A Look at Bipolar Mania and Depression
Bipolar Disease is a psychiatric disease characterized by episodes of extreme mood swings of both Depression and mania. Depression is defined by feelings in the patient hopelessness, low energy, and no desire or interest in everyday activities. The patient could become suicidal. Mania is characterized by excess activity to the point of exhaustion, euphoria, aggressiveness, and at times, a feeling of being super human. Examples of manic behavior might be suddenly quitting your job and going to Hollywood to become an actress even though you have no previous acting history or interest. An individual in a manic phase may suddenly go on a shopping spree, buying items that are not really needed. The disorder can affect any age, but it is often triggered between ages of 25-