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From high to low. From mania to depression. From recklessness to listlessness. These are the extremes associated with bipolar disorder, a mental illness characterized by mood instability that can be serious and disabling. Bipolar disorder is also known as manic-depression or manic-depressive illness — manic behavior is one extreme o this disorder, and depression is the other. The deep mood swings o bipolar disorder may last or weeks or months, causing great disturbances in the lives o those a ected, and those o amily and riends, too. Today, a growing volume o research suggests that bipolar disorder occurs across a spectrum o symptoms, and that many people aren!t correctly diagnosed. "e t untreated, bipolar disorder generally worsens, and the suicide rate is high among those with bipolar disorder. But with e ective treatment, you can live an en#oyable and productive li e despite bipolar disorder. • Symptoms
Bipolar disorder symptoms are characterized by an alternating pattern o emotional highs $mania% and lows $depression%. The intensity o signs and symptoms can vary rom mild to severe. There may even be periods when your li e doesn!t seem a ected at all.
Bipolar disorder symptoms re lect a range o moods.
Manic phase of bipolar disorder
ppetite problems Fatigue "oss o interest in daily activities *roblems concentrating )rritability 0hronic pain without a known cause Types of bipolar disorder Bipolar disorder is divided into two main subtypes' Bipolar I disorder.gitation )ncreased physical activity +isky behavior &pending sprees )ncreased drive to per orm or achieve goals )ncreased sexual drive -ecreased need or sleep Tendency to be easily distracted )nability to concentrate -rug abuse Depressive phase of bipolar disorder &igns and symptoms o the depressive phase o bipolar disorder may include' • • • • • • • • • • • • &adness . . 2ith • . with or without previous episodes o depression. 1ou!ve had at least one manic episode. and not as severe. • Bipolar II disorder.&igns and symptoms o the manic phase o bipolar disorder may include' • • • • • • • • • • • • • • • • • (uphoria (xtreme optimism )n lated sel -esteem *oor #udgment +apid speech +acing thoughts . 1ou!ve had at least one episode o depression and at least one hypomanic episode. hypomanic episode is similar to a manic episode but much brie er. lasting only a ew days.opelessness &uicidal thoughts or behavior .ggressive behavior .nxiety /uilt &leep problems .
and you don!t re3uire hospitalization. some people with bipolar disorder have rapid cycling bipolar disorder. • #is$ %actors • . &ymptoms o psychosis may include hearing or seeing things that aren!t there $hallucinations% and alse but strongly held belie s $delusions%. (nvironmental causes may include problems with sel -esteem. 0yclothymia is a mild orm o bipolar disorder. • !enes. Other bipolar disorder symptoms )n addition. .hypomania. sometimes within #ust hours. also may play a role. the periods o depression are typically much longer than the periods o hypomania. • Ca ses )t!s not known what causes bipolar disorder. The signi icance o these changes is still uncertain but may eventually help pinpoint causes. genetic and environmental actors seem to be involved in causing and triggering bipolar episodes' Biochemical. )n mixed state bipolar disorder. you may have an elevated mood. symptoms o both mania and depression occur at the same time. • Cyclothymia. &ome evidence rom high-tech imaging studies indicates that people with bipolar disorder have physical changes in their brains. But a variety o biochemical. but generally you can carry on with your normal daily routine and unctioning. This is the occurrence o our or more mood swings within 45 months. which are tied to mood. pointing to a shared genetic cause.ormonal imbalances also are thought to be a culprit. &ome studies also show links between bipolar disorder and schizophrenia. These moods shi ts can occur rapidly. irritability and some changes in your unctioning. (nvironment also is thought to play a causal role in some way. • "nvironment. &evere episodes o either mania or depression may result in psychosis. &ome studies o identical twins show that one twin has the condition while the other doesn!t — which means genes alone aren!t responsible or bipolar disorder. +esearchers are trying to ind genes that may be involved in causing bipolar disorder. 0yclothymia includes mood swings but the highs and lows are not as severe as those o ull-blown bipolar disorder. )n bipolar )) disorder. The naturally occurring brain chemicals called neurotransmitters. signi icant loss or high stress. or a detachment rom reality. &ome studies show that bipolar disorder is more common in people whose biological amily members also have the condition.
