LIVING WITH BIPOLAR
CONTENTS
What Is Bipolar Disorder?
Getting An Accurate Diagnosis
Different Types of Bipolar Disorder
Reinventing Thoughts and Relationships
Preventing Suicide and Other Damaging Behaviors
Types of Episodes
Causes of Bipolar Disorder
Biochemistry of the Disorder
Negative Thoughts and Social Factors
Triggers and the Prognosis
Medications
Treatment
Creating Your Recovery Plan
Food, Fun and Exercise
What Is Bipolar Disorder?
Bipolar disorder is a manic depressive illness that occurs due to an
imbalance of chemicals in the brain. As a result, the sufferer will have unusual
shifts in energy, mood and ability to function.
This is very different from what normal people go through, as the symptoms of
anyone suffering from this type of disorder are very severe. People who are
unable to manage it will have difficulty in maintaining relationships, finding a
job and excelling in school.
Studies show that there are about 5.7 million Americans or 2.6% of the total
population at different age levels that have bipolar disorder. This may begin
during childhood while some may develop it later on in life.
This may happen to adults who are either alcohol or drug dependent but this has
occurred frequently in people with seasonal depression and certain anxiety
disorders like PTSD or posttraumatic stress disorder.
According to the World Health Organization, bipolar disorder is considered to be
the 6th most disabling illness.
The chemical imbalance mentioned earlier is caused by a complex set of factors.
Some say genetics plays a role because 60% of patients have had someone in the
family with this disorder. Until now, scientists have only been able to identify
4 genes that are associated with this disorder. More studies need to be done to
determine if the environment also has a role.
So how can you tell if a person is suffering from bipolar disorder? This can
easily be determined by looking at the person’s behavior. Some of these symptoms
include increased activity or restlessness, extreme irritability; the person is
easily distracted, uses poor judgment, engages in spending sprees, denies that
there is nothing wrong, increased sexual drive, little sleep needed and signs of
aggressive behavior.
If you know someone who experiences this from time to time, the chances are that
he or she has manic episodes. But to be sure, the person must at least show
three or more of these symptoms during most of the day constantly for a week or
longer.
Some people who suffer from bipolar disorder may experience depressive episodes.
That person will feel worthless, helpless, have low levels of energy, is tired
all the time and a lack of interest in some of the activities that were
enjoyable before. They won’t be able to eat or even sleep. Worst of all, that
person may even contemplate committing suicide or has done it unsuccessfully
several times.
Unlike a manic episode, a person with depressive episodes of bipolar disorder
can only be diagnosed if he or she shows 5 or more of the symptoms mentioned
daily over a 2 week period or longer.
In terms of gender, bipolar disorder is equal between men and women but females
tend to switch moods more quickly. In fact, women will have more periods of
depression than men.
Bipolar disorder is not recognized as an illness, which is why a lot of patients
are often misdiagnosed. The doctor may think that the patient is suffering from
either schizophrenia or some other severe mental illness. Similar to diabetes
and heart disease, the good news is that it can be treated.
For this to work, doctors will use a combination of medications, psychotherapy
and if things are severe, ECT or electro convulsive therapy. This will make it
possible for the sufferer to achieve a comfortable balance of moods and thus
reduce the risk of suicide.
You shouldn’t expect the drugs or the therapy to work overnight. They usually
take effect after a few weeks and with the support of family and friends, you
will be able to take control of your life once again. It may even help to join a
support group as you are not the only one who is experiencing this disorder.
In short, bipolar disorder can make the person go from one end of the spectrum
to the other. Doctors do not yet know the exact cause so it is impossible at
this time to prevent it. There is also no cure at the moment because more
research needs to be done. However, if people are able to recognize the symptoms
and are able to get help, the higher the chances of an effective treatment that
will prevent long periods of this illness, confinement in the hospital or even
suicide.
Getting An Accurate Diagnosis
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Getting an accurate diagnosis for bipolar disorder is not as easy as it
looks. This is because doctors cannot simply give the answer by extracting some
blood or doing a CT scan. What makes matters worse is that some of the symptoms
of this illness can be confused with something else. So in order to get an
accurate diagnosis, various tests need to be done.
The first step the doctor will do is conduct a physical exam and examine the
patient’s medical history. This is because it is possible that the individual
could be suffering from AIDS, a brain or head trauma, diabetes, epilepsy, lupus,
Lyme disease, multiple sclerosis, neurosyphilis, sodium balance or thyroid
disorder. Naturally, these have to be ruled out which is why such tests are
necessary.
The doctor will also need to review the psychiatric history of the patient as
mood swings associated with bipolar disorder are also present in people who are
suffering from ADHD or attention deficit hyperactivity disorder, due to alcohol
or drug abuse, borderline personality disorder, delusional disorder, depression,
eating disorders, panic disorder, Schizophrenia, and Schizoaffective Disorder.
Since bipolar disorder is often times genetic, the doctor will need to know if
this illness has occurred to someone else in the family. If it has happened
before, then there is a good indication that this could also be present in the
patient.
Lastly, the doctor will also evaluate the patient based on the current symptoms
because bipolar disorder will either make the person feel high or low.
As we discussed previously, some of the things to watch out for in someone who
is experiencing manic episodes include increased activity or restlessness,
extreme irritability; the person is easily distracted, uses poor judgment,
engages in spending sprees, denies that there is anything wrong, increased
sexual drive, little sleep needed and signs of aggressive behavior.
People who experience depressive episodes will feel worthless, helpless, have
low levels of energy, get tired easily and show no interest in activities that
were enjoyable before. They won’t eat or get sleep. Some have even contemplated
killing themselves or have already done it unsuccessfully several times.
So back to the question, how can you get an accurate diagnosis for bipolar
disorder? Most experts will only be able to diagnose a patient if no physical
cause is found, no other psychiatric disorders explain the current symptoms and
if the symptoms of the mania or depressive episodes have been of significant
duration. This means that this has happened several times a day over the past
few weeks.
