Bipolar disorder - Definition
The manic-depressive psychosis also named bipolar highly emotional disorder is the psychical disease, as a rule, conditioned by the inherited factor, defiant the anomalous changes of mood and level of activity. A manic-depressive psychosis usually shows up makes debut in late juvenile or early mature age, but sometimes the first symptoms appear already in childhood. The too glad, overdriven state is named a maniac phase, and anomalously sad, oppressed -- by depressed. When the state of man includes the symptoms of both craze and depression, it is named mixed, during such state the state a man is unrestrained and painfully sensible. The symptoms of this disease of manic-depressive psychosis differ from the periodic getting up and slumps, peculiar to all people. Parahypnosiss, and also changes of behavior and activity, accompany changing of mood, sometimes a delirium and hallucinations appear also. Usually maniac and depressed phases are alternated with the normal state, such facilitated form of disease is named cyclothymia. For a patient bipolar highly emotional disorder can be diagnosed, if such unstable state is observed during all day and almost every day on an extent at least of two weeks. It is known that a 1 man suffers bipolar disorders from 100. However the row of scientists supposes that bipolar disorders meet everywhere, but at swingeing majority flow in an easy form. For many people illness can remain not educed, because they do not apply for medicare or their symptoms do not answer the generally accepted criteria. From them an erroneous diagnosis is put part "depression". Thus, prevalence of bipolar disorders in a population can come to 6%. Bipolar disorders of I of type are identically widespread among men and women, and disorder of II of type, especially with the rapid changing of phases, anymore characteristic for women. A debut of bipolar disorder usually is on age 15-30.
Reasons of bipolar disorder are unknown. However scientists are inclined to consider that to provoke of bipolar disorder can be some biochemical, genetic and external factors.
The results of hi-tech researches show that patients with bipolar disorders have physical changes in the tissues of cerebrum. The degree of expressed of these changes remains unknown until now, however they can throw light on reasons of this disease. So, in development of bipolar disorder can act part neurotransmitters, natural chemicals of cerebrum, that is responsible for a mood. Another reason of this disease can be hormonal disorders.
The genetic factors of Research show that children of patients, suffering bipolar disorders, anymore subject to this disease. Scientists try to find a gene that participates in development of bipolar disorder. Some researchers find connection between bipolar disorder and schizophrenia, specifying that both these diseases have general genetic reason. External factors Surroundings of man also play role in development of bipolar disorder. Researches show that one of twins can suffer bipolar disorder, while the second it remains to absolutely healthy. It means that reasons of this disease are not limited to genetics. External reasons can be strong stress, tragedies in the personal life, falling of self-appraisal.
Studies show that children of patients with bipolar disorders are more likely to be affected by this disease. Scientists are trying to find a gene that is involved in the development of bipolar disorder. Some researchers find a link between bipolar disorder and schizophrenia, indicating that both of these diseases have a common genetic cause.
Human environment also plays a role in the development of bipolar disorder. Studies show that bipolar disorder can suffer from one of the twins, while the second remains perfectly healthy. This means that the causes of this disease are not limited to genetics. External causes can be severe stress, tragedy in your personal life, a drop in self-esteem.
The risk of developing bipolar disorder is increased by the following factors:
- the presence of bipolar disorders in family members;
- severe stress;
- drug abuse;
Serious tragedies in your personal life, for example, loss of a loved one.
The main symptom of bipolar disorder is a constant change of mood - emotional upsurge (manic phase) and recessions (depressive phase). The severity of these symptoms can be from low to high. Sometimes in the life of such a patient there may be periods when he is not at all subject to emotional differences.
Manic phase of bipolar disorder
The manic phase of bipolar disorder may include the following symptoms:
- excessive optimism;
- heightened self-esteem;
- lack of sanity;
- fast speech;
- skipping thoughts;
- aggressive behavior;
- increased physical activity;
- strong desire to achieve the goal;
- increased sexual activity;
- no need for a full sleep;
- inability to concentrate;
- abuse of medicines.
