By Arthur Buchanan

Bipolar disorder, once known as manic-depression, is a psychiatric diagnosis referring to a mental health condition defined by periods of extreme, often inappropriate, and sometimes unpredictable mood states.

Bipolar individuals generally experience mania, hypomania or mixed states alternating with clinical depression and euthymic or normal range of mood over varied periods of time. There are many variations of this disorder. A person with bipolar disorder generally tends to experience more extreme states of mood than other people. Moods can change quickly (many times a day) or last for months.

Bipolar individuals tend to have very 'black and white' thinking, where everything in life is either a positive aspect or a negative. Mood patterns of this nature are associated with distress and disruption, and a relatively high risk of suicide. Bipolar disorder is also associated with a variety of cognitive deficits, in particular, difficulty in organizing and planning. The disorder may also skew the ability to judge others' emotion, and alter sense of awareness.

Bipolar disorder is usually treated with medications and/or therapy or counselling.

As well as being linked to disability, studies have suggested a correlation between creativity and bipolar disorder, although it is unclear what the relationship is between the two.[2][3][4] Studies have also indicated increased striving for, and sometimes obtaining, goals and achievements more generally; in other words, many with bipolar disorder tend to be more driven, extremely goal oriented, and hard working.

Contents

* 1 Aspects of bipolar disorder
o 1.1 The Depressive Phase
o 1.2 Mania
o 1.3 Hypomania
o 1.4 Mixed state
o 1.5 Rapid cycling
o 1.6 Cognition
o 1.7 Creativity
* 2 Suicide risk
* 3 Divorce rate
* 4 Diagnosis
o 4.1 Diagnostic criteria
o 4.2 Treatment lag
o 4.3 Children
* 5 Treatment
o 5.1 Prognosis and long-term treatment
* 6 Relapse
* 7 Research findings
o 7.1 Heritability or inheritance
o 7.2 Genetic research
* 8 Ongoing research
o 8.1 Medical imaging
o 8.2 New treatments
* 9 Etiology
* 10 History of bipolar disorder
* 11 Epidemiology
* 12 Mortality
* 13 References
* 14 Further reading
* 15 See also
* 16 External links

Aspects of bipolar disorder

Bipolar disorder is commonly categorised as either Bipolar Type I, where an individual experiences full-blown mania, or Bipolar Type II, in which the hypomanic "highs" do not go to the extremes of mania. The latter is much more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing depression. Psychosis can occur, particularly in manic periods. There are also 'rapid cycling' subtypes.

Because there is so much variation in the severity and nature of mood-related problems, the concept of a bipolar spectrum is often employed, which includes cyclothymia. There is no consensus as to how many 'types' of bipolar disorder exist (Akiskal and Benazzi, 2006). Many people with bipolar disorder experience severe anxiety and are very irritable (to the point of rage) when in a manic state, while others are euphoric and grandiose.

The Depressive Phase

Signs and symptoms of the depressive phase of bipolar disorder include (but in no way are limited to): persistent feelings of sadness, anxiety, guilt, anger, isolation and/or hopelessness, disturbances in sleep and appetite, fatigue and loss of interest in usually enjoyed activities, problems concentrating, loneliness, self-loathing, apathy or indifference, depersonalization, loss of interest in sexual activity, shyness or social anxiety, irritability, chronic pain (with or without a known cause), lack of motivation, and morbid/suicidal ideation.[6]
Mania

Main article: Mania

People having a manic episode of mood can be elated, euphoric, irritated and/or suspicious. There will be an increase in physical and mental rate and quality. Increased energy and over-activity is common; speech can become racing. The need for sleep is reduced. Attention span is low and easily distracted. Unrealistic, grandiose or over optimistic ideas may be voiced or attempted. Social skills are impaired, and impractical ideas may lead to financial and relationship indiscretions.

Hypomania

Main article: Hypomania

Hypomania is generally a less destructive state than mania, and people in the hypomanic phase generally experience less of the symptoms of mania than those in a full-blown manic episode. The duration is usually also shorter than in mania. This is often a very 'artistic' state of the disorder, where there is a flight of ideas, extremely clever thinking, and an increase in energy.

Mixed state

Main article: Mixed state (psychiatry)

In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).

Mixed episodes can be the most volatile of the bipolar states, as moods can easily and quickly be triggered or shifted. Suicide attempts, substance abuse, and self-mutilation may occur during this state.