Even when these conditions are met, doctors are still unable to confirm if the
person has bipolar disorder or not because on average, it takes about 5 years to
reach the correct diagnosis.
The key to getting an accurate diagnosis for bipolar disorder is looking for a
doctor that can tell the difference between this illness and those that are
similar. This is because most doctors are not very familiar with bipolar.
The best way to find professional help is to contact a local support group that
helps those suffering from this illness. When you have found one and there is
reason to believe that you have bipolar disorder, it is time to figure out which
symptom is frequent in your condition so the proper medication and treatment can
be given.
Usually, treatment begins with medication to stabilize his or her mood.
Psychotherapy is used next because doctors need to understand how the patient
thinks and how this has affected their lives. Chances are, they are already not
able to keep a job or have a good relationship with friends. But this can change
in the months ahead.
Bipolar disorder should be treated as early as possible because without proper
treatment, things can get worse. The individual could harm others and also him
or herself. Sadly, a lot of people who know they have a problem are not willing
to get help because they are ashamed.
There are more than 2 million Americans who suffer from bipolar disorder and
this number continues to grow as there is no cure yet for this illness. The only
thing doctors can do is suppress the episodes from happening.
Different Types of Bipolar Disorder
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- What Are the Different Types of Bipolar Disorder?
This is often distinguished as “high” episodes of mania and “low” episodes of
depression. But in between these two, there are several others that can be mild
or severe and this really depends on the person’s symptoms.
Let’s first talk about the two most basic then discuss in further detail their
symptoms.
When you experience manic episodes of bipolar disorder, you will feel very
energetic and restless. Sadly, you will often exercise poor judgment, find it
difficult to concentrate and show signs of aggressive behavior.
Those who suffer from depressive episodes will experience the exact opposite.
They will have low levels of energy and won’t feel like doing anything. He or
she will get tired easily; feel helpless and worthless to the point of
considering suicide.
But when someone experiences both at the same time, the person may suffer from
Bipolar 1 and mania. The symptoms of someone suffering from this include a
marked increase in strength, disconnected thoughts, extreme irritability, and
feelings of impotence, grandiose ideas, hallucinations, open promiscuous
activity, paranoia and violent behavior. This can happen anywhere from a week to
several months; and, the hospitalization may be in order for the patients’ own
safety.
Patients who have bipolar 2 and hypomania will suffer episodes of severe
depression with some “mild” mania from time to time. For those who are confused
between mania and hypomania, the difference is that the person will not
experience any delusions.
Just the same, this may still cause impaired functioning. In fact, studies have
shown that although bipolar 2 is “milder” than bipolar 1, the suicide rate is
much higher.
Next is the Cyclothymic Disorder. Instead of suffering from manic or depressive
episodes at the same time, the person switches from one to the other. It is not
as severe as bipolar 1 and 2 but this lasts for long periods with no break in
between.
In some cases Cyclothymic disorder can later become a full-blown bipolar
disorder or just stay as a low-grade chronic condition.
There is also “rapid cycling.” Basically, this means that the person will
experience 8 to 10 manic or depressive episodes in one lifetime. Doctors may
only tell if you are suffering from this should this happen at least 4 times in
one year.
Then there is the mixed episode where the symptoms of both happen at the same
time. The difference between this is that the person will feel excited and
depressed at the same time while Bipolar 1 and 2 goes toward one extreme. Such a
combination increases the risk of suicide.
The number of people suffering from the different types of bipolar disorders is
equal among men and women. In fact, only about one third of those diagnosed seek
treatment. It is estimated that 15% to 20% of those who know there is something
wrong and do not receive medical attention commit suicide.
If you think you are suffering from one of these types or know of someone who
might, it is best to consult a psychiatrist.
Diagnosing someone is a challenge because there aren’t any lab tests like a CT
scan or a blood test that can confirm this. In teens, this may sometimes be
mistaken for something else like attention deficit hyperactivity disorder
(ADHD), schizophrenia and posttraumatic stress disorder.
The doctor may make some observations but will need to get a complete history of
the patient including family history because close to 60% of those suffering
from bipolar disorder have had someone in the family who had it before.
However, if it has been determined that you are suffering from one of the types
of bipolar disorders, you may be given medication or undergo psychotherapy.
On your end, you should identify what provokes you to experience periods of
mania or depression. By knowing that, you will be able to prepare for times that
you are most vulnerable or even prevent it from happening all together.
There are more than 2 million Americans suffering from one type of bipolar
disorder or another. The good news is that it can be treated so that the person
does not cause any harm to others or towards him or herself.
Reinventing Thoughts and Relationships
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Nobody wants to accept the fact that there is something wrong with them.
But if others see it and you also notice it, then something has to be done.
After all, accepting that there is a problem is just the first step in
reinventing your thoughts about bipolar disorder and how you will be able to
save your relationships with others.
Bipolar disorder is a mental condition. You may experience manic or depressive
episodes and those who don’t understand what you are going through will keep
their distance. If you want to maintain your current relationship or still make
new friends, you should be able to tell them that you have this illness and that
you are getting help to make things better.
Since action speaks louder than words, you should get yourself checked by a
doctor and follow whatever advice is given. Yes, drugs will be given and there
will be side effects but this should go away within a few weeks and is a small
price to pay in order to feel better.
In order to explain this to people, you have to be educated. Look up what
bipolar disorder is on the web and other resources then explain this to them so
they will be able to understand what you are going through. You will also need
to have realistic expectations and coping options.
Although you are the one suffering from this illness, the one thing you must do
is get the family involved in this situation. This will enable your siblings and
parents to be prepared for what lies ahead. In fact, their support is very
important so someone will be able to facilitate discussions during sessions.
