Understanding Bipolar Disorder

Many of us have experienced times when our emotions seemed to be on a roller coaster, whether due to stress, fatigue, or hormonal issues. Usually, within a day or two, things settle down and our emotions are back on a more even keel. But for some people, the roller coaster never stops. Bipolar disorder, formerly called manic depression, creates extreme mood swings that range from the highest highs (mania or hypomania) to intense anger and irritability, to the deepest lows (depression). During the “high” times, those with bipolar disorder feel euphoric and full of energy, but then their mood shifts and they are plunged into depression. Now, they feel sad or hopeless, and often lose interest or pleasure in activities they normally enjoy.

Some may experience these mood shifts several times a week, while for others they may only occur every few months. In either case, bipolar disorder can be disruptive to having a normal life. Without treatment, it can cause problems at work, school and with relationships.

Are there different types of bipolar disorder?

Yes, there are actually several types, as well as related disorders. For each type, the symptoms can vary from person to person. In general, the changes in mood are usually severe enough to cause noticeable difficulty in dealing with daily life, and are not caused by alcohol, drug use or a medical condition. There may also be signs of unusual talkativeness or activity in a manic episode, or excessive sleeping or inability to function in a depressed episode. When depressed, patients may also demonstrate suicidal tendencies.

Doctors look to see if a manic episode has occurred and is followed by a depressed episode. Frequency, duration, and other factors then determine exactly which type of bipolar disorder (or related) a person has.

Is bipolar disorder ongoing?

Bipolar disorder is an illness that requires long-term treatment. Some people go for long periods without episodes, others “cycle” frequently through symptoms, while still others are influenced by the seasons. Whatever the circumstances, treatment is required and must be maintained to avoid relapses.

What causes bipolar disorder?

The exact causes are unknown, but several factors seem to be involved. People with bipolar disorder have physical changes in their brains. Scientists are still researching what these changes mean. There is also an imbalance in naturally-occurring brain chemicals called neurotransmitters; neurotransmitters play a significant role in bipolar and other mood disorders.

There may be a gene that causes bipolar disorder and researchers are pursuing this possibility. Bipolar disorder is more common in people who have a sibling or parent with the condition and may be inherited.

How is bipolar disorder treated?

Specific treatment varies according to the individual and the exact type of the disorder they are diagnosed with. Those with a bipolar disorder may also be prone to post-traumatic stress disorder, anxiety disorders, ADHD, substance abuse, and physical issues. It is important that these associated conditions also be treated.

In all cases, treatment is best undertaken by a professional with experience and expertise in this area. Typically, the first step after a full diagnosis is to prescribe medications to balance the mood swings. Once these are under control, additional medications may be prescribed to help with other symptoms, if present–anti-psychotics, antidepressants, and anti-anxiety medications may all be used if needed. Your physician will usually only add one drug at a time in order to evaluate which medication works best on which symptoms, and to try to find those drugs that cause the fewest side effects. Finding the right combination of prescriptions that work best can take some time as certain medications can take weeks to months to fully take effect.

Other treatments for bipolar disorders include psychotherapy. This may be done in a private setting or a group setting. A number of different therapy options may be suggested, including cognitive behavioral therapy, which identifies unhealthy and negative thoughts and behaviors and replaces them with positive ones, and interpersonal therapy, psychodynamic or social rhythm therapy, which helps patients stabilize daily rhythms such as sleeping, waking and meal times. Sticking to a consistent schedule can help individuals better manage their moods.

What about Transcranial Magnetic Stimulation (TMS)?

TMS may be recommended for those who have not responded to antidepressants. During TMS, the patient sits in a reclining chair with an electronic coil placed against their scalp. The coil sends magnetic impulses to the brain, targeting those areas that are involved n controlling mood and depression. The treatment is not painful and has proven very successful in many cases. Five to six weekly treatments are usually required in order to see results.

Changing Your Lifestyle Can Help

If you suffer from bipolar disorder, it is important to make healthy lifestyle changes. Do not drink and do not take illegal drugs. Get involved in positive activities that you enjoy. Keep busy and surround yourself with positive people. Get regular physical exercise. A good workout releases positive endorphins that make you feel better; it reduces stress, and will help you sleep. Getting plenty of good sleep is also key. If you are sleep deprived, you are more likely to be depressed or irritable. If sleeping well is an issue, talk with your doctor. Finding ways to reduce stress is also helpful, whether that means joining a support group, or taking up a proven relaxation activity such as yoga, tai chi or meditation.

Why is continuing treatment important?

People who discontinue treatment are at risk for having a relapse of symptoms. Such a relapse may not be minor, it could trigger an all-out manic or depressed episode. This could put them at risk for hospitalization or suicide.

How do I know if someone is bipolar?

If you or someone you love have symptoms of mania or depression, see your doctor or mental health provider right away. A mental health provider can diagnose the situation fairly quickly and start providing the help needed. Bipolar disorders do not get better on their own and can lead to even more serious issues, including risky behavior, drug use, alcohol abuse, and suicide. Bipolar disorder can occur in children and teens, although it is more difficult to diagnose in those age groups due to normal mood swings that typically occur. Still, if you have concerns, consult a mental health professional.

The good news is that bipolar disorder is very treatable and people with the condition can lead productive, fulfilling lives once treated. The sooner the illness is diagnosed and treated, the sooner quality of life can be restored. Bullet

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