Rapid cycling

Rapid cycling, defined as having four or more episodes per year, is found in a significant fraction of patients with bipolar disorder. It has been associated with greater disability or a worse prognosis, due to the confusing changeability and difficulty in establishing a stable state. Rapid cycling can be induced or made worse by antidepressants.

Cognition

Numerous studies show that bipolar disorder involves certain cognitive deficits or impairments, even in states of remission.[9] Deborah Yurgelun-Todd of McLean Hospital in Belmont, Massachusetts has argued these deficits should be included as a core feature of bipolar disorder.

According to McIntyre et al. (2006), "study results now press the point that neurocognitive deficits are a primary feature of BD; they are highly prevalent and persist in the absence of overt symptomatology. Although disparate neurocognitive abnormalities have been reported, disturbances in attention, visual memory, and executive function are most consistently reported."[10]

Creativity

Main article: Creativity and mental illness

A number of recent studies have observed a correlation between creativity and bipolar disorder, although it is unclear in which direction the cause lies, or whether both conditions are caused by some third, unknown, factor. It has been hypothesized that temperament may be one such factor.

Suicide risk

Although many people with bipolar disorder who attempt suicide never actually complete it, the annual average suicide rate in males and females with diagnosed bipolar disorder (0.4%25) is 10 to more than 20 times that in the general population

Individuals with bipolar disorder tend to become suicidal, especially during mixed states such as dysphoric mania and agitated depression.[citation needed] Persons suffering from Bipolar II have high rates of suicide compared to persons suffering from other mental illnesses, including Major Depression. Major Depressive episodes are part of the Bipolar II experience, and there is evidence that sufferers of this disorder spend proportionally much more of their life in the depressive phase of the illness than their counterparts with Bipolar I Disorder (Akiskal %26 Kessler, 2007).
Divorce rate

This article or section deals primarily with the United States and does not represent a worldwide view of the subject.
Please improve this article or discuss the issue on the talk page.

The divorce rate for couples where at least one spouse is bipolar is 90%25. For comparison purposes, the general divorce rate is commonly held to be about half as much (around 50%25), implying that this illness causes substantial additional burdens on married life.

Diagnosis

Diagnostic criteria

Main article: Current diagnostic criteria for bipolar disorder
Flux is the fundamental nature of bipolar disorder. Both within and between individuals with the illness, energy, mood, thought, sleep, and activity are among the continually changing biological markers of the disorder. The diagnostic subtypes of bipolar disorder are thus static descriptions–snapshots, perhaps–of an illness in continual change, with a great diversity of symptoms and varying degrees of severity. Individuals may stay in one subtype, or change into another, over the course of their illness. The DSM V, to be published in 2011, will likely include further and more accurate sub-typing (Akiskal and Ghaemi, 2006).

There are currently four types of bipolar illness. The Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) details four categories of bipolar disorder, Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder NOS (Not Otherwise Specified).
For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, there requires one or more manic or mixed episodes. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.

Bipolar II, which occurs more frequently is usually characterized by at least one episode of hypomania and at least one depression.
A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do not meet full criteria for major depressive episodes. The main idea here is that there is a low-grade cycling of mood which appears to the observer as a personality trait, but interferes with functioning.

If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the criteria for one of the subtypes above, he or she receives a diagnosis of Bipolar Disorder NOS (Not Otherwise Specified).

Although a patient will most likely be depressed when they first seek help, it is very important to find out from the patient or the patient's family or friends if a manic or hypomaniac episode has ever been present, using careful questioning. This will prevent misdiagnosis of Depressive Disorder and avoids the use of an antidepressant which may trigger a "switch" to hypomania or mania or induce rapid cycling. Recent screening tools such as the Hypomanic Check List Questionnaire (HCL-32) have been developed to assist the quite often difficult detection of Bipolar II disorders.

Treatment lag

The behavioral manifestations of bipolar disorder are often not understood by patients nor recognized by mental health professionals, so people may suffer unnecessarily for over 10 years in some cases before receiving proper treatment.
That treatment lag is apparently not decreasing, even though there is now increased public awareness of the illness in popular magazines and health websites. Recent TV specials, for example the BBC's The Secret Life of the Manic Depressive, MTV's True Life: I'm Bipolar, talk shows, and public radio shows, and the greater willingness of public figures to discuss their own bipolar disorder, have focused on mental illnesses thereby further raising public awareness.

Despite this increased focus, individuals are still commonly misdiagnosed.