Depressive phase of bipolar disorder
The depressive phase of bipolar disorder may include the following symptoms:
- depressed mood;
- a feeling of despair;
- suicidal thoughts or behavior;
- feeling of anxiety;
- poor sleep;
- poor appetite;
- increased fatigue;
- loss of interest in life;
- focus on problems;
- chronic pain without a physical cause.
Types of bipolar disorder
There are two main subtypes of bipolar disorder.
Bipolar disorder type I:
- The patient had at least one manic episode, preceded or not preceded by depression.
Bipolar II disorder:
- The patient had at least one depressive episode and one hypomanic episode. Hypomanic episode is similar to manic, but unlike the last one lasts only a few days and proceeds in a less severe form. During the hypomaniac episode, there may be an upbeat mood, increased excitability, difficulty concentrating, but as a rule, in this state, people normally cope with daily duties, hospitalization is not required. For bipolar II disorder, longer periods of depression are characteristic than hypomania.
Cyclothemia is a mild form of bipolar disorder. Cyclothymia is characterized by mood swings, but the phases of depression and mania are not as strong as with a full bipolar disorder.
Other types of bipolar disorder
Some people suffer from bipolar disorder with a rapid phase change. At such people sharp change of mood can be observed from 4 times a year. The mood can change very quickly, in less than an hour. There is also a bipolar disorder of mixed type. It is characterized by the simultaneous presence of symptoms of mania and depression.
Acute episodes of mania or depression can lead to psychosis or loss of sense of reality. Symptoms of psychosis may include delusions, visual and voice hallucinations.
Progression of the disease leads to serious emotional, financial and legal problems that affect all aspects of the patient's life.
The most common complications caused by bipolar disorder:
- alcohol or drug dependence;
- problems with law;
- financial difficulties;
- problems in personal life;
- poor performance or poor academic performance.
To diagnose bipolar disorder apply psychological tests and chemical analyzes. They allow you to exclude other diseases, clarify the diagnosis, and identify complications caused by the disease.
Usually the diagnosis includes the following components.
Physical health check - measurement of height and weight, measurement of blood pressure and temperature, listening to the heart and lungs, palpation of the abdominal cavity.
Lab tests - a general blood test, a blood test for thyroid hormones, other blood tests, sometimes a general urine test.
Psychological research- It is concluded in an interview with a psychotherapist. The doctor asks the patient about his thoughts, feelings, behavior, learns about alcohol and tobacco dependence. Sometimes a doctor can ask a patient to answer questions about psychological tests. In some cases, to clarify the diagnosis, the therapist communicates (with the consent of the patient) with close friends and relatives of the patient.
Diagnostic criteria for bipolar disorder
Diagnostic criteria for bipolar disorder are based on specific types of this disease, developmental history and types of episodes: manic, hypomanic and depressive.
Some researchers believe that the existing diagnostic criteria are too tough. In fact, the clinical practice of recent years shows that bipolar disorder can be combined with other diseases, which is manifested by a whole range of different symptoms. Some researchers believe that bipolar disorder is often not diagnosed, or the patient with this disease is diagnosed incorrectly and, accordingly, he does not receive the necessary treatment. This is because the existing diagnostic criteria do not describe the symptoms of milder, but no less serious forms of bipolar disorder.
When is medical care needed?
If you have at least one symptom of bipolar disorder, you should immediately seek medical help. This disease does not pass independently, if it is not treated. Until now, many people with bipolar disorders do not receive treatment and even avoid it. Despite sharp mood swings, they do not realize the effect the disease has on their lives and the lives of people close to them. Usually they like periods of euphoria, increased efficiency, but sooner or later they are replaced by a sharp emotional decline that leads to depression, a feeling of devastation, exhaustion, sometimes financial and legal problems.
For successful treatment of bipolar disorder, you need to contact a psychotherapist or psychiatrist who has experience with the treatment of this disease and can teach the patient to eliminate the symptoms of the disorder. Patients who are skeptical about the help of a therapist need to be brave and tell their problem to a loved one, close friend or spiritual mentor. Close people who can be trusted will help to make the first step in the fight against this disease.
Are you tormented by thoughts of suicide?
Patients with bipolar disorders often visit thoughts about suicide. Unfortunately, among people with mental illnesses, it is people with bipolar disorders who most often commit suicide. Such patients need to know the telephone numbers of social services that provide psychological assistance in such situations.
