security to them. In this way they can remove bipolar disorder among people.
ROLE OF SOCIETY:
Role of society is that they should not neglect the acts of the patients, they must appreciate their work, give positive response to what they are saying, understand them and their problem. In this way society can remove the bipolar disorder among people.
There’s no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
If you’ve been diagnosed with bipolar disorder, some strategies can help prevent minor episodes from becoming full-blown episodes of mania or depression:
Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You and your caregivers may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel you’re falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.
Avoid drugs and alcohol. Even though you may feel better, using alcohol or street drugs makes your symptoms more likely to come back.
Take your medications exactly as directed. Medications can have unwanted side effects, and you may feel unhappy about having a mental health condition that requires lifelong treatment. During periods when you feel better, you may be tempted to stop treatment. This can have immediate consequences — you may become very depressed, feel suicidal, or go into a manic or hypomanic episode. If you think you need to make a change, call your doctor.
Check first before taking other medications. Call the doctor who’s treating you for bipolar disorder before you take medications prescribed by another doctor. Sometimes other medications trigger episodes of bipolar disorder or may interfere with medications you’re already taking to treat bipolar disorder.
If your doctor determines that you have bipolar disorder, he or she will explain your treatment options and possibly prescribe medication for you to take. You may also be referred to another mental health professional, such as a psychologist, counselor, or a bipolar disorder specialist. Together, you will work with your healthcare providers to develop a personalized treatment plan.
COMPREHENSIVE TREATMENT FOR BIPOLAR DISORDER:
A comprehensive treatment plan for bipolar disorder aims to relieve symptoms, restore your ability to function, fix problems the illness has caused at home and at work, and reduce the likelihood of recurrence. A complete treatment plan involves:
- Medication – Medication is the cornerstone on bipolar disorder treatment. Taking a mood stabilizing medication can help minimize the highs and lows of bipolar disorder and keep symptoms under control.
- Psychotherapy – Therapy is essential for dealing with bipolar disorder and the problems it has caused in your life. Working with a therapist, you can learn how to cope with difficult or uncomfortable feelings, repair your relationships, manage stress, and regulate your mood.
- Education – Managing symptoms and preventing complications begins with a thorough knowledge of your illness. Education is a key component of treatment. The more you and your loved ones know about bipolar disorder, the better able you’ll be to avoid problems and deal with setbacks.
- Lifestyle management – By carefully regulating your lifestyle, you can keep symptoms and mood episodes to a minimum. This involves maintaining a regular sleep schedule, avoiding alcohol and drugs, following a consistent exercise program, minimizing stress, and keeping your sunlight exposure stable year round.
- Support – Living with bipolar disorder can be challenging, and having a solid support system in place can make all the difference in your outlook and motivation. Participating in a bipolar disorder support group gives you the opportunity to share your experiences and learn from others who know what you’re going through. The support of friends and family is also invaluable.
SELF-HELP FOR BIPOLAR DISORDER :
There are many things you can do to stabilize your mood and stay well. The way you live your life is just as important, if not more so, than the medication you take. Making healthy choices for yourself can make a huge difference in how you feel.
MEDICATION TREATMENT FOR BIPOLAR DISORDER:
Most people with bipolar disorder need medication in order to keep their symptoms under control. When medication is continued on a long-term basis, it can reduce the frequency and severity of bipolar mood episodes, and sometimes prevent them entirely.
If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right drug or combination of drugs for your needs. Because everyone responds to medication differently, you may have to try several different medications before you find one that relieves your symptoms.
- Check in frequently with your doctor. It’s important to have regular blood tests to make sure that your medication levels are in the therapeutic range. Getting the dose right is a delicate balancing act. Close monitoring by your doctor will help keep you safe and symptom-free.
- Continue taking your medication, even if your mood is stable. Don’t stop taking your medication as soon as you start to feel better. Most people need to take medication long-term in order to avoid relapse.
- Don’t expect medication to fix all your problems. Bipolar disorder medication can help reduce the symptoms of mania and depression, but in order to feel your best, it’s important to lead a lifestyle that supports wellness. This includes surrounding yourself with supportive people, getting therapy, and getting plenty of rest.
