BIPOLAR DISORDER
Bipolar disorder, sometimes called manic-depressive disorder, is characterized by extreme mood swings that range from the lows of depression to the highs of mania. The "mood swings" between mania and depression can be very quick.
Bipolar disorder is a long-term serious mental illness that must be carefully managed throughout a person's life. It can lead to risky behavior, damaged relationships and careers, and even suicidal tendencies if it is not treated.
CAUSES
Bipolar disorder often develops in a person's late teens or early adult years. It usually starts between ages 15 to 25.
The exact cause is unknown, but researchers believe there is a genetic component.
TYPES
Bipolar I
A person affected by bipolar I disorder has had at least one manic episode and periods of major depression. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.
Symptoms I
Easily distracted, little need for sleep, poor judgment, poor temper control, reckless behavior and lack of self control, very elevated mood, very involved in activities, very high self-esteem (false beliefs about self or abilities), impulsive sex, and impulsive business investments.
Bipolar II
Bipolar II is less severe than bipolar I. People with bipolar disorder type II have never had full mania. Instead they experience periods of high energy levels and impulsiveness that are not as extreme as mania (called hypomania). These periods alternate with episodes of depression.
Symptoms II
In people with bipolar disorder II, the symptoms of mania are similar but less intense.
Cyclothymia
Cyclothymia is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disturbing, but the highs and lows are not as severe as they are with other types of bipolar disorder.
BIPOLAR SYMPTOMS
The depressed phase of both types of bipolar disorder includes the following symptoms:
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.
GOALS OF TREATMENT
Avoid moving from one phase to another, avoid the need for a hospital stay, help the patient function as well as possible between episodes, prevent self-injury and suicide, make the episodes less frequent and severe.
TREATMENT
To date, there is no cure for bipolar disorder, but proper treatment helps most people with bipolar disorder gain better control of their mood swings and related symptoms.
Usually, bipolar medications are prescribed by a psychiatrist.
Mood stabilizing medications are usually the first choice to treat bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for years except for lithium.
Many of these medications are anticonvulsants.
• Lithium (sometimes known as Eskalith or Lithobid) is effective at stabilizing mood and preventing the extreme highs and lows of certain categories of bipolar disorder.
Periodic blood tests are required, since lithium can cause thyroid and kidney problems. Common side effects include restlessness, dry mouth and digestive issues.
• Anticonvulsants. These mood-stabilizing medications include valproic acid (Depakene, Stavzor), divalproex (Depakote) and lamotrigine (Lamictal). The medication asenapine (Saphris) may be helpful in treating mixed episodes.
Common side effects include weight gain, dizziness and drowsiness. Rarely, certain anticonvulsants cause more serious problems, such as skin rashes, blood disorders or liver problems.
Valproic acid may increase levels of testosterone (a male hormone) in teenage girls and lead to polycystic ovary syndrome (PCOS) in women who begin taking the medication before age 20.
• Antipsychotics. Certain antipsychotic medications may help people who don’t benefit from anticonvulsants.
• Antidepressants. In some people with bipolar disorder, antidepressants can trigger manic episodes, but may be fine if taken along with a mood stabilizer.
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