There is no miracle drug that can remove bipolar disorder. This means that you
will have to put your trust in the doctor, in the medication given and hope that
it works. If it doesn’t, you will just have to try something else because this
can also be successful through process of trial and error.
Your friends and family can help because there are techniques known as
psychotherapy or talk therapy that enables others to get involved and support
you through this difficult time. They may even drop by and attend a session with
you and this shows their concern for your welfare.
On your end, you can manage the episodes by identifying triggers so these can be
avoided or lessened. You can monitor the episodes by keeping a diary that
records your feelings and behavior then reviewing it later on.
Those who know you well can escort you to a safe place that is not toxic so you
can recover. This will give you time to take your medication, breathe deeply and
just get yourself together once again so you will be able to continue what you
are doing.
Bipolar disorder will be with you for as long as you live until a cure is found.
No one knows when that day will come so you must not lose hope. If you feel
down, there will be people around to help you get through this because in some
ways, this affects them as well.
You should also take care of yourself. On your own, you can sign up in a gym and
exercise, eat right, get sufficient rest and simply follow your daily routine.
By sticking to this, you will be able to manage your day properly without
worrying what should be done next.
Knowing the problem should already make you aware of a crisis plan if things get
out of hand. Since some patients go on shopping sprees, it is best to let them
hide most of your cash and especially your credit cards. If the medication does
not work and things get violent, they must understand that you have to be
brought to the hospital no matter what happens.
It is going to be a difficult battle when you are faced with bipolar disorder.
You need to have the right mind set so you can handle it and at the same time
maintain your existing relationship with those around you. So just be strong and
don’t lose hope.
Preventing Suicide and Other Damaging Behaviors
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How to Prevent Suicide and other Damaging Behaviors
Suicide and other damaging behavior towards oneself or others are very similar
to just about any medical disorder. This is because it does not happen at once
and is usually preceded by emotional turmoil such as agitation, anxiety,
feelings of hopelessness or helplessness and impulsivity.
Other people will notice the change in terms of his or her performance at work
or in school as well as the actions done at home. If the person enjoys hanging
out with friends and then shuts them away, these are just signs that things will
get worse.
Some of the warning signs of destructive behavior other than killing oneself are
agitated behavior, giving away money and properties, overdosing, verbalizing
death and wrist slashing.
If you know of someone who is contemplating on doing it, instead of doing
nothing, the best thing to do is to reach out and talk to that person. Chances
are they will be encouraged to express their feelings.
Simply asking if there is a problem and then clarifying if that person has
entertained any destructive thoughts may be all it takes to save a life. If you
are able to reach out, such a deed does two things. First, it shows you are
concerned about that person’s welfare and second, it helps the individual
acknowledge that a problem exists and there is an urgent need to address it.
When you make yourself available to that person, you are reassuring them that no
matter what, you are there. If you need assistance, you should get professional
help by calling the police or the mental health services in your area.
Family and friends alone can’t overcome suicide or other damaging behaviors. The
one who has intentions of doing it must wake up in order for it to work and this
requires behavior modification.
Behavior modification is the use of empirical demonstrated behavior techniques
to change the attitude of the individual. This is done through positive and
negative reinforcement at the same time reducing the maladaptive behavior of
positive and negative punishment.
These are based on the principles of operant condition that were developed by
B.F. Skinner. It is believed that this behavior modification technique can be
applicable to both human and animal behavior and has been used ever since he
first published his book entitled The Behavior of Organisms in 1938.
The individual will probably have to be confined first if his or her loved ones
feel that they cannot watch over the person. Professionals will then take over
and see what they can do to stop these damaging behaviors from entering the
mind.
When they feel that this person is no longer a threat to him or herself and
others, only then will the patient be released.
Behavior modification in some way helps the individual learn what is wrong and
then deal with it. Suicide is just a quick way to get out of a situation but
addressing the issue head on makes one feel stronger than before.
This is what some consider as the practical four step process better known as
the CARE Approach that is used on those that have a disorder such as behavior
and depression.
In fact, it has had some success in stopping people from ending their lives as
those around hear their cry for help and are more than willing to listen before
it is too late.
Behavior modification can also be done through hypnosis. The professional will
induce a deep trance and try to remember the significant events or
accomplishments in one’s life.
At the same time, the individual will push away the negative and unhappy
thoughts and pull in the positive ones. This is better known as the principle of
substitution as the conscious mind focuses on the most important thoughts.
When he or she wakes up, the patient will have a positive view of life because
there are a lot of good things that can be done just like before and this can
only be achieved by looking toward the future.
There are many behavior modification techniques in use today to help prevent
suicide and other damaging behaviors. If you know someone, it is best to act
while this is still in its early stages.
Types of Episodes
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Episodes
Bipolar disorder is a mental disorder characterized by mood swings. The person
may at times feel high or low and can last for a few hours or last for several
weeks or even months. A lot of people have probably experienced it for brief
periods without even knowing they have this illness. Just to give you an idea,
here are some of these episodes.
The two most general are the manic and the depressive episodes. In a manic
episode, the person is extremely happy, very hyperactive and experiences racing
thoughts that usually lead to rapid speech.
Those who experience depressive episodes are sad, lack the energy to do anything
and are unable to enjoy the pleasures of life. They feel helpless and hopeless.
In between these two extremes, there are other episodes.
There is the major depressive episode and this happens when five or more
symptoms associated with bipolar disorder occur during a 2-week period. This
includes being depressed, show no signs of interest in anything most of the day,
significant weight loss as a result of not eating, insomnia or hypersomnia,
fatigue, feelings of worthlessness, diminished ability to think or concentrate
and recurrent thoughts of death.
Another is the mixed episode wherein the person will feel high and low daily for
at least a week. The person will probably be confined in a hospital for some
time to prevent him or her from doing harm to themselves or others. It should be
noted that these symptoms are not a direct result of taking drugs or any other
medical condition.
