Bipolar Disorder

Description

Bipolar disorder describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated moodreferred to as mania or, if milder, hypomania.Individuals who experience manic episodes commonly experience depressive episodes or symptoms,in which features of both mania and depression are present at the same time.These episodes are normally separated by periods of normal mood.Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations.

Signs and symptoms

Signs and symptoms of the depressive phase of bipolar disorder include: persistent feelings of sadness, anxiety, guilt, anger, hopelessness, disturbances in sleep, fatigue and loss of interest in usuall activities, problems concentrating, loneliness, indifference, depersonalization,shyness or social anxiety, irritability, chronic pain , lack of motivation, and suicidal ideation.

Manic episode

Mania is generally characterized by a distinct period of an irritable mood state.Attention span is low and a person in a manic state may be easily distracted.Judgment may become impaired.They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills.Their behavior may become aggressive or intrusive.A person in a manic state can begin to experience psychosis, or a break with reality, where thinking is affected along with mood.

Hypomanic episode

Hypomania is less extreme state than mania, and people in the hypomanic phase generally experience fewer symptoms of mania than those in a full-blown manic episode.One might feel an uncontrollable impulse to laugh at things.This is often a very "artistic" state of the disorder, in which a flight of ideas, extremely clever thinking, and an increase in energy can occur.

Causes

Bipolar disorder is not either environmental or physiological that is, many genes and environmental factors combine to create the disorder. Since bipolar disorder is so heterogeneous, bipolar disorder tends to run in families.More than two-thirds of people with bipolar disorder have at least one close relative with the disorder.

When faced with a very stressful, negative major life event, such as a failure in an important area, an individual may have his first major depression.When an individual accomplishes a major achievement he may experience his first hypomanic or manic episode. Individuals with bipolar disorder tend to experience episode triggers involving either interpersonal or achievement-related life events. An example of interpersonal-life events include falling in love or, conversely, the death of a close friend.

Treatment

Bipolar disorder cannot be cured; instead, the emphasis of treatment is on effective management of acute episodes and prevention of further episodes.Hospitalization may occur, especially with manic episodes. This can be voluntary or involuntary Following a hospital admission, support services available can include drop-in centers, visits from members of a community mental health team or Assertive Community Treatment team, supported employment and patient-led support groups.The mainstay of treatment is a mood stabilizer medication which have been shown to be effective in preventing relapses of manic, or depressive episodes.

The first known mood stabilizer is lithium,originally used as an anticonvulsant.Other anticonvulsants used in bipolar disorder include carbamazepine, reportedly more effective in rapid cycling bipolar disorder, and lamotrigine, which is the first anticonvulsant shown to be of benefit in bipolar depression.