Bipolar Disorder

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					Bipolar Disorder

  By: Disha Bhagwat
Bipolar Disorder
   3 types
       Bipolar I disorder- mood swings can cause
        significant difficulty in job, school and
        relationships. Manic episodes can be
       Bipolar II Disorder- less severe than Bipolar I. May
        have an elevated mood, irritability, but you can
        carry on with normal routine. Instead of a full
        blown mania you experience a less severe form
        called hypomania. Periods of depression last
        longer than hypomania.
Bipolar 3 types continued
 Cyclotymia-mild form of bipolar
 disorder. Hypomania and depression
 can be disruptive, but the highs and
 lows are not as severe.
 It was first noticed as far back as the second
 Aretaeus of Cappodocia first recognized the
  symptoms of mania and depression, and
  realized they could be linked together.In
  1913, Emil Krapelin established the term
  manic-depressive with an extensive study
  surrounding the effects of depression and a
  small portion about the manic state
 Throughout the 1960s many with the disorder
  were institutionalized and given little help
  financially because the US Congress refused
  to recognize it as a legitimate illness. People
  afflicted were only treated in the early 1970s.
 In 1980 the term bipolar disorder replaced
  manic-depressive disorder as a diagnostic
  term in the DSM0III
 The exact symptoms vary from person
 to person. For some people, depression
 causes the most problems, while others
 suffer the most from mania.
   Manic Phase
       Euphoria
       Extreme optimism
       Inflated self-esteem
       Poor judgment
       Rapid speech
       Racing thoughts
       Aggressive behavior
       Agitation or irritation
   Manic Phase (Cont)
       Increased physical activity
       Risky behavior
       Spending sprees/unwise financial choices
       Increased drive to achieve goals
       Increased sex drive
       Decreased need for sleep
       Inability to concentrate
       Careless use of drugs and alcohol
 Manic   Phase
   Frequent absences from school or work
   Delusions or break from reality (psychosis)

   Poor performance at work or school
   Depression Phase
       Sadness
       Hopelessness
       Suicidal thoughts or behavior
       Anxiety
       Guilt
       Sleep problems
       Low appetite or increased appetite
       Fatigue
       Loss of interest in daily activities
 Depression       phase
   Problems       concentrating
   Irritability

   Chronic pain without a known cause
   Frequent absences

   Poor performance
 Seasonal changes in mood
 Psychosis
       Severe episodes of either mania or depression
        may result in a detachment from reality
   Rapid cycling bipolar disorder
       Rapid mood shifts
       Four or more mood swings within a single year
Symptoms of Childhood
Bipolar Disorder
 Explosive temper
 Rapid mood shifts
 Reckless behavior
 Aggression
 giddiness
 Shifts occur within hours or less
 Biological   Differences
   Physical  changes in the brain. The
    significance is still unknown, but it may
    help us pinpoint causes in the future
 Neurotransmitters
   An   imbalance in neurotransmitters
 Hormones
   Imbalanced   hormones
 Environment
   Stress,abuse, significant loss, or other
    traumatic experiences may play a role
 Inherited   traits
   Ismore common in people who have a
    blood relative with the condition
   Still trying to find specific genes involved in
    the cause
Treatments and Therapy
 Requires  lifelong treatment, even in
  moments of stability
 Primary treatments include
   Medications

              group or family psychological
   Individual,
    counseling (psychotherapy)
   Education and support groups
Treatment and Therapy
   Initial treatment
       Involves taking medication to balance moods right
   Continued treatment (maintenance treatment)
       Used to manage on a long-term basis. People who
        skip it are at risk of a relapse of symptoms or
        having minor mood changes turn into full-blown
        mania or depression
   Hospitalization
       May be necessary if behavior is dangerous, you
        feel suicidal, or experience psychosis
Treatments and Therapy
 Medication
   Doctors  suggest combining medications for
    maximum effect
   Include those that prevent the extreme
    highs and lows and medications that help
    with depression or anxiety
   Anticonvulsants
       Includes valproic acid, divalproes, and lamotrigine.
   Lithium
       Effective at stabilizing mood and preventing
        extreme highs and lows. Periodic blood tests are
        required. Can cause thyroid and kidney problems.
        Common side effects include tremor, weight gain
        and digestive issues
   Antipsychotics
       May help people who don’t get help from
        Anticonvulsants. May affect memory and attention
        and cause involuntary facial or body movements.
   Symbyax
       Combines antidepressant and antipsychotic to
        work as a mood stabilizer
   Antidepressants
       Can trigger manic episodes, but can be ok if taken
        with a mood stabilizer
 Benzodiazepines
   Anti-anxietymeds that may help anxiety and
   improve sleep. Generally used for relieving
   anxiety only on a short-term basis
 Findingthe right medication requires trial
 and error. Generally only one medication
 is changed at a time which can take
 months or longer.
   Cognitive behavioral therapy
       Identifies unhealthy, negative beliefs and
        behaviors and replaces them with healthy, positive
        ones. Helps identify what triggers bipolar episodes
        and helps you learn effective strategies to manage
        stress and cope with upsetting situations
   Education
       Can help you and loved ones understand the
        disorder. Awareness of warning signs of mood
   Group Therapy
       Provides forum to communicate with and learn
        from others in a similar situation. May help build
        better relationship skills
   Family therapy
       Seeing a psychologist with family members. Can
        help identify and reduce stress within a family.
        Helps to communicate better, solve problems, and
        resolve conflicts
Treatment and Therapy
 Electroconvulsive   Therapy (ECT)
   Can  be effective for people who have
    episodes of severe depression, feel
    suicidal, or people who have not seen any
    improvements in symptoms despite
   Electric currents are passed through the
    brain which causes changes in brain
    chemistry that leads to improvements in
Current Research
 Children of Older Fathers at Higher Risk
 for Bipolar Disorder
   September   3, 2008
   Sperm likely to have damaged DNA due to
    ravages of time
   Conducted by Swedish medical university
    Karolinska Institute
Current Research
        Disorder and Attitudes Toward
 Bipolar
 Having Children
   November    7, 2007
   Australia

   Over  a third of relatives of people with
    bipolar disorder are afraid to have children.
    The reason for their fear seems to be a
    stigma associated with the disorder.

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