For the month of April I am participating in the annual A-Z Blogging Challenge. The Challenge was started by author/blogger, Arlee Byrd. http://tossingitout.blogspot.com

Each day of the month (except Sundays) we will post something based on that days correlating letter. Some of us chose a theme and others are winging it. My theme is the A-to-Z’s of Mental Health, Raising Awareness. It is a topic that is very close to my heart. I hope you find the posts interesting and you will comment and share the posts everywhere. To see a list of all of the participants or for more information-click on the badge over there to the right >

Today’s letter is B

                                                                                        Bipolar Disorder

Bipolar  is a brain disorder that causes one to endure extreme up and down shifts in mood.  The shifts can be anywhere from severe depression to mania which is an overly exaggerated sense of joy and energy. The mood swings can negatively impact school, jobs and relationships. They mood swings are much more than life’s normal ups and downs.

Bipolar Disorder tends to run in families.

The disorder may also be present itself in a mixed state, in which you might experience both mania and depression at the same time. During a mixed state, you might feel very agitated, have trouble sleeping, experience major changes in appetite and have suicidal thoughts. People in a mixed state may feel very sad or hopeless while at the same time feel extremely energized.

 A person with severe swings of mania or depression can also have psychotic- symptoms which can lead to bipolar disorder being mistakenly diagnosed as schizophrenia. If you are having psychotic symptoms during a manic episode you might think you are a race car driver, you have boatloads of money or you can fly. If you are having psychotic symptoms during a depressive episode, you may have no hope and believe nobody wants you to live.

 People with bipolar disorder may also abuse alcohol or substances, have relationship problems, or perform poorly in school or at work. It may be difficult to recognize these problems as signs of a major mental illness.

 At least fifty percent of cases start before the age of twenty-five with most symptoms first appearing during teen years.

Diagnosis

 A doctor should first rule out any medical causes for mood swings such as but not limited to thyroid disease, kidney disease, stroke and brain tumor.

 If the problems are not caused by other illnesses, your health care provider may conduct a mental health evaluation or provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

Doctors diagnose bipolar disorder using guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM). There are four basic types of bipolar disorder:

  Bipolar I Disorder—defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.

  Bipolar II Disorder—defined by a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.   

   Bipolar Disorder Not Otherwise Specified (BP-NOS)—diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II. However, the symptoms are clearly out of the person’s normal range of behavior.

    Cyclothymic Disorder, or Cyclothymia—a mild form of bipolar disorder. People with cyclothymia have episodes of hypomania as well as mild depression for at least 2 years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.

Anxiety disorders, such as post-traumatic stress disorder (PTSD) and social phobia, also co-occur often among people with bipolar disorder. Bipolar disorder also co-occurs with attention deficit hyperactivity disorder (ADHD), which has some symptoms that overlap with bipolar disorder, such as restlessness and being easily distracted.

People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses. These illnesses may cause symptoms of mania or depression. These can also be side effects of  certain  treatments for bipolar disorder.

Bipolar Disorder cannot be cured, but it can be treated effectively over the long-term. An effective ongoing maintenance treatment plan usually includes a combination of medication and psychotherapy. A maintenance plan be in place for life.

Medications

Mood stabilizers are usually the first choice to treat bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for years. Lithium (also known as Eskalith or Lithobid) is an effective mood stabilizer. It was the first mood stabilizer approved by the FDA in the 1970’s for treating both manic and depressive episodes.

Anticonvulsants are also used as mood stabilizers.

Antidepressants are sometimes used to treat symptoms of depression in bipolar disorder.

Psychotherapy

When done in combination with medication, psychotherapy can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:

• Cognitive behavioral therapy (CBT), which helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviors.
• Family-focused therapy, which involves family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. This therapy also improves communication among family members, as well as problem-solving.
• Interpersonal and social rhythm therapy, which helps people with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
• Psychoeducation, which teaches people with bipolar disorder about the illness and its treatment.A licensed psychologist, social worker, or counselor typically provides psychotherapy. He or she should work with your psychiatrist to track your progress.Sleep Medications—People with bipolar disorder who have trouble sleeping usually sleep better after getting treatment for bipolar disorder.Herbal Supplements—In general, not much research has been conducted on herbal or natural supplements and how they may affect bipolar disorder. An herb called St. John’s wort (Hypericum perforatum), often marketed as a natural antidepressant, may cause a switch to mania in some people with bipolar disorder. St. John’s wort can also make other medications less effective, including some antidepressant and anticonvulsant medications. Scientists are also researching omega-3 fatty acids (most commonly found in fish oil) to measure their usefulness for long-term treatment of bipolar disorder. Study results have been mixed.To help a friend or relative

• 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 or relative expresses and be understanding about situations that may trigger bipolar symptoms
• Invite your friend or relative out for positive distractions, such as walks, outings, and other activities
• Remind your friend or relative that, with time and treatment, he or she can get better.Never ignore comments from your friend or relative about harming themselves. Do whatever you have to do to get help immediately.*FDA Warning on AntidepressantsAntidepressants are safe and popular, but some studies have suggested that they may have unintentional effects on some people, especially in adolescents and young adults. The FDA warning says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment. Possible side effects to look for are depression that gets worse, suicidal thinking or behavior, or any unusual changes in behavior such as trouble sleeping, agitation, or withdrawal from normal social situations. For the latest information, see the FDA website .