The hotline number of the Center for Emergency Psychological Assistance of the Ministry of Emergency Situations of Russia is 8 (495) 205-05-50.
For a patient who does not want to talk to a social worker, when thinking about suicide, you need to talk with a loved one: call family members or a good friend, a doctor who is treating you.
Is a person close to you suffering from bipolar disorder?
If a person close to you has already attempted suicide or has a serious intention to commit suicide, seek medical help. Such a person may need urgent hospitalization.
Methods of treatment
Bipolar disorder is a chronic disease that requires constant treatment throughout the life of the patient, including during periods of remission. Usually treatment is carried out by a psychiatrist who has experience in the treatment of this disease. In the treatment process, psychologists can also take part.
Correctly selected treatment can significantly reduce the frequency and intensity of manic and depressive episodes, allowing the patient to lead a normal lifestyle. Supportive treatment, which is carried out during periods of remission, also plays an important role. In patients who refuse supportive treatment, the risk of recovering the symptoms of mania and depression is higher. If the patient is abusing alcohol or drugs, he needs to prescribe a treatment that relieves addiction, since drugs and alcohol enhance the symptoms of bipolar disorder.
For the treatment of bipolar disorder, the following methods
Medications are vital for patients with bipolar disorders. Often patients refuse to take medication, because medications have side effects. The doctor's task is to select a drug that will be most suitable for the patient and not have serious side effects.
Drugs from the following groups are used to treat bipolar disorder.
- Stabilizers of mood (timoleptics) - the most commonly prescribed medication for bipolar disorder. They help to stabilize the mood and exclude changes from mania to depression. The drug of the first choice for the treatment of bipolar disorder is lithium salt. Sometimes mood stabilizers must be taken until the end of life to prevent the development of manic episodes or make their flow more mild.
- Anticonvulsants (anticonvulsants) - these drugs are used to prevent mood swings, especially in patients with bipolar fast-cycle disorder. Anticonvulsants (valproate, lamotrigine) are also used to regulate mood.
- Antidepressants - the use of antidepressants in the treatment of bipolar disorders is still in question. Some sources indicate that antidepressants are effective in bipolar disorder, but can cause manic episodes. Therefore before their appointment it is necessary to weigh all pros and cons.
Other drugs - some antipsychotics such as olanzapine and risperidone may be effective in cases in which anticonvulsants do not help. Soothing drugs, such as benzodiazepines, can improve patient sleep.
The choice of drugs for the treatment of bipolar disorder is quite wide. If some drugs are ineffective, they can be replaced by others. Sometimes it may be necessary to administer several drugs. The drug starts to work a few weeks after the start of the procedure.
It must be remembered that all drugs have side effects and can cause harm to health. For example, neuroleptics increase the risk of developing diabetes, obesity and increase blood pressure. In this regard, when taking medications, the doctor must constantly monitor the patient's health. Stabilizers of mood should be carefully prescribed to pregnant and lactating women, as they can harm a child. If a woman suffering from bipolar disorder plans a pregnancy, she should consult a doctor in order to weigh the risks and benefits of the drugs taken by the woman.
Psychotherapy is another important component of bipolar disorder therapy.
Cognitive Behavioral Therapy - this is the most commonly used type of psychotherapy for bipolar disorder. The goal of cognitive behavioral therapy is to identify a disadaptive (leading to aggravation of problems instead of solving them) behavior and teach the patient a more positive perception of reality. The doctor teaches the patient effective behavior in stressful situations, which allows to overcome them with the least damage to health and emotional balance.
Family therapy - more expensive and less common type of psychotherapy. The doctor conducts a session with the patient and members of his family to identify and minimize stressful situations in everyday family life. In the process of family therapy, family members are trained in the peaceful resolution of conflict situations.
Group therapy - this type of therapy allows patients to communicate with other patients suffering from bipolar disorder and share their experience of fighting this disease.