seek medical help as soon as possible. worn out. &hen yo have s icidal tho ghts &uicidal thoughts and behavior are common among people with bipolar disorder. such as the death o a loved one &hen to see$ medical advice ) you have any symptoms o bipolar disorder. a health care pro essional. . pushing its prevalence as high as 6 percent o the population. whether it!s a riend or loved one. ) you simply don!t want to do that.aving other biological amily members with bipolar disorder *eriods o high stress -rug abuse :a#or li e changes.owever. or whatever reason. try to work up the courage to con ide in someone. )n addition. some researchers suggest that bipolar disorder occurs on a continuum. 1et many people with the disorder don!t get treatment or are reluctant to get treatment.44 or your local emergency services number.nd i you!re like some people with bipolar disorder. . you may en#oy the eelings o euphoria and cycles o being more productive — but they!re bound to be ollowed by emotional crashes that can leave you depressed. and that many more people may have other orms o the disorder. Tragically. some people may go undiagnosed because they don!t seek treatment. the rapid cycling orm. and perhaps in inancial or legal trouble. bipolar disorder usually starts between ages 47 and 89. but bipolar )). Factors that may increase the risk o developing bipolar disorder include' • • • • • . They can help you take the irst steps to success ul treatment. people with bipolar disorder o ten don!t recognize how greatly it a ects their lives — and the lives o their loved ones. is more common in women. you have other choices or reaching out to someone' • 0ontact a amily member or riend . Bipolar ) disorder a ects about the same number o men and women. talk to someone now. a aith leader or someone else you trust. Bipolar disorder doesn!t get better on its own. -espite the mood extremes. ) you!re considering suicide right now and have the means available. because their condition is mistaken or depression or because their symptoms don!t meet current diagnostic criteria. ) you!re reluctant to seek treatment.)t!s estimated that about 4 percent o the population has bipolar disorder. the suicide rate is higher in bipolar disorder than most other mental illnesses. /etting treatment rom a mental health provider with experience in bipolar disorder can help you learn ways to manage your symptoms. )n either case. The best choice is to call .
1ou may also ill out psychological sel -assessments and 3uestionnaires. amily members or close riends may be asked to provide in ormation about your symptoms and possible episodes o mania or depression. such as heart rate. 1ou may not be able to orce someone to seek pro essional help. This may include measuring height and weight< checking vital signs. spiritual leader or someone in your aith community • /o to your local hospital emergency room • 0all a crisis center or hot line • 'elping a loved one (ith bipolar disorder symptoms ) you have a loved one you think may have symptoms o bipolar disorder. ) you have a loved one who has harmed himsel or hersel . This manual is published by the . • )sychological eval ation. • Test and Diagnosis 2hen doctors suspect someone has bipolar disorder. such as manic. These exams and tests generally include' )hysical exam. or is seriously considering doing so. eelings and behavior patterns. • *aboratory tests. but you can o er encouragement and support and help your loved one ind a 3uali ied doctor or mental health provider. . . mental health provider or other health care pro essional • 0ontact a minister. they typically run a battery o medical and psychological tests and exams. -iagnostic criteria or bipolar disorder are based on the speci ic type o bipolar disorder as well as the history and types o episodes. doctor or mental health provider will talk to you about your thoughts. have an open and honest discussion about your concerns.ssociation and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse or treatment. blood pressure and temperature< listening to the heart and lungs< and examining the abdomen. pinpoint a diagnosis and also check or any related complications. you must meet the criteria spelled out in the -iagnostic and &tatistical :anual o :ental -isorders $-&:%. These may include a complete blood count $0B0% as well as thyroid tests and other blood tests. hypomanic or . These can help rule out other problems.nd with your permission. • Diagnostic criteria for bipolar disorder To be diagnosed with bipolar disorder.0ontact a doctor. 1ou may also have a urinalysis. take them to the hospital or call or emergency help. 1ou may be asked about substance or alcohol abuse.merican *sychiatric .