Then there is the hypomanic episode. This is the exact opposite of the major
depressive episode because the person will have an inflated self esteem, does
not need a long time to sleep, very talkative, feel that a lot of ideas and
thoughts are coming in, becomes easily distracted, wants to engage in goal
oriented activities and wants to get deeply involved in pleasurable activities.
This may last for up to 4 days and four of the symptoms mentioned have to be
present. Unlike the major depressive episode, those who suffer from it will
still be able to socialize with others and does not require hospitalization.
Bipolar disorder is often accompanied by psychosis wherein the individual will
experience hallucinations or strange delusions. At times, they may even hear
voices or see people that are not there. To make matters worse, there will be a
sense of paranoia and that person will think he or she is being watched or
followed. Just the same, it is best to seek medical help.
There are different levels of bipolar disorder. We alluded to these in a
previous chapter. Let’s take a closer look. There is bipolar disorder 1, bipolar
disorder 2 and cyclothymic disorder.
The difference between bipolar disorder 1 and 2 is that either the manic or the
depressive is more dominant than the other. For instance, a study shows that 60
to 70% of the time, manic episodes precede or follow a depressive episode.
Those who experience bipolar disorder 1 will experience it for a week but those
with bipolar disorder 2 will feel it in milder forms and a shorter duration.
Cylclothymic Disorder is not as bad as the first two mentioned. In fact, the
person will just feel irritated and this could last for up to two years with
single episodes that may last for up to two months. The interesting thing about
this type is that it can be a precursor to a full-blown bipolar disorder or just
a low-grade chronic condition.
Bipolar disorder is recurrent. So if it happens once, chances are this will
happen again. On average, someone with bipolar disorder may live a normal life
for up to three years with just in between episodes of mania or depression.
But it does not mean that you should not seek medical attention. By getting help
from professionals, you will be able to reduce the number of episodes by
restoring balance to your mood. This will enable you to gain control of your
life again instead of the other way around. First, the doctor will have to make
the right diagnosis to confirm that you have bipolar disorder so he or she can
provide the right medication and therapy.
Causes of Bipolar Disorder
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What Causes Bipolar Disorder
What causes bipolar disorder? This question is hard to answer given that doctors
have not done that much research yet on this subject. We already discussed that
they have reason to believe the illness is genetic since it is common among
previous patients that have had one member of the family suffer from it in the
past.
However, some believe that there is a chemical imbalance in the brain. There
could be too much or too low levels of norepinephrine that is the cause of cause
bipolar disorder. When these are too high, the person will suffer from mania
episodes and when these are too low, the person may experience depression.
Another group believes that this may be the result of a premature death of the
brain cells especially those that deal with emotion and mood thus causing
someone to suffer from mood swings.
People who suffer from bipolar disorder will experience episodes during the day
and more often in the following weeks. The episodes are frequently set off by
“triggers.” Some of these have already been identified so let us talk about
them.
Since bipolar disorder can happen later on in life, it is possible that severe
stress can trigger either mania or depression in a person. It can get worse by
turning into one of the many types of bipolar disorder or just stay that way for
the long term.
A major life-changing event may also cause someone to suffer from bipolar
disorder. This could be an accident, getting married, going to college, starting
a new job, retiring, coming home from a war and a lot more.
Substance or alcohol abuse is another trigger. Studies have shown that illegal
substances like amphetamines, ecstasy, and cocaine can trigger mania while
alcohol and tranquilizers may trigger depression.
Certain medications have also been known to trigger bipolar disorder especially
if these are antidepressant drugs. Other examples include over-the-counter cold
medicine, appetite suppressants, caffeine, corticosteroids, and thyroid
medication.
The changes in the weather may also trigger the bipolar disorder. In fact,
studies have shown that manic episodes happen during the summer and depressive
episodes happen during fall, winter and spring.
Close to stress is sleep deprivation. If the person is not able to get the right
amount of bed rest, this can make the person very irritable.
All of these triggers can be controlled except the weather. You will have to
find out which one is triggering your bipolar disorder by writing it first in a
journal then reviewing it one by one till you have the answer. Once you know the
triggers, you can take the appropriate steps to avoid them.
People who do not deal with bipolar disorder will have problems in the future
especially in their careers and relationships with others. If you think you have
this illness, you should consult a psychiatrist at once so he or she can make
the proper diagnosis.
You may exhibit some of the symptoms but this does not necessarily mean you have
bipolar disorder. This is because mood swings can be caused by other medical
conditions and the symptoms of some are very similar to bipolar disorder.
Some of these include head trauma, thyroid problem, brain tumor, epilepsy,
neurosyphilis, anorexia nervosa, drug abuse, bulimia nervosa, panic disorder,
social phobia, schizophrenia and delusional disorder.
Patients who are diagnosed with bipolar disorder are usually given medication
and in some cases undergo psychotherapy. You won’t see any immediate results but
in a few weeks, you will be able to notice a change in your mood.
Despite everything, doctors do not know yet the exact cause of bipolar disorder
but there have been significant discoveries over the past 10 years. Before, the
patient was just locked up in a mental institution. Now there are medications,
therapies and support groups to help those that have this illness.
Biochemistry of the Disorder
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What is The Biochemistry of the Disorder?
Research has shown that an abnormality in brain biochemistry causes bipolar
disorder. However, the reason why these abnormalities occur is still a mystery
and this requires involving brain scanning and other techniques.
There is estimated to be at least 100 chemicals in the human brain. These
chemicals carry messages or signals between the brain cells or neurons. Some of
these neurotransmitters have a strong link to mood disorders. So if there is an
abnormality, chances are the person could be suffering from bipolar disorder or
something similar.