Electroconvulsive therapy - electroshock therapy (electroconvulsive therapy, electroconvulsive therapy) is mainly prescribed for patients suffering from deep depression with suicidal thoughts, and those who are not helped by other medication. Electroconvulsive therapy is based on triggering convulsive seizures in patients with electric stimulation of the brain. Scientists do not know how this type of therapy works. It is assumed that during convulsions caused by an electric shock, changes occur in the brain that have a beneficial effect on the patient's well-being.
Hospitalization - some patients with bipolar disorder may benefit from hospitalization. Psychiatric treatment in a hospital allows you to stabilize the mood when the patient is experiencing a manic or depressive episode. In some settings, patients with bipolar disorder are offered day care programs that also have a beneficial effect on health.
Prevention - scientists do not know how to prevent bipolar disorder. It can only be said with certainty that starting treatment in the early stages helps to stop the progression of the disease. Prolonged preventive treatment also helps to significantly alleviate episodes of mania and depression.
Lifestyle and self-control
Treatment of bipolar disorder should be controlled by a doctor. However, patients can improve the quality of the treatment process if they comply with the following recommendations.Take the medicine strictly according to the schedule compiled by the doctor. Part of the patients, feeling better, stop taking drugs. This can not be done, because the symptoms of the disease are likely to return.
Pay attention to the appearance of the first symptoms of the disease
It is necessary to discuss with the doctor what symptoms are signs of bipolar disorder and what factors can trigger the onset of the episode. The patient may ask family members to monitor his behavior and report symptoms of the disease. If the episode is suspected, contact your doctor. The therapeutic measures taken at an early stage of the episode hamper its development.
Exclude alcohol and cigarettes.
Cigarettes and alcohol can trigger the onset of an episode of bipolar disorder.
Consult with your doctor about medications.
Patients undergoing treatment for bipolar disorder should consult a doctor before taking medication prescribed by other doctors.
Fighting the disease
The fight against bipolar disorder can be long and complicated. Medicines can give undesirable side effects, and the realization that the disease needs to be treated throughout life, many causes resentment and resentment. During periods of remission, when symptoms recede, there is a great temptation to stop treatment. The following recommendations can help to successfully cope with bipolar disorder.
Gather as much information as possible about bipolar disorder
Self-education will help to better understand the therapeutic tactics of the doctor and will be an incentive for the patient's strict adherence to the curative plan.
Meet people with bipolar disorder
Communication with people who have encountered a similar problem provides good psychological support to the patient.
Always remember the purpose of treatment
Treatment of bipolar disorder is a lengthy process that requires patience and work on oneself. It is necessary to remember constantly that the purpose of treatment is not only therapy of episodes of bipolar depression, but also improvement of relationships with surrounding people, colleagues in work, solving financial and other problems.
Find a useful application of your energy
Manic episodes of bipolar disorder are easier to keep under control if you direct energy to useful activities: hobbies, fitness or outdoor activities.
Practicing relaxing techniques
You can try such well-known relaxation techniques, like yoga, meditation or Tai Chi.
St. John's wort (Hypericum perforatum)
For centuries, this herb has been used to treat various diseases, including depression. Despite the fact that it is not a medicine, it can be included in the diet. St. John's wort as a remedy for depression is especially popular in Europe. Some studies have shown its effectiveness in the treatment of mild and moderate depression.
Synthetic analogue of the natural component of blood. The product improves mood in depression, as well as the function of the liver, joints and nervous system. In Russia, adenosylmethionyl is available in the form of Heptral and Heptor preparations, which are prescription-dispensed.
Omega-3 polyunsaturated fatty acids
The preparation contains fish oil obtained from fish species that live in cold water, including salmon and mackerel. It consists of polyunsaturated fatty acids: eicosapentaenoic acid and decosahexaenoic acid (DHA). In nature, these acids are contained in flaxseed and linseed oil, as well as in smaller amounts in soy oil and canola oil. Omega 3 improves vitality and performance, alleviating the symptoms of depression.
Precautions for treatment with alternative agents
When you include in the medicinal process of alternative means, do not stop taking medications prescribed by the doctor.
Do not hide from the attending physician what preparations and alternative methods you are using or are going to try.
It must be remembered that alternative agents, even of natural origin, can interact with the main drugs prescribed by the doctor.