- Be extremely cautious with antidepressants. Research shows that antidepressants are not particularly effective in the treatment of bipolar depression. Furthermore, they can trigger mania or cause rapid cycling between depression and mania in people with bipolar disorder.
ABOUT BIPOLAR DISORDER MEDICATION :
Mood stabilizers, antidepressants, and antipsychotics are the main types of medication used to treat bipolar disorder. Learn how to find the right drug or drug combination for you, work with your doctor, and manage side effects.
THERAPY FOR BIPOLAR DISORDER: AN IMPORTANT PART OF TREATMENT
Research indicates that people who take medications for bipolar disorder are more likely to get better faster and stay well if they also receive therapy. Therapy can teach you how to deal with problems your symptoms are causing, including relationship, work, and self-esteem issues. Therapy will also address any other problems you’re struggling with, such as substance abuse or anxiety.
Three types of therapy are especially helpful in the treatment of bipolar disorder:
- Cognitive-behavioral therapy
- Interpersonal and social rhythm therapy
- Family-focused therapy
In cognitive-behavioral therapy, you examine how your thoughts affect your emotions. You also learn how to change negative thinking patterns and behaviors into more positive ways of responding. For bipolar disorder, the focus is on managing symptoms, avoiding triggers for relapse, and problem-solving.
Interpersonal and social rhythm therapy
Interpersonal therapy focuses on current relationship issues and helps you improve the way you relate to the important people in your life. By addressing and solving interpersonal problems, this type of therapy reduces stress in your life. Since stress is a trigger for bipolar disorder, this relationship-oriented approach can help reduce mood cycling.
For bipolar disorder, interpersonal therapy is often combined with social rhythm therapy. People with bipolar disorder are believed to have overly sensitive biological clocks, the internal timekeepers that regulate circadian rhythms. This clock is easily thrown off by disruptions in your daily pattern of activity, also known as your “social rhythms.” Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these rhythms are stable, the biological rhythms that regulate mood remain stable too.
Living with a person who has bipolar disorder can be difficult, causing strain in family and marital relationships. Family-focused therapy addresses these issues and works to restore a healthy and supportive home environment. Educating family members about the disease and how to cope with its symptoms is a major component of treatment. Working through problems in the home and improving communication is also a focus of treatment.
COMPLEMENTARY TREATMENTS FOR BIPOLAR DISORDER:
Most alternative treatments for bipolar disorder are really complementary treatments, meaning they should be used in conjunction with medication, therapy, and lifestyle modification. Here are a few of the options that are showing promise:
- Light and dark therapy – Like social rhythm therapy, light and dark therapy focuses on the sensitive biological clock in people with bipolar disorder. This easily disrupted clock throws off sleep-wake cycles, a disturbance that can trigger symptoms of mania and depression. Light and dark therapy for bipolar disorder regulates these biological rhythms—and thus reduces mood cycling— by carefully managing your exposure to light. The major component of this therapy involves creating an environment of regular darkness by restricting artificial light for ten hours every night.
- Mindfulness meditation – Research has shown that mindfulness-based cognitive therapy and meditation help fight and prevent depression, anger, agitation, and anxiety. The mindfulness approach uses meditation, yoga, and breathing exercises to focus awareness on the present moment and break negative thinking patterns.
- Acupuncture – Acupuncture is currently being studied as a complementary treatment for bipolar disorder. Some researchers believe that it may help people with bipolar disorder by modulating their stress response. Studies on acupuncture for depression have shown a reduction in symptoms, and there is increasing evidence that acupuncture may relieve symptoms of mania also.
Female, Age 48 years, Bipolar Disorder
This 48-year-old female suffered from bipolar disorder for 30 years prior to seeking help from upper cervical chiropractic care. The episodes of depression and mania started during her teenage years and she had tried a number of different medications over the years.
During her upper cervical chiropractic evaluation, an upper neck injury was discovered. She recalled experiencing a horse back riding accident during her junior high years in which she sustained a concussion. She concluded her neck injury could have occurred then. After receiving treatment for her neck injury, she reported a marked improvement in her health, specifically the bipolar problem was reduced tremendously. She reported that she received more results from upper cervical care versus any other treatment or medication she had tried over the years.