Just to prove a point, the cause of depressive episodes are a deficit of the
neurotransmitters called dopamine, norepinephrine and serotonin. If there is an
over supply, the patient will experience mania episodes.
Now let us discuss these three neurotransmitters further.
Dopamine is responsible for controlling our body movements and pattern of
thought. It also regulates how hormones are released.
Norepinephrine is used by central nervous system and the peripheral sympathetic
nervous system. It controls our anxiety, arousal, “fight or flight” response and
memory.
Serotonin, also called 5-hydroxytryptamine or 5HT, controls our appetite, body
temperature, mood, sensory perception and sleep. It also regulates the rate at
which hormones are released and is believed to have something to do with
inflammation.
There is nothing you can do if your neurotransmitters are abnormal. Brain
surgery won’t do any good but getting the right treatment will enable you to
manage the illness.
This, of course, can only be achieved by having a good relationship with your
doctor. If his or her diagnosis has confirmed that you have bipolar disorder,
you should put your trust in the professional.
One thing you should understand about bipolar disorder is that there is no “one
treatment fits all.” Some drugs work while others don’t. And, what works for one
patient may not work for another. If after a few weeks there is no significant
improvement, they doctor will realize that increasing the dosage is not solution
but a stronger drug needs to be used.
When working with drugs, you should ask the doctor beforehand what are the side
effects. Although this is normal, you should be well aware of it.
Two of the most commonly used are lithium and valaproate. Lithium is a mood
stabilizer while valaproate is an anticonvulsant drug.
Drugs are not the only means to manage bipolar disorder. Another effective
technique is psychotherapy also known as “talk therapy.” Here, you will be able
to communicate how you feel and what causes these triggers to occur.
There are three types of psychotherapy. These are namely psycho education,
cognitive behavioral therapy and interpersonal and social rhythms therapy. This
is done in a variety of settings. You can talk to the doctor; talk with fellow
bipolar disorder sufferers or together with your family members.
Aside from your doctor, you can also consult a clinical psychologist, a social
worker or an advanced practice registered nurse. These individuals are trained
to identify
Although there is no cure for bipolar disorder, 80 to 90% of those who seek
medical help are successfully treated. Since this will last for the remainder of
the individual’s life, it is important that maintenance drugs must be taken in
order to reduce the number of episodes that may occur.
You can also manage bipolar disorder by identifying the triggers that cause
these episodes to occur. Again, this is different for each individual so one has
to observe carefully and write these down so this can be discussed with the
health professional that will teach you how to prevent them from happening.
There are approximately two million Americans who suffer from bipolar disorder
and this number will increase in the years to come until there is a cure. Some
of them will be children and this will happen regardless of gender or race. Such
a problem means that the cost of lost productivity will also go up as well as
the number of those who will attempt suicide and actually do it.
Aside from these three, other neurotransmitters chemicals have been identified
with bipolar disorder and these are acetylcholine, GABA (gamma-aminobutyrate)
and glutamate. There is ongoing research that suggests that neuropeptides plays
a role as well but that still has to be validated.
Negative Thoughts and Social Factors
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How to Overcome Negative Thoughts and Social Factors
Again, studies have shown that more people who suffer from bipolar disorder are
genetic in origin. This means that someone in the family experienced this before
and this can happen again in future generations. Despite that, some doctors
believe that there are social factors as well as negative thoughts that cause
these to happen. If this is the case, can it be overcome?
The answer to this question is yes. This is because regardless if the person got
this genetically or from somewhere else, the trigger is always something
external. This means a person can experience an episode due to stress or some
other reason.
The only way you can overcome negative thoughts and social factors is by
identifying these triggers. Patients together with their support group can do
this by listing down previous episodes. Once you know what they are, you can
avoid them and with some medication keep it stable. Although what triggers
bipolar episodes in people are different, here are some that are very common.
The average person needs 8 hours of sleep in the evening. If you do not get
enough sleep and your mania or depressive episode happens, you will simply have
to follow a sleeping schedule so you are able to get sufficient amount of rest.
Episodes are also triggered by poor nutrition. If you don’t know how to make an
eating plan, you can get the help of a nutritionist or a dietitian that will be
more than happy to make the plan. You should also avoid drinking alcohol and any
beverage that has caffeine or sugar because this has been known to also cause
triggers. This will help you avoid other health problems like diabetes or heart
disease.
Another trigger commonly faced by patients is stress. Even if you don’t have
bipolar disorder, you should know by experience that pressure makes it almost
impossible to think or do the right thing. If you think you can’t handle it and
you feel an episode coming, you should get up and go somewhere where you can
relax.
You can even do some deep breathing exercises or play some relaxation
recordings. Those who have time can release that tension by engaging in physical
exercise.
This next trigger is the decision of the one suffering from bipolar disorder.
Knowing that he or she has a problem, they try to shut out the world around them
thinking that this will make things better when, in reality, it only makes
things worse.
This is better known as isolation. The only way, of course, to overcome this
situation is by joining a support group or talking about this illness with other
individuals. Having someone there to listen really helps because you know that
someone cares.
Some people feel better after taking medication and if after some time no more
episodes occur, they stop medication. This must never happen because studies
have shown that once a person experiences one episode, this could happen again
two years from now or even longer. They have to realize that there is no cure
yet for this illness and the maintenance medication given is the only thing that
keeps these episodes at bay.
Drinking and taking drugs have often been associated with bipolar disorder.
Although no study has shown that this is the exact cause, people who take drink
or take these have worse episodes than those who don’t. Everyone knows that you
can’t quit drinking or using illegal drugs overnight. But if you are able to
stick to the program, these won’t be any of your vices later on.
If the treatment given to you by the doctor is not working, you will relapse
again into another episode. To overcome this illness, you must have a good
relationship with your doctor. If things are not working out, you shouldn’t be
afraid to tell them that there is no improvement so he or she can increase the
dosage, prescribe another drug or recommend a different type of therapy.
