Bipolar Disorder
There is a tendency to romanticize bipolar disorder. Many artists, musicians and writers hold suffered from its mood swings. But in truth, many lives are ruined by this disease; and minus effective treatment, the virus is associated with an increased risk of suicide.[1]
Bipolar disorder, also specified as manic-depressive illness, is a serious brain disease that cause extreme shifts in mood, drive, and functioning. It affects approximately 2.3 million adult Americans--about 1.2 percent of the population.[2] Men and women are equally plausible to develop this disabling illness. The disorder typically emerge in young adulthood or early middle age, but in some cases appears within childhood.[3] Cycles, or episodes, of depression, mania, or "mixed" manic and depressive symptoms typically recur and may become more frequent, commonly disrupting work, school, family connections, and social life.
Depression: Symptoms include a inexorable sad mood; loss of interest or pleasure in undertakings that were once enjoy; significant change contained by appetite or body weight; difficulty sleeping or oversleeping; physical slowing or agitation; loss of animation; feelings of worthlessness or improper guilt; difficulty thinking or concentrating; and recurrent thoughts of release or suicide.
Mania: Abnormally and persistently elevated (high) mood or irritability accompany by at least three of the following symptoms: overly-inflated self-esteem; decrease need for sleep; increased talkativeness; race thoughts; distractibility; increased goal-directed activity such as shopping; physical agitation; and excessive involvement in risky behaviors or events.
"Mixed" state: Symptoms of mania and depression are present at like peas in a pod time. The symptom picture frequently includes agitation, trouble sleeping, significant change within appetite, psychosis, and suicidal thinking. Depressed mood accompanies manic activation.
Especially impulsive in the course of weakness, the episodes may be separated by periods of wellness during which a personage suffers few to no symptoms. When 4 or more episodes of illness take place within a 12-month time, the person is said to own bipolar disorder with speedy cycling. Bipolar disorder is often complicated by co-occurring alcohol or substance invective.[4]
Severe depression or mania may be accompany by symptoms of psychosis. These symptoms include: hallucinations (hearing, seeing, or otherwise sensing the presence of stimuli that are not there) and delusion (false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a personality's cultural concepts). Psychotic symptoms associated with bipolar typically parallel the extreme mood state at the time.
Treatments
A variety of medication are used to treat bipolar disorder.[5] But even with optimal medication treatment, plentiful people next to the illness own some residual symptoms. Certain types of psychotherapy or psychosocial interventions, in combination with medication, habitually can provide additional benefit. These include cognitive-behavioral analysis, interpersonal and social rhythm therapy, domestic therapy, and psychoeducation.[6,7]
Lithium have long been used as a first-line treatment for bipolar disorder. Approved for the treatment of acute passion in 1970 by the U.S. Food and Drug Administration (FDA), lithium have been an successful mood-stabilizing medication for many those with bipolar disorder.
Anticonvulsant medication, particularly valproate and carbamazepine, enjoy been used as alternatives to lithium surrounded by many cases. Valproate be FDA approved for the treatment of acute mania contained by 1995. Newer anticonvulsant medications, including lamotrigine, gabapentin, and topiramate, are one studied to determine their efficacy as mood stabilizers in bipolar disorder. Some research suggests that different combinations of lithium and anticonvulsants may be helpful.
According to studies conducted in Finland in patients near epilepsy, valproate may increase testosterone levels within teenage girls and produce polycystic ovary syndrome within women who began taking the medication past age 20.[8] Increased testosterone can lead to polycystic ovary syndrome beside irregular or absent menses, portliness, and abnormal growth of tresses. Therefore, young feminine patients taking valproate should be monitored carefully by a physician.
During a depressive episode, citizens with bipolar disorder commonly require further treatment with antidepressant medication. Typically, lithium or anticonvulsant mood stabilizers are prescribed along next to an antidepressant to protect against a switch into mania or swift cycling. The comparative efficacy of various antidepressants contained by bipolar disorder is currently being studied.
In some cases, the newer, atypical antipsychotic drugs such as clozapine or olanzapine may comfort relieve severe or refractory symptoms of bipolar disorder and prevent recurrences of mania. More research is needed to establish the sanctuary and efficacy of atypical antipsychotics as long-term treatments for this disorder.
Research Findings
More than two-thirds of people beside bipolar disorder have at smallest one close relative with the disorder or beside unipolar major depression, indicating that the disease have a heritable component.[9] Studies seeking to identify the genetic basis of bipolar disorder indicate that susceptibility stems from multiple genes. Scientists are continuing their dig out for these genes using advanced genetic analytic methods and large sample of families artificial by the illness. The researchers are hopeful that ID of susceptibility genes for bipolar disorder, and the brain proteins they code for, will make it possible to develop better treatments and preventive interventions targeted at the underlying complaint process.
Researchers are using advanced imaging techniques to examine brain function and structure in empire with bipolar disorder.[10,11] An historic area of imaging research focuses on identify and characterizing networks of interconnected nerve cell in the brain, interactions among which form the principle for normal and peculiar behaviors. Researchers hypothesize that abnormalities within the structure and/or function of certain brain circuits could underlie bipolar and other mood disorders. Better sensitive of the neural circuits involved in regulating mood states will influence the development of bright and better treatments, and will ultimately aid in diagnosis.
New Clinical Trial
NIMH have initiated a large-scale study at 20 sites across the U.S. to determine the most effective treatment strategies for family with bipolar disorder. This study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), will follow patients and document their treatment outcome for 5 to 8 years. For more information, call round the Clinical Trials page of the NIMH Web site.
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