Bipolar Affective Disorder

About 1 in 100 people in the US has bipolar affective disorder, also known as manic depression. in this disorder, episodes of elation and abnormally high activity levels tend to alternate with episodes of low mood and abnormally low energy levels (depression). More than half of all people with bipolar affective disorder have repeated episodes. trigger factor for manic and depressive episodes are not generally known, although they are sometimes brought on in response to a major life-event, such as a marital breakup or bereavement. Bipolar affective disorder usually develops in the early 20s and can run in families, but exactly how it is inherited is not known.

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Symptoms of mania and depression tend to alternate, each episodes of symptoms lasting an unpredictable length of time. between periods of mania and depression, mood and behavior are usually normal. however, a panic phase may occasionally be followed immediately by depression. sometimes, either depression or mania predominates to the extent that there is little evidence of a pattern of changing moods. Occasionally, symptoms of mania and depression are present during the same period.

The symptoms may include:

· Elated, expansive, or sometimes irritable mood.
· Inflated self-esteem, which may lead to delusions of great wealth, accomplishment, creativity, and power.
· Increased energy levels and decreased need for sleep.
·Distraction and poor concentration.
· Loss of social inhibitions.
· Unrestrained sexual behavior.
· Spending excessive sums of money on luxuries and vacations.

Speech may be difficult to follow because the person tends to speak rapidly and change topic frequently. At times, he or she may be aggressive or violent and may neglect diet and personal hygiene.

During an episode of depression, the main symptoms include:

· Feeling generally low.
· Loss of interest and enjoyment.
· Diminished energy level.
· Reduced self-esteem.
· Loss of hope for the future.

While severely depressed, an affected person may not care whether he or she lives or dies. About 1 in 10 people with bipolar disorder eventually attempts suicide.

In more severe cases of bipolar disorder, delusions of power during manic episodes may be made worse by hallucinations. When manic, the person may hear voices that are not there praising his or her qualities. In his or her depressive phase, these imaginary voices may describe a person’s inadequacies and failures. in such cases, the disorder may resemble schizophrenia.

It may be helpful to think of the various mood states in bipolar disorder as a spectrum or continuous range. At one end is severe depression, above which is moderate depression and then mild low mood, which many people call “the blues” when it is short-lived but is termed “dysthymia” when it is chronic. Then there is normal or balanced mood, above which comes hypomania (mild to moderate mania), and then severe mania.

In some people, however, symptoms of mania and depression may occur together in what is called a mixed bipolar state. Symptoms of a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. A person may have a very sad, hopeless mood while at the same time feeling extremely energized.

Bipolar disorder may appear to be a problem other than mental illness—for instance, alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships. Such problems in fact may be signs of an underlying mood disorder.

What might be done?
During a manic phase, people usually lack insight into their condition and may not know that they are ill. Often a relative or friend observes erratic behavior in a person close to him or her and seeks professional advice. A diagnosis of bipolar affective disorder is based on the full range of the person’s symptoms, and treatment will depend on whether the person is in a manic or a depressive phase. For the depressive phase, antidepressants are prescribed, but their affects have to be monitored to ensure that they do not precipitate a manic phase. during the first days or weeks of a manic phase, symptoms may be controlled by antipsychotic drugs.

Some people may need to be admitted to the secure environment of a hospital for assessment and treatment during a manic phase or a severe depressive phase. They may feel creative and energetic when manic and may be reluctant to accept long-term medication because it makes them feel “flat”.

Most people make a good recovery from manic-depressive episodes, but recurrences are common. for this reason, initial treatments for depression and mania may be gradually replaced with lithium, a drug that has to be taken continuously to prevent relapse. If lithium is not fully effective, other types of drugs, including certain anticonvulsant drugs, may be given. In severe cases in which the drugs have no effect, electroconvulsive therapy may be used to relieve symptoms by including a brief seizure in the brain under general anesthesia.

Once symptoms are under control, the person will need regular follow-ups to check for signs of mood changes. A form of psychotherapy can help the person come to terms with the disorder and reduce stress factors in his or her life that may contribute to it.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies


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