Bipolar disorder can be managed with the help of a good doctor, the support of
friends and your own willpower. So if you want to gain control of your life, you
should seek help and do your share.
Triggers and the Prognosis
(Back to Top of Page)
What's the prognosis?
There is no known cure yet for bipolar disorder. The episodes that people
experience come and go but is it possible to prevent them from happening? We’ve
discussed some of these possibilities, yet we can’t emphasize the importance of
identifying the triggers.
In some cases, it is possible. But first, you have to find out what triggers
these episodes to occur.
What Sets Off An Episode?
What sets off an episode? There are a lot of things and it just proves that
bipolar disorder is not caused by just genetics. These external factors are
better known as triggers and once they are set off, the patient will suffer from
either mania or depression episodes. Here are some of them.
Stress is the number one factor. If the person is not able to keep up with the
pressure he or she will just lose it. Believe it or not, being overworked does
trigger either mania or depression in someone with a genetic vulnerability to
bipolar disorder. Once this occurs, the illness itself develops a life of its
own and the biological as well as psychological processes take over and keep
this active. Running a close second to stress not getting enough sleep is also
known to trigger an episode of mania.
Life changing events have also been known to trigger an episode of bipolar
disorder. This is different for each individual because this could happen as a
result of a death in the family, moving into a new home, losing one’s job, going
to school far away from home, and a lot more.
Some drugs that used to help one illness may cause the person to suffer from an
episode. Some examples of these are antidepressant drugs, appetite suppressants,
caffeine, over the counter cold medicine, corticosteroids, and thyroid
medication are all known to trigger mania episodes.
The weather also triggers episodes. Studies have shown that people with bipolar
disorder feel extremely happy during the summer and depressed during the fall,
winter and spring.
Now let us talk about preventing these four episodes. Yes, you can prevent
episodes caused by stress by following a daily schedule. You should get the
right amount of sleep and sustenance so you don’t feel tired later on during the
day. This should be followed up by making a mood chart that can be shown to the
doctor so he or she can see how you are doing. This is the best way to determine
if the drugs being taken are effective or not.
Other ways to combat stress include practicing deep breathing exercises and
listening to soft music. You can download a few songs into your Ipod and then
place this where it follows you as you are going about your duties. You can even
exercise so you are able to release the tension you are feeling.
Life changing events will happen. You cannot control if someone close to you
dies or the company decides to lay you off if the business is not doing that
well. You just have to remember that the end of something is the beginning of
another. You just have to face that fact and then look forward to the future.
Drugs and alcohol are things that people choose to do. If they know they have
bipolar disorder, they should simply reduce the intake and eventually stop
taking them. It will be hard because those who smoke and take drugs will
experience withdrawal symptoms. If they can’t do it themselves, then they should
not be ashamed to ask for help.
Who says you can’t do anything about the weather? You can change your mood with
bright light therapy. This has been proven to manage episodes of mania and
depression during the different seasons of the year so all you have to do is buy
a lamp from the store.
But what if the episode is happening? What is the best thing to do? When you
feel an episode is there, it is advisable to leave the situation before it gets
worse. At work, you can probably excuse yourself for a few minutes to get some
air. This will give you some time to close your eyes, breathe deeply and take
your medication. You should only go back when you are ready to work again.
If the episode is happening at home, you should turn down the down the lights,
play some soft music and just close your eyes.
Episodes may occur for a few hours or even longer. If you know the triggers, you
can prevent it from happening so this will never turn into a full-blown episode.
So, do some self-analysis so you know the triggers because this is different for
each individual.
Strictly speaking, anyone who has suffered three or more episodes will have to
undergo a lifetime of medication. If you know someone in your family that has
had this before, perhaps you should be on alert because this could happen to one
of your siblings or even yourself.
Remember that there is no known cure yet for bipolar disorder. The best that
anyone can do right now is accept that it is there then take whatever measures
are given even if it means going to the hospital for the few days until the mood
normalizes.
Medications
(Back to Top of Page)
What about Medication?
If tests have shown that you do have bipolar disorder, your doctor will
administer medical treatment to help you deal with this illness.
One of the most frequent drugs used to treat bipolar disorder is lithium. This
is because it evens out mood swings in both directions. Also, it serves as
maintenance treatment in patients which is why it is used for weeks or even
months until the mood is balanced.
In most cases, antipsychotic medications are used in the first few days of
treatment until lithium is able to take effect. In fact, some of the newer
antipsychotic drugs are being used for a longer period of time if this has been
proven in helping the patient.
Lithium can even be added with other drugs to make it effective. A good example
is an antidepressant but this must be given carefully because an overdose could
switch into mania in some individuals.
But lithium does not work the same for everyone. Some people who have used it
once no longer experience these episodes while others will have more episodes
and need to use this to keep their moods stable. Some will not even see any
improvement after taking lithium so you will never know until you try.
Those who will be taking lithium have to take regular blood tests. This is
because if this is too little, the medicine may not work and if it is too much,
the patient will suffer from its side effects.
These side effects include drowsiness, fatigue, hand tremors, increased thirst
and urination, nausea and weight gain. These will only occur for a short while
but can be avoided with proper diet and by drinking low or no calorie
refreshments.
Lithium can also be used to treat children with bipolar disorder so parents
should be prepared since they will probably wet the bed more often. However,
this can be managed by simply lowering the dosage.
Another side effect to using lithium is that it can cause changes in the thyroid
gland. This can be restored with thyroid hormones therapy.
But what is Lithium? Basically, it is a salt that is able to lower the levels of
sodium in a person’s body. If the person experiences a diarrhea, fever, heavy
sweating or vomiting, the doctor must be informed immediately so the dosage can
be changed.