depressed. Talk to your doctor about which type o bipolar disorder you have so that you can learn more about your speci ic situation and its treatments. &ome researchers believe that many people go undiagnosed or misdiagnosed — and thus don!t get appropriate treatment — because the criteria don!t account or less severe but still serious symptoms. social workers and psychiatric nurses. including psychologists. But you may have others on your treatment team as well. you must get treatment or those. since they can worsen bipolar symptoms. Bipolar disorder treatment is usually guided by a psychiatrist skilled in treating the condition. though. 0omplications that bipolar disorder may cause or be associated with include' • • • • • • • • &uicide &ubstance and alcohol abuse "egal problems Financial problems +elationship troubles )solation *oor work or school per ormance Treatment and Dr gs Bipolar disorder is a long-term condition that re3uires li elong treatment. ( ective and appropriate treatment is vital or reducing the re3uency and severity o manic and depressive episodes and allowing you to live a more balanced and en#oyable li e. Because medications or bipolar disorder can cause serious but rare side e ects. )ndeed. . a growing volume o evidence indicates that bipolar disorder can be thought o more as a spectrum o disorders. :aintenance treatment — continued treatment during periods o remission — also is important. &ome researchers believe the current diagnostic criteria are too strict. • Complication "e t untreated. bipolar disorder can result in severe emotional and even legal and inancial problems that a ect every area o your li e. because the condition can a ect so many areas o your li e. even during periods when you eel better. ) you have problems with alcohol or substance abuse. *eople who skip maintenance treatment are at high risk o a relapse o their symptoms or having minor episodes turn into ull-blown mania or depression. you may be reluctant to take . with varying degrees o symptoms. too.ere are the core treatments or bipolar disorder' Medications :edications are a vital part o bipolar treatment.
• ?umerous medications are available to treat bipolar disorder. • . :edication options include' Mood stabili+ers. 0ertain antipsychotic medications. &o women with bipolar disorder who want to become pregnant or do become pregnant must ully explore with their health care providers their options and the bene its and risks o medications. =se o antidepressants in bipolar disorder. may help people who don!t gain bene its rom anti-seizure medications.ntidepressants. )t can take several weeks a ter irst starting a medication to notice an improvement in your symptoms.lso. :ood stabilizers are most the commonly prescribed medications or bipolar disorder. such as olanzapine $>yprexa% and risperidone $+isperdal%. But you can work with your psychiatrist and other health care pro essionals to ind a medication regimen that works or you. The medications are used to prevent mood swings. has been approved by the Food and -rug . such as benzodiazepines.nti-sei+ re medications. obesity and high blood pressure. )n addition. mood-stabilizing medications may harm a developing etus or nursing in ant. may help improve sleep. These medications. . 1our doctor may recommend that you take mood stabilizers or the rest o your li e to prevent and treat manic episodes. may increase the risk o diabetes. one medication. • Other medications. These medications help regulate and stabilize mood so that you don!t swing between depression and mania. These medications are also known as anticonvulsants. "ithium $(skalith. .ntidepressants may not be advised at all. such as valproic acid $-epakene%. care ully weigh the pros and cons with your doctor.dministration to treat both the manic and depressive episodes o bipolar disorder. • . especially in people with rapid cycling bipolar disorder. &everal types o therapy may be help ul. . ) one doesn!t work well or you. although once common. Be aware that all medications have side e ects and possible health risks.nd anti-anxiety medications.medications. "ithobid% has been widely used as a mood stabilizer and is generally the irst line o treatment or manic episodes. talk to your doctor about being monitored or health problems. There!s limited data indicating that antidepressants are e ective or bipolar disorder. ) you take these medications. 0ertain atypical antipsychotic medications. there are many others to explore. )sychotherapy *sychotherapy is another vital part o bipolar disorder treatment. is now controversial. also are widely used as mood regulators. depending on your situation. . 3uetiapine $&ero3uel%. 1our doctor may advise combining certain medications or maximum e ect. Be ore taking antidepressants. or instance. and in some cases they can trigger manic episodes. divalproex $-epakote% and lamotrigine $"amictal%.