Children

Main article: Bipolar disorder in children
Children with bipolar disorder do not often meet the strict DSM-IV definition. In pediatric cases, the cycling can occur very quickly (see section above on rapid cycling).

Children with bipolar disorder tend to have rapid-cycling or mixed-cycling. Rapid cycling occurs when the cycles between depression and mania occur quickly, sometimes within the same day or the same hour. When the symptoms of both mania and depression occur simultaneously, mixed cycling occurs.

Often other psychiatric disorders are diagnosed in bipolar children. These other diagnoses may be concurrent problems, or they may be misdiagnosed as bipolar disorder. Depression, ADHD, ODD, schizophrenia, and Tourette syndrome are common comorbid conditions.
Misdiagnosis can lead to incorrect medication. Incorrect medications can trigger mania and/or suicidal ideation and attempts.

Treatment

Main article: Treatment of bipolar disorder

Currently, bipolar disorder cannot be cured, though psychiatrists and psychologists believe that it can be managed.
The emphasis of treatment is on effective management of the long-term course of the illness, which usually involves treatment of emergent symptoms. Treatment methods include pharmacological and psychotherapeutic techniques.

Prognosis and long-term treatment

A good prognosis results from good treatment which, in turn, results from an accurate diagnosis. Because bipolar disorder continues to have a high rate of both under-diagnosis and misdiagnosis, it is often difficult for individuals with the illness to receive timely and competent treatment.

Bipolar disorder is a severely disabling medical condition. However, with appropriate treatment, many individuals with bipolar disorder can live full and satisfying lives. Persons with bipolar disorder are likely to have periods of normal or near normal functioning between episodes.

Ultimately one's prognosis depends on many factors, which are, in fact, under the individual's control: the right medicines; the right dose of each; a very informed patient; a good working relationship with a competent medical doctor; a competent, supportive, and warm therapist; a supportive family or significant other; and a balanced lifestyle including a regulated stress level, regular exercise and regular sleep and wake times.

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Arthur Buchanan

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Tags: Bipolar Disorder, Manic Depression

By Rick Seager

Bipolar disorder is also known as manic depression. It is a severe illness but it can be treated. Bipolar is a brain disorder that is commonly characterized by extreme mood swings.

The symptoms of bipolar in children are present in early childhood or even possibly during infancy. The symptoms of bipolar may also not emerge until the adolescence or adulthood years. Bipolar in children can be treated easier now.

Early prevention and treatment for children with bipolar will increase the chances of getting better and living a normal life. Properly treating bipolar children will help reduce any adverse effects not only in the life of the children with bipolar but in their families lives as well.

Learning about bipolar disorder is the first step for finding the right treatment. The families of children with bipolar disorder can become desperate for support and information.

There is not enough data to tell us how many children with bipolar disorder there is out there. But what we do know is that bipolar does affect around 1%25 to 2%25 of adults around the world. Diagnosing symptoms of bipolar in children can help prevent its long-term effects.

Symptoms of bipolar disorder in children is also commonly linked with ADHD, also known as Attention-Deficit with Hyperactivity Disorder.

The symptoms of bipolar in children may appear different when compared to adults. Usually, children will have continuous, ongoing mood swings, combined with symptoms of depression and mania. This severe and rapid cycling among their different moods can produce chronic irritability in the child. Sometimes, state of wellness is manifested between the episodes.

Here is a list of some of the common symptoms for children with bipolar disorder:

* Lack of enthusiasm in play

* Rapid mood swings that can last for several hours

* Extreme sadness

* Lengthy, explosive, destructive rages

* Separation anxiety

* Defies authority

* Distractibility

* Hyperactivity

* Bed wetting, night terrors

* Dare devil behavior

* Racing thoughts

* Hallucinations, delusions

The symptoms of bipolar in children can emerge early, even in infants. Often times, mothers of children with bipolar disorder say that their children often have trouble with sleeping.

Children with bipolar can often times seem really clingy to their parents. On the other hand, children with bipolar can also have uncontrollable rages and tantrums, especially when they hear the word no.

There are more and more studies now being done to further explore the characteristics and symptoms of children with bipolar disorder. The results are beginning to look very promising. Properly treating children with bipolar disorder can let your child live a normal life.