Doctors will not prescribe lithium to patients who have had brain damage,
epilepsy, kidney, heart or thyroid disorders. Pregnant women are also prohibited
from taking it since this could cause problems for the baby.
Patients that will be taking lithium should not combine this with other
medications. They should also avoid drinking coffee or anything that has
caffeine because this too may cause confusion, drowsiness, muscle twitching,
nausea, irregular heartbeat, seizures and vomiting.
When the person is taking lithium, it is best to inform other doctors as well
like the dentist so they are aware that it is used to treat a certain medical
condition.
In general, lithium is safe to use as long as it is generally monitored. If you
can’t take it, perhaps you can use anticonvulsant drugs.
One anticonvulsant drug frequently used to treat bipolar disorder is Valproic
acid. It is very effective in treating rapid cycling.
Just like lithium, though, there are side effects and these include anxiety,
confusion, double vision and headaches. It has been known to cause liver
problems, which is why liver function tests are conducted regularly before and
after therapy.
Other examples of anticonvulsant drugs include carbamazepine (Tegretol),
lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax) that
are used in treating short term mania.
If things are getting out of hand, the doctor may recommend antipsychotic drugs.
The duration of the medication will depend on the patient so it may last for the
short or long term.
Most patients who have bipolar disorder use more than one medication and this
must be taken even when the symptoms subside. After all, if it happens once,
this may recur again in the future and also because there is no cure for bipolar
disorder. The best that anyone can do right now is take control of it so that
person will still be able to live a normal life.
Treatment
(Back to Top of Page)
We have covered much information about bipolar disorder including triggers
and medications. Now, let us clearly focus on the options for treatment.
Treatment
There is no cure for those suffering from bipolar disorder. To make things
worse, there is no “one sure” treatment or therapy that could stabilize your
condition. It is a trial and error process that may take months or even years.
The two episodes of bipolar disorder will make the person either feel “high” or
“low.” Treatment for bipolar disorder can only be administered once the doctor
identifies what may have triggered the attack. This means observing the patient
for some time and in his or her absence, the person will have to write this down
in a journal so this can be reviewed for analysis later on. There’s that journal
again. Think it’s important?
The high is known as mania and here are some of the common treatments given to a
patient. It is possible that the doctors will use an antipsychotic drug like
benzodiazepine to quickly take control of your hostility, hyperactivity,
irritability, or sleeplessness.
In some cases, mood stabilizers will also be prescribed to help control mood
swings and to prevent them from happening and can even be taken by people who
are at risk of committing suicide. Two of the most common around are lithium a
few other anticonvulsant drugs.
Aside from medication, hospitalization may be necessary if doctors feel the
patient is a threat to others or him or herself. If the situation does not
improve, doctors will have no choice but to use ECT or electroconvulsive
therapy.
If the medication to help control your mania doesn’t work, your doctor could
either increase the dosage or make you start using something else.
Aside from drugs and hospitalization, there is also psychotherapy or talk
therapy which enables the patient to interact with health professionals and
their loved ones.
Unlike mania, depressive episodes are far more challenging and controversial.
This is because the use of antidepressants may make the person experience a
mania episode. In October 2004, the FDA came out saying that antidepressant
drugs may increase the risk of suicidal thinking in children and teens suffering
from depression.
To avoid this from happening, the doctor should carefully prescribe the dosage
and then decide later on whether to increase or decrease it.
Six years ago, the American Psychiatric Association has suggested using lithium
or anticonvulsant drugs like Lamictal to help patients suffering from depressive
episodes. If this does not work, the doctor may recommend Zyprexa, another
antipsychotic drug or something similar but tests have shown that this is only
effective in varying degrees.
As a last result, the doctor may also recommend ECT or electroconvulsive
therapy. Studies have shown that it has helped 75% of patients.
Again, non-drug treatments like psychotherapy can also be used to help patients
experiencing depressive episodes.
The type of treatment for each patient depends on the type of bipolar disorder.
If episodes are not that frequent, the best to prescribe is lithium. However if
the individual experiences 4 or more mood swings in one year, then it is best to
use anticonvulsant mood stabilizers.
The drugs given will not work instantly and it may take several days or weeks
before they take effect. This is the reason that the doctor must observe the
patient carefully together with the help of their family to determine the next
course of action.
Should things workout for the better, the doctor will recommend a maintenance
drug that the patient must take regularly. At times, more than one is given for
best results but if things go the other way, then it is time to find a better
solution.
Until such time that there is a cure of bipolar disorder, doctors and patients
will have to rely on medication, psychotherapy and ECT. Given that this illness
is a long-term condition, it requires lifelong treatment even when the person
has not felt an episode take place after a long period of time.
Apart from the psychotherapist who is the authority figure in this matter, the
patient may also seek help from psychologists, health workers, nurses and family
members. The person should just keep an open mind and not lose hope because if
modern medicine has been able to find cures for some illnesses, it is only a
matter of time before there will also be an answer for this one.
Creating Your Recovery Plan
Creating a Recovery Plan
(Back to Top of Page)
You now know that bipolar disorder is a recurring disease. If you are able to
identify the stressors, you are already on your way in developing a recovery
plan against this illness. This is because you simply have to avoid these
triggers so an episode will not occur.
For instance, if you have identified lack of sleep as a trigger, you simply have
to sleep at a certain time at night so you can get enough hours of sack time.
Should this be caused by stress, try working on the smaller problems now then
work on the bigger ones when you feel like taking a crack at it.
The time frame for creating a recovery plan and seeing it actually work varies
by the individual. But for many, it takes months so your doctor can help out by
explaining to your family and even your employer what is going on.
A lot of patients who are getting their lives back will often feel fragile and
vulnerable for fear that these episodes will happen again. These feelings are
normal and part of creating the recovery plan should involve activities outside
work like volunteering in a charity, taking up a new hobby or sport.
