BIPOLAR DISORDER


 BIPOLAR DISORDER

Definition:

•Bipolar disorders are described by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a group of brain disorders that cause extreme fluctuation in a person's mood, energy, and ability to function.

Triggers of bipolar disorder:

•Insufficient amount of sleep.

•Substance abuse 

•Altercation with loved ones 

•Loss of loved ones 

•Seasonal disorder 

•Pregnancy and other hormonal imbalance.

Risk Factors and etiology:

•Stressful life 

•Family history and genetics 

•Substance abuse 

•Neurological and brain disorders


GABA and Acetylcholine plays important role in many neurological functions and imbalance in these two can cause bipolar disorder.

Clinical features:

•There are mood episodes among people suffering from bipolar disorder.

•Over joyous or over excited state of behavior for longer period of time is called as "manic episode".

•Lowered mood or less pleasure in day to day activities for longer period of time is called as "depressive episode."

•Mood can swing between hypermania to hypomania and severe depression to mild depression depending upon the symptoms of each episode.

Symptoms:

Behavioral changes during manic episodes:

• Talking very fast 

•Jumbing from one idea to another 

•Distracted easily 

•Sleeping less or no sleep at all  

•Restless 

•Impulsive behavior 

Mood changes during manic episodes:

•Feeding over joy 

•Jumbing ideas and over excited 

Behavioral changes during depressive episodes:

• Feeling low.

•Sleeping disturbances.

•No concentration.

• Eating habits changed 

•Sucidal thoughts 

Mood changes during depressive episodes: 

• Lowered mood.

•Less interested.

Types of bipolar disorder:

Bipolar I disorder: It has  at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).

Bipolar II disorder: It has at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.

Cyclothymic disorder: Lasts at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).

Unsepcified bipolar : not coming under any other type of bipolar and are related to disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.

Diagonsis:

•Phsyical examination.

•Psychological examination.

•Mood charting.

•DSM-5 where symptoms are the criteria.

Management:

•Medication:

》Mood stabilizers; Lithium

》Anti-anxiety; Banzodiazapine

》Antidepressants; mood stabilizers and anti psychotic 

》Antipsychotics; Olanzapine

•Psychtherapies:

》Interpersonal and social rhythm therapy (IPSRT); IPSRT focuses on the stabilization of daily rhythms, such as sleeping, waking and mealtimes

》Cognitive behavioral therapy (CBT):The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones.

》Psychoeducation: Learning about bipolar disorder (psychoeducation) can help you and your loved ones understand the condition. 

》Family-focused therapy: Family support and communication can help you stick with your treatment plan and help you and your loved ones recognize and manage warning signs of mood swings.

•Substance abuse treatment.

•Early hospitalization if patient is violent.















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