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Bipolar disorder


Doc,

When I was in my twenties, I was hospitalized after I went through a phase of having highs and lows in my mood. I was diagnosed with bipolar disorder, but it has been a struggle ever since, especially in terms of getting on the right medications. Could you explain this disease and how it works, and who is at risk for developing it? What kind of medications can be used to treat it and why is it so difficult to manage?

From,

Moody Monday

Moody Monday,

Bipolar disorder, or manic depression as it's also known, affects 5.7 million Americans each year, which is around 2.6% of the population. Despite its relatively small numbers, the World Health Organization notes it is the 6th leading cause of disability worldwide. Most Americans may know one or more people who suffer from this disease, which is why it is important to understand how it can affect our loved ones or ourselves.

Bipolar disorder is defined as a mental disorder that can cause rapid shifts in mood and energy level in a short period of time. It is diagnosed equally across all ethnic groups and has about similar numbers of male and female sufferers. Usually experiencing their first symptoms in their mid-twenties, people with bipolar disorder can have their first symptoms as late as their 40s.

Manic depression is called such because of the mood swings associated with it. Mania is a distinct period in which sufferers may define themselves as feeling "up" or "wired", having lots of energy, talking and thinking very quickly, or participating in risky behaviors, such gambling sprees or reckless driving. These periods can last for days to months depending on their intensity, and it is often during these phases that people can be hospitalized. In contrast to the mania, sufferers can also develop severe depression. Depression is defined by "feeling down", low energy, sleep changes, and a general sadness about life which can last months to years.

Bipolar disorder is typically diagnosed by a licensed health care provider, usually a psychiatrist. If you are experiencing these symptoms, going to your primary care doctor is important to ensure your symptoms are not caused by another medical condition.

Bipolar disorder tends to coexist with other mental health disorders. Most commonly, people can experience psychosis, which can consist of hallucinations or delusions. These thoughts will often follow which mood is on display. For example, if someone is in the midst of a manic phase, they may believe they're famous or be very rich. If someone is experiencing depression, they may feel like they're penniless or ruined.

Many people with this disorder can also experience anxiety or substance abuse issues. It is important if you notice signs of drug abuse, that you try to get your loved one into a medical provider or a substance abuse program to deal with their addiction issues.

Bipolar disorder is typically linked with genetics or a family history of mental illness. Certain genes can increase our risk of developing this disease, as can having parents who suffer from bipolar disorder.

Often, many people go undiagnosed for years before receiving a correct diagnosis of bipolar disorder. Manic depression is a lifelong illness, and while it can be controlled with medications, it is important that those with the disorder stay connected with a healthcare provider. People are more likely to seek treatment during a depressive phase, but it is important they relay any symptoms of intermittent uplifted mood to avoid a false diagnosis.

Typically, treatment for bipolar can include mood stabilizers (like lithium), antipsychotic medications (like Seroquel), or a combination of these medications with an antidepressant (like citalopram). In addition to medications, therapy can be very beneficial. Cognitive behavioral therapy (CBT) is a form of therapy that teaches the individual how to recognize when they are having mood shifts and how to deal with those moods and any other stressors appropriately. Therapists can also do family-focused therapy for those who family life suffers due to their disease.

Bipolar disorder has so many facets, but with the wonders of modern medicine, those who suffer can lead a normal, healthy life as long as they stay connected to the healthcare system.

Nisha Viswanathan is a graduate of UAMS, a hospitalist physician at White River Medical Center, and a Board of Trustee member of the Arkansas Medical Society. Have questions regarding health or health policy? Please send an email to AskTheDoc@guardonline.com.