The recovery plan will not work without the use of maintenance drugs. Both you
and the doctor have to find out which one works and what dosage as they are
designed to eliminate the symptoms and prevent them from coming back.
If you stop treatment, your mania or depressive episodes will return within a
couple of years. In fact, the odds of this happening are 80% higher even after
many years of stability. But for those who only experienced one mild single
episode, you can stop medication after a year or two.
Although the medication given has side effects, none of them are addictive. Some
of them even lessen in time. The doctor will even monitor your blood level and
body organ functioning during this time to avoid the risk of other medical
complications. Another thing that should be noted about these is that there have
not been any reported changes in personality as a result of taking these drugs
even for a number of years.
Part of the long-term plan for recovery also involves counseling and
psychotherapy. This can be done one on one with the doctor, a nurse or a health
worker, with a group of patients who also have this problem or simply with a
family member. These resources may help in developing better strategies to
reduce the symptoms so you can live a normal life.
The patient will also have to make some changes in his or her lifestyle. This
means staying away from alcohol and illegal substances because they increase the
risk of relapse. It is best to also eat healthy and exercise since these can
positively affective one’s mood. As mentioned earlier, if stress or lack of
sleep is a trigger then one should also develop healthy sleeping habits.
Isolation should also be avoided when experiencing any of the symptoms of
bipolar disorder because this can make matters worse as the person will feel
more depressed, demoralized or sad. So surround yourself with friends and family
in order to make things exciting.
You should also monitor your symptoms closely as you may notice a new trigger
causing your episode to happen. There’s that doggone diary again!
Developing a recovery plan for bipolar disorder will be challenging but if you
are able to set realistic goals and objectives, it can succeed. After putting
this on paper, these ideas and concerns must be discussed with your psychiatrist
so he or she can help make this happen. Aside from them, you should also get
your family involved because this is not a personal matter but something that
has to be dealt with by everybody.
The end goal of developing a recovery plan for bipolar disorder will allow you
to smoothly re-enter society. This means letting other people know of your
illness, like your teachers if you are studying and your employer if you are
working. It is not your fault that you got this condition and your efforts in
taking this problem head on will show to people that you have the courage to
fight back and gain control of your life once again.
Food, Fun and Exercise
Food, Fun and Exercise
(Back to Top of Page)
Some of the triggers of the symptoms associated with bipolar disorder include
stress, poor eating habits and lack of sleep. While these three are just some of
the possible triggers, there are ways to take control of these with food, fun
and some exercise.
Food is necessary so we get the right amount of nutrients daily. This means
eating a balanced meal with fruits, vegetables and a few dairy, poultry and fish
products. It will also be helpful to take multivitamins and food supplements.
Eating right also means staying away from beverages with alcohol and caffeine.
Instead, you can drink alcohol free or reduced variations as well as
non-caffeinated products.
Chances are you will be taking medication to help you deal with your mood
swings. Some of these drugs have side effects and one of them is weight gain. So
aside from eating right, you should exercise to increase the metabolism in your
body and combat stress.
Some exercises to think about include jogging, running and walking. You can do
this on a treadmill or in the streets so don’t get tired staring into black
space when your brain is able to relax looking at the natural environment.
Exercising outdoors also has one more benefit and that is exposing yourself to
sunlight that has proven to affect your mood positively.
If the area outside is polluted, naturally you will have to exercise indoors.
You can buy a DVD or enroll in a gym that provides non- strenuous programs. A
couple examples of these include Pilates and Yoga. These exercises are designed
to make your mind relax as you breathe deeply which promotes both flexibility
and strength.
Another form of exercise you can do is playing basketball or any other sport you
know with friends. It also wouldn’t hurt to learn something new because it is
always educational and fun.
Before you start out any exercise, it is best to see a doctor so he or she can
say if the program you are getting into is safe. If what you plan in mind is not
feasible, surely something else can be recommended.
Since you sweat when you exercise, don’t forget to drink lot of water. This will
help replenish the liquids lost as certain medications may also cause your body
to overheat.
Seasonal changes may also affect your mood. Studies have shown that during the
fall, winter and spring those who are suffering from bipolar disorder are
depressed. You can counter this by planning ahead so you know what you are
supposed to do for that day.
It also wouldn’t hurt to say “no” so you are not pressured to do something when
you really don’t feel like doing it. You should also work on a budget so you
don’t overspend buying gifts and then worrying later on how you are going to pay
for them when the bill comes in.
The same strategy can also be used who experience mania episodes during the
summer. This is to avoid getting yourself over excited as to where to go during
the Memorial Day weekend. As much as possible you find to relax.
Although it is not advisable for people with bipolar disorder to isolate
themselves it wouldn’t hurt once in a while to do some things on your own. After
all, you are not a baby anymore who can’t take care of yourself. Just remember
that after some alone time, you should hang out with friends and family because
they are the only people you have left that can help you with this problem. You
can go watch a movie and talk about the good old days that will surely make you
laugh.
There are more than 2 million Americans who suffer from bipolar disorder and
this can happen to anyone regardless of age and gender. Although doctors have
yet been unable to find a cure, treatment with or without the use of medication
can make life normal again for these people.
So eat right, find something to do and have fun. If you are able to work on a
schedule and stick to it, you will not experience an episode that will surely
ruin your day.
*********
DISCLAIMER: This information is not
presented as being from a medical practitioner and is for educational and
informational purposes only. The content is not intended to be a substitute for
professional medical advice, diagnosis, or treatment. Always seek the advice of
your physician or other qualified health provider with any questions you may
have regarding a medical condition. Never disregard professional medical advice
or delay in seeking it because of something you have read.
Since natural and/or dietary supplements are not
FDA approved they must be accompanied by a two-part disclaimer on the product
label: that the statement has not been evaluated by FDA and that the product is
not intended to "diagnose, treat, cure or prevent any disease."
*********
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