Is There Any Antidepressants That Do Not Cause Weight Gain Bipolar Disorder In A Nutshell

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Bipolar Disorder In A Nutshell

Bipolar disorder, formerly called manic-depressive illness, is one of several disorders known as mood disorders. Mania and depression alone or in combination are the characteristics of the mood disorders. Mania is characterized by a feeling of euphoria in which the individual has grandiose ideas, exhibits boundless energy, needs little sleep, and displays great self-assurance. While in a manic state, people’s thoughts race, they speak too quickly, and show poor judgment. Manics may impulsively spend too much money, commit sexual indiscretions, and alienate people with their irritability and impatience. Hypomania refers to a milder form of mania that is an excessive amount of elation but does not significantly affect the individual’s life.

Depression can be characterized by many symptoms, including feelings of worthlessness, guilt and sadness. When one is depressed, life seems empty and overwhelming. The depressed individual has difficulty concentrating, cannot make decisions, lacks confidence and cannot enjoy activities that were previously enjoyable. Physical symptoms may include weight gain or loss, too much or too little sleep, agitation or lethargy. Depressed individuals may be preoccupied with death or suicide. They may believe that they have committed the unforgivable sin and that loved ones would be better off without them.

Bipolar disorder is so named because those affected by it experience both mania and depression, unlike those with unipolar disorders, who experience only one extreme, usually depression. Bipolar disorders are classified into two types, Bipolar I and Bipolar II. In Bipolar I, the individual experiences both mania and depression; in Bipolar II the individual experiences hypomania and depression. Mania or hypomania is the key to diagnosing bipolar disorder. A person who experiences a manic state even once is assumed to have bipolar disorder. Manic and depressive states can immediately precede or follow each other or can be separated by long time intervals, and the individual can have more episodes of one pole than the other. Some individuals, known as rapid cyclers, will experience four or more episodes per year.

The age of onset for bipolar disorder is younger than for unipolar depression and usually begins in the late teens or twenties, but rarely begins after age 40. In some cases, it is preceded by a condition called cyclothymia, which is a milder form of mood disorder, characterized by marked moods and mood swings for at least two years. Bipolar disorder is a chronic disorder and even with treatment less than half of the individuals who experience it go five years without a manic or depressive episode. People with bipolar are at risk for suicide during the depressive phase and are more prone to accidental death during the manic phase due to impulsivity and poor judgment.

The causes of bipolar disorder are unclear, but it is likely determined by multiple factors. Family and adoption studies have consistently indicated a genetic predisposition to mood disorders. First-degree relatives of individuals with bipolar disorder are much more likely than the general population to experience bipolar depression, unipolar depression, and anxiety. At this point, however, there is no clear evidence that a particular gene is linked to the transmission of bipolar disorder; instead it seems that a family history increases vulnerability to various disorders.

Neurotransmitters in the brain have been widely studied and are very likely involved in bipolar disorder, but in complex and interacting ways not yet understood. The relationship between neurotransmitters and the hormones secreted by the hypothalamus, pituitary and adrenal glands seems to be significant. There is also speculation that bipolar disorder may be related to circadian rhythms, as some people with bipolar disorder are particularly sensitive to light and show abnormalities in sleep patterns such as entering REM sleep too quickly, intense dreaming and the deeper stages of miss sleep

Stressful life events can trigger episodes of mania or depression, but do not appear to be the primary cause of bipolar disorder. Psychosocial factors such as attributional style, learned helplessness, attitudes, and interpersonal relationships all appear to be correlated with bipolar disorder but have not been identified as causes; they are often the result of such a disorder. It seems that a genetic vulnerability combined with stressful psychological and sociocultural events can result in bipolar disorder.

Three primary treatment modalities are most commonly used for bipolar disorder. Medication is often used, especially lithium. For reasons that are not yet fully understood, lithium reduces the frequency of episodes, and many individuals with bipolar disorder are kept on lithium for long periods. Lithium levels must be carefully monitored through blood tests, and there can be side effects such as weight gain, lethargy and kidney failure. Because of the side effects of medication and because they lack the energy of hypomania and manic states, people with bipolar disorder may stop taking their medication. The newer antidepressants that affect serotonin levels are often used, but there is some suspicion that they may contribute to faster cycling. Antiseizure medication, such as carbamazepine, is also used.

A second treatment approach that is sometimes used is electroconvulsive therapy (ECT). This approach is only used in severe cases in which uncontrollable behavior or the threat of suicide makes it impossible to wait two to three weeks for medication to take effect. ECT, used to treat people who have not responded to other forms of treatment, is often effective but is subject to side effects: temporary short-term memory loss and confusion immediately after treatment.

Psychotherapy is the third treatment approach. While many psychotherapeutic approaches have been tried, cognitive therapy and interpersonal therapy are currently the most popular. Cognitive therapy focuses on identifying and correcting faulty thinking and attributional styles so that the client can gain cognitive control of emotions. Interpersonal therapy focuses on developing the skills to identify and resolve interpersonal conflicts, which often accompany bipolar disorder. Both of these psychotherapies are highly structured and short-term. Many people receive a combination of both medication and psychotherapy to stabilize them and prevent relapse.

In addition to addressing the potential causes of bipolar disorder, psychotherapists help people deal with a number of problems that arise in life with the disorder. One is the difficulty of living with interruptions in his life that bring manic and depressive states. People may be too sick to work or elderly and may even be hospitalized. Another problem is undoing or dealing with inappropriate behavior that was carried out in a manic state, when the individual may have recklessly spent money, made grandiose promises, or said inappropriate things. A third common problem is dealing with negative reactions and distrust from family, friends and co-workers who are affected by the individual’s extreme mood swings. Taking medication regularly is a struggle for some people, a struggle that is exacerbated by the tendency for people in a manic or hypomanic state to feel that they do not need medication. People with bipolar disorder deal with the constant fear that their feelings can spin out of control. They often feel powerless and as if their illness is in control and could take over at any moment. There is also the question of why God allows people to go through such struggles. People with bipolar disorder need therapists who help them exercise cognitive control over their emotions, recognize when they are getting too high or too low, manage interpersonal relationships, cope with life stressors, and understand how to cope with bipolar successfully accepting and living with disorder.

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