Rick Seager was diagnosed with bipolar disorder several years ago but he was determined not to let it take control of his life. So he fought back and has gone on to become the bestselling author of the ebook "Bipolar Disorder Uncovered" Check out his website now for more info =%26gt;http://www.BipolarDisorderUncovered.com

 

Tags: Manic Depression, Symptoms of Bipolar

By Jason Hunter

Bipolar disorder at one time was known by the term manic depression. People diagnosed with this problem went from deeply depressive moods to wildly high moods. A person in the grasp of a manic episode can be in a state of pure euphoria or extreme irritability. Their thought patterns can be grand with whatever they are doing, seen as the best or greatest ever, or paranoid, imagining aliens following monitoring their every move. Other symptoms of bipolar disorder include poor judgment, offensive behavior, promiscuity, spending sprees, reckless behavior, increased energy and activity, and a reduced need for sleep.

To be diagnosed with bipolar disorder, the person must currently be in a manic episode, must have had one previous major depressive, manic, or mixed episode that cannot be accounted for by some other schizoid, psychotic, or delusional disorder.

Studies indicate that approximately 30 percent of depressed patients under treatment may have bipolar disorder. Almost two percent of the entire adult population in the U.S. suffers from the affliction. Many studies show that 25 to 50 percent of bipolar patients attempt suicide at least once. Studies show that 15 percent succeeded, 30 times the rate found in the general population.

Numerous areas of the brain may be involved in bipolar disorder. They include the amygdala, hippocampus, thalamus, cerebellum, prefrontal cortex, striatum, and pallidus. Researchers are beginning to study the physical structure of the brain to see if there are differences between a normal brain and the brain of a bipolar patient. Early studies suggest there may be abnormalities in the structure and blood flow of these particular areas of the brain, but there have not yet been enough studies with the proper controls to come to a definite conclusion.

Treatment for this disease most likely involves being on medication for life, which would provide credibility to the idea that perhaps there is some type of permanent change or difference in the bipolar's brain structure and circuitry. The types of medication that are currently found to be the most effective are the antidepressants bupropion and SSRIs (selective serotonin reuptake inhibitors). MAOIs (monoamine oxidase inhibitors) can also be used.

Omega-3 may help ease the symptoms of bipolar disorder patients and work as an alternative to lithium as a mood-stabilizing agent by inhibiting neuronal signals.

Although bipolar disorder requires a lifetime of treatment with medications - a proper diet including omega-3, the maintenance of bipolar disorder may be easier and more effectively accomplished. Results of the tests with fish oil capsules found that 64 percent treated with omega-3 responded to treatment, and remained in remission much longer after termination of the supplement.

Jason Hunter is a natural health advocate. He is webmaster of a natural health web site called Home Health and Natural Remedies, which he gives tips on reversing and curing some of today's deadliest lifestyle diseases. Visit his web site at http://www.hhesonline.com.

 

Tags: Bipolar Disorder, Manic Depression

By Ryan Rafeh Bipolar Disorder (Manic Depression)
If you already are not aware of this condition, bipolar disorder is "a diagnostic category describing a class of mood disorders where the person experiences states or episodes of depression and/or mania, hypomania, and/or mixed states."(Look at Sources Below)
Bipolar disorder is also known as a manic-depressive illness, which can suddenly shift a person's mood, energy, and their ability to function. As in every person, someone with bipolar disorder has their up's and down's to a much higher level. This is a very serious condition, which can lead to depression.
A sign of this disorder can range anywhere from an usual damaged relationship with a person who is close to you, poor school/job performance, or even thoughts of, or actual suicide. Major mood swings from extreme happiness to extreme irritability (or vice versa) are the most common symptoms of this manic depression. A sign of depression can also be little sleep or even unrealistic beliefs in one's ability. Other commons signs are spending sprees, denial, poor judgment, and increased sexual drive. People with manic depressions can also abuse medications, drugs, and alcohol. The signs of the depression are the about the same as those listed in the previous posts.
So who can get bipolar disorder or manic depression? Just about ANYONE, including kids, teenagers, and adolescents. If any of the signs and symptoms occur for longer than a week's period, consulting a doctor is recommended.
Although bipolar illness is a long term illness, there is hope for controlling the episodes (high and low points). Long-term preventive treatment (medication and psychosocial) is strongly suggested. Also a chart of sleeping patterns, treatment, and daily mood symptoms prove helpful.
Another form of treatment that can be considered is anitdepressant medication.
Sources:
Wikipedia.com,
National Institute of Mental Health

I have a blog about depression.
www.signofdepression.blogspot.com

Tags: Bipolar Disorder, Manic Depression