resist any temptation to skip your medications. (ven i you!re eeling well. )t may also help build better relationship skills. positive ones. • )revention There!s no sure way to prevent bipolar disorder. ) you stop. 1ou also learn e ective strategies to manage stress and to cope with upsetting situations. Family therapy involves you and your amily members. treatment at the earliest sign o a mental health disorder can help prevent bipolar disorder rom worsening.owever. But you can do some things or yoursel that will build on your treatment plan' Ta$e yo r medications as directed. 1ou and your caregivers may have identi ied a pattern to your bipolar episodes and what triggers them. 0all your doctor i you eel you!re acing an episode. people with bipolar disorder may bene it rom inpatient hospitalization. • *ife Style and 'ome #emedies Bipolar disorder isn!t an illness that you can treat on your own. "ong-term preventive treatment also can help prevent minor episodes rom becoming ull-blown episodes o mania or depression.Cognitive behavioral therapy. )nvolve amily members or riends in • . Family therapy can help identi y and reduce stressors within your amily.ospitalization or psychiatric treatment can help stabilize your mood. *artial hospitalization or day treatment programs also are options to consider. ."CT/ (lectroconvulsive therapy is geared mainly or people who have episodes o severe depression with suicidal tendencies or or people who haven!t seen improvements in their symptoms despite other treatment. • !ro p therapy. (lectroconvulsive therapy is a procedure in which electrical currents are passed through your brain to trigger a seizure. But it!s thought that the seizure causes changes in brain chemistry that may lead to improvements in your mood. This is a common orm o individual therapy or bipolar disorder. The ocus o cognitive behavioral therapy is identi ying unhealthy. bipolar signs and symptoms are likely to come back. • "lectroconv lsive therapy. you can learn about bipolar disorder and its treatment and what may trigger your bipolar episodes. • )ay attention to (arning signs. • %amily therapy. . negative belie s and behaviors and replacing them with healthy. )t can help your amily improve its communication style and problemsolving skills and resolve con licts. )n addition. +esearchers don!t ully understand #ust how (0T works. whether you!re in a ull-blown manic episode or a deep depression. /roup therapy provides a orum to communicate with and learn rom others in a similar situation. 'ospitali+ation )n some cases.
lthough some complementary treatments can be a good addition to your regular treatment. • Be honest with your doctors and mental health providers. Try such stress reduction techni3ues as meditation. • Coping and S pport 0oping with bipolar disorder can be di icult. +ecovery rom bipolar disorder can take time. . improve mood and reduce stress.ere are some ways to cope with bipolar disorder' • *earn abo t bipolar disorder. :edications can have unwanted side e ects. . (ven over-the-counter or so-called natural supplements can inter ere with your prescribed medications. • %ind healthy o tlets. )llicit drugs and alcohol may be part o what triggers episodes o bipolar disorder. and vitamin and herbal supplements. such as hobbies. • . Tell them exactly which complementary treatments you practice or would like to explore. exercise and recreational activities. These treatments may include prayer or spiritual healing. • Stay foc sed on yo r goals. • Chec$ first before ta$ing other medications. -uring periods when you eel better. • . yoga or tai chi.lternative Medicine &ome people with bipolar disorder turn to complementary and alternative medicine treatments to help manage symptoms. (ducation about your condition can empower you and motivate you to stick to your treatment plan. .ddressing symptoms early on can prevent episodes rom becoming ull blown. meditation. • *earn relaxation and stress management.void dr gs and alcohol. 0omplementary medicine is not a substitute or regular medical care. • 0oin a s pport gro p. take some precautions irst' -on!t stop taking your prescribed bipolar medications or skip therapy sessions. and you may eel angry or resent ul about having a serious condition that re3uires li elong treatment. &tay motivated by keeping your recovery goals in mind and reminding yoursel that you can work to repair damaged relationships and inancial and legal problems. &upport groups or people with bipolar disorder can help you reach out to others acing similar challenges. • Be aware that some complementary treatments can inter ere with your regular treatment. (xplore healthy ways to channel your energy. you may be tempted to stop treatment. 0all the doctor who!s treating you or bipolar disorder be ore you take medications prescribed by another doctor.watching or warning signs. • . &ometimes other medications trigger episodes o bipolar disorder or may inter ere with medications you!re taking to treat bipolar disorder.
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