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					Bipolar Disorder (which used to be called                    •   Increased energy, feeling hyperactive and/or              individuals diagnosed with bipolar disorder attempt
                                                                                                                                                1
“Manic-Depression”) is a serious disorder that causes            restless; needing very little sleep;                      suicide at least once .
extreme mood swings that affect one’s energy levels,         •   Excessively ‘high’ or euphoric mood and/or extreme
attitudes, thoughts, and behaviours.                             irritability;                                             Possible Causes of Bipolar: Bipolar affects
                                                                                                                           both males and females, typically developing in late
It’s important to note that                                  •   Inflated self-esteem or sense of grandiosity;             adolescence and early adulthood. There is no single
these shifts in mood are                                         unrealistic belief in one’s abilities;                    cause of bipolar disorder. Instead, it is likely that several
different from the mood                                                                                                    factors play a role in its development.
                                                             •   Racing thoughts; jumping from one idea to another;
swings most people
experience. They can                                         •   Speaking very fast (‘like the words cannot come out       Individuals who have biological relatives with the same
impair one’s judgement &                                         fast enough’); others find it hard to follow what you     condition are at a slightly higher risk of developing
general ability to function,                                     are talking about;                                        bipolar disorder themselves, suggesting some genetic
sometimes with severe                                                                                                      link. However, studies of identical twins demonstrate
consequences; extreme                                        •   Easily distracted, can’t concentrate well;                that genes are not the whole story. It is most likely that
moods can cause damage                                       •   Feeling less inhibited; being over-familiar or            environmental factors are crucial too. Periods of high
to relationships, poor                                           aggressive with others;                                   stress, major life changes, alcohol & substance abuse,
performance at school or                                                                                                   may trigger episodes.
on the job, financial debt,                                  •   Poor judgment & increased impulsivity, which may
and suicide.                                                     include spending money recklessly or dangerous
                                                                 behaviours, such as drug abuse or unsafe sex,
                                                                                                                           How is it diagnosed? Bipolar disorder cannot
                                                                 which may lead to disastrous consequences.                be determined physiologically (say, with a blood test).
These dramatic mood                                                                                                        Instead, a diagnosis is made on the basis of symptoms
swings – from overly ‘high’                                  A hypomanic episode is similar to a manic                     and, when available, family history. Correct diagnosis is
and/or irritable, to hopelessness & despair – can last for   episode but the symptoms are less severe and may only         essential to determine the most effective treatment. For
weeks or months, often with periods of normal mood in        last a few days. These episodes may feel good to the          instance, some conditions are misdiagnosed as
between. The period of highs and lows are called             person who may even function well and be more                 depression; for someone with bipolar disorder,
episodes of mania and depression, respectively.              productive than usual. He/she may not believe anything        antidepressants alone are not effective and can, in
                                                             is wrong and is unlikely to seek medical help. However,       some cases, worsen symptoms.
Signs and symptoms of a    depressive episode
                                                             without proper treatment, hypomanic symptoms may
include:
                                                             become more severe and incapacitating, or may switch          A mental health professional will ask about your
•   Feeling sad, tearful, anxious, or ‘empty’; being         into depression.                                              thoughts, feelings, and behaviour patterns. With your
    unable to enjoy things or feel pleasure;                                                                               permission, he/she may speak with your relatives or
                                                             Mixed bipolar states occur when both manic and                close friends for further information on possible
•   Sleeping too much or too little; feeling much less                                                                     symptoms of mania or depression. Any history or
    energetic, ‘slowed down’ or exhausted;                   depressive symptoms occur at the same time. For
                                                             example, someone may feel very hopeless and suicidal,         current use of alcohol or drugs should also be
                                                                                                                           assessed.
•   Difficulty concentrating, making decisions, or           while at the same time feeling very energized.
    thinking clearly;
                                                             Sometimes, severe episodes can trigger symptoms of            Treatment:        Bipolar disorder is a long-term illness
•   Feeling guilty, worthless; ruminating on perceived                                                                     that must be carefully managed throughout a person’s
    failures or mistakes in the past;                        psychosis. Psychotic symptoms may include
                                                             hallucinations (seeing, hearing, or sensing things that       life, even during periods when he/she feels better.
•   Changes in appetite; unintended weight loss/gain;        are not there) or delusions (strongly held beliefs that are   Effective & appropriate treatment is vital for reducing the
                                                             false & not influenced by logical reasoning). Delusions       frequency & severity of manic & depressive episodes
•   Chronic pain or persistent bodily symptoms that          tend to reflect the current mood state – for instance, in a   and allowing the person to benefit from a more balanced
    cannot be explained by physical illness or injury;       manic episode, one might have grandiose ideas,                & enjoyable life.