Male, Age 23 years, Bipolar Disorder, Epilepsy, Sleep Disorder, Headaches, Back Pain
This 23-year-old male suffered a closed head injury at age 17 in which he landed on his head due to a pole-vaulting accident at a high school track meet. Since the fall, he suffered from bipolar disorder (rapid-cycling mood swings), seizures (2-3 per day), daily headaches, daily neck and back pain, and sleep disorder (he would often be awake for 24-36 straight hours before finally going to sleep and then often would sleep for 24 or more hours). He was taking tegretol for bipolar disorder and pain medication for headaches.
During this patient’s upper cervical exam, an upper neck injury was found, most likely stemming from the pole-vaulting accident. The injury was compromising this patient’s brain and spinal cord function. After five months of upper cervical care, all mood swings, headaches, seizures, pain, and sleep trouble were corrected, and all medications were discontinued. All family members remarked at the enormous change in the patient’s mental outlook, personality, and health.
RESEARCH DONE ON BIPOLAR DISORDER:
Genes play a large role in the etiology of bipolar disorder – approximately 50% have relatives with this disorder. If both of your parents have this disorder your chances are 75%. If you have a family member who has the bipolar disorder you are also at risk of developing unipolar disorder.
In addition to drug treatment, ECT (electroconvulsive therapy) is used for depression and mania when medications do not work.
Also bright light has been used for a seasonal form of winter depression.
Transcranial magnetic stimulation has been used for bipolar disorder.
Bipolar disorder rarely comes without other disorders. As we take a look at the affective spectrum, we see that many disorders are included and it is common for people to have one or many additional disorders.
The following have been identified (so far) as part of the medical spectrum which may accompany affective disorders.
- attention deficit disorder (ADD & ADHD)
- body dysmorphic disorder
- eating disorders (bulimia, anorexia, binging)
- fibromyalgia (includes chronic fatigue)
- impulse-control disorders
- irritable bowel syndrome
- migraine/severe headache
- obsessive-compulsive disorder
- panic disorder
- Tourette’s disorder
The following may also be a part of the spectrum accompanying affective disorders.
- anxiety disorders
- chronic pain
- intermittent explosive disorder
- pathological gambling
- personality disorders
- post traumatic stress disorder
- substance abuse and addiction (includes alcoholism)
All disorders must be diagnosed and treated.
Therapy such as cognitive therapy is particularly helpful in working through one’s life and group therapy with this population is also particularly helpful. Studies has shown that this form of therapy has reduced the number of hospitalizations and failed marriages.
A “bad childhood” has nothing to do with developing bipolar disorder. However families are encouraged to become involved with the patient’s treatment plan and become educated about the disorder.
Recently a study revealed that out of people that were hospitalized due to mania or mixed episodes, 50% were symptom free a year later. However 25% of that had a satisfactory job and family life. Another study revealed that four years later one third were supporting themselves by working.
Harvard Mental Health Letter
AN OVERVIEW OF RATE OF BIPOLAR DISORDER:
Worldwide, the rate of bipolar disorder is 2.4% – but in the United States it’s 4.4%, says a newly published study by the World Mental Health Survey Initiative that interviewed more than 61,000 people. The study also found that 75% of those with bipolar had at least one other disorder. Panic disorder and other anxiety disorders were the most common of these, followed by behavior and then substance abuse disorders. Bipolar disorder can cause suicidal ideation that leads to suicidal attempts. One out of 3 people with bipolar disorder report past attempts of suicide or complete it
Across the world, fewer than half of those with BP received any kind of mental health treatment, and the figure dips to just 25% in low-income countries. The study was conducted in 11 countries in the Americas, Europe, Asia, the Middle East and New Zealand.
In general, higher-income countries had higher rates of BP than lower-income. Some theories about why this is so include genetics, cultural differences in the way people respond to surveys in general, and cultural reluctance to discuss psychiatric issues.
The lowest national rate of bipolar disorder found was India, with just .1%.
Japan had a lifetime prevalence of 0.7%. Colombia, a lower-income nation, also deviated from the trend with a relatively high prevalence of 2.6%.In Pakistan 1 out of 20000 people are suffering from bipolar disorder.
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