•   Feeling hopeless; having thoughts of death or            believing oneself to be on a special mission or having
    suicide.                                                 extraordinary abilities, while delusions of guilt or          Psychotherapy helps you to understand patterns to
                                                             worthlessness might occur during a depressive episode.        episodes and factors that typically trigger them. You and
A manic episode can be a time of extreme well-                                                                             your therapist work together to identify early warning
being, energy, and optimism but it can impair your                                                                         signs & to address symptoms before they become
                                                             The risk of suicide is relatively high among those
thinking & judgment. You may make some bad                   with bipolar disorder; it is estimated that 25% to 50% of
decisions, or behave in embarrassing or sometimes
risky ways. One’s behaviours & thoughts are markedly
                                                                                                                           1   Jamison (2000) J Clin Psychiatry: 61 Suppl 9:47-51.
different from usual. Symptoms include:
overwhelming. You can develop strategies to cope with        •   Psychoeducation: Read more about bipolar
mood changes & prevent them from becoming full-                  disorder & ask questions about your medication(s)
blown episodes of mania or depression. A therapist can           & further strategies to stay symptom-free. Explore
also help you to improve stress management and
relaxation skills.
                                                                 any concerns you have about your treatment plan
                                                                 with your doctor or psychologist.                       Understanding
               Medication plays a vital role in
                balancing mood & minimizing the
                                                             •   Social support: When you are well, help your
                                                                 friends & family understand what happens to you        Bipolar Disorder
                negative effects of manic and                    and how best they can support you if you feel
               depressive episodes. Medication for               unwell.
                bipolar disorder should be prescribed by
                a psychiatrist i.e. a medical doctor         •   Maintaining well-being: Regularly monitor your
               specialising in mental health.                    moods with exercises designed to increase self
                                                                 awareness & develop coping strategies. Take your
There are several classes of medications that are                medication regularly, as directed, and keep up with
effective in regulating & stabilising mood in bipolar            your therapy appointments.
disorder. These include mood stabilizers (e.g. lithium),
anticonvulsants (e.g. Depakote, Tegretol), and               •   Reducing risk: Keep an eye out for early warning
atypical antipsychotics (e.g. Risperdal). More than              signs that you are beginning to feel unwell (recruit
one may be prescribed for optimal treatment. It is               close family & friends to help); address symptoms
important to find the right drug, or combination of drugs,       early on to prevent debilitating episodes. Avoid
that best suits each individual. It can take several weeks       mood-altering drugs, including alcohol.
before there is noticeable improvement in symptoms, so
it is vital to take the medication consistently.             Looking for further information?
Be aware that all medications have side effects. If you      http://kidshealth.org/teen/ is a website
experience adverse effects, dosages can be adjusted or       for young people with an article on
alternative drugs may be prescribed. Always speak with       bipolar disorder.
your psychiatrist before stopping medication.
                                                             The following sites have information on
In almost all cases, bipolar disorder is best controlled     many mental health issues, including bipolar
when treatment is continuous, even during periods of         disorder:
remission (i.e. when the person is symptom-free). This       http://www.rcpsych.ac.uk/mentalhealthinfoforall.aspx
is called maintenance therapy. It can be very tempting
to stop treatment when one feels better but this greatly     http://www.nimh.nih.gov/health/publications/
increases the risk of re-experiencing mania and/or
depression in the future.                                    http://www.mayoclinic.com


Self-help: While bipolar disorder is not a condition         At UWI, the Counselling & Psychological
that you can treat on your own, there are many things        Services (CAPS) offers free and confidential
you can do to optimize your well-being:                      counselling to students. Call 662 2002, ext 2491 for
•   Taking good care of yourself: Take regular               information or to make an appointment. Or email
    physical exercise; try to eat healthily and at regular   counsellor@sta.uwi.edu
    times each day. As far as possible, stick
    to a regular bedtime & wake-time;                        We are located in the Health Service Unit (HSU) and
    ensure you get sufficient sleep.                         open throughout the year, Mondays to Fridays, from
                                                             8:30am to 4:30pm, with evening sessions till 7pm during
•   Minimizing stress: Reduce work                           semesters.
    & personal stress as much as is
    practical. Practice good stress
    management & relaxation skills                               This leaflet prepared by the Counselling &
    (e.g. yoga, meditation) regularly. Make                      Psychological Services, UWI, St Augustine.                   662-
                                                                                                                         CAPS 662-2002, ext 2491
    time for things you enjoy.

				
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posted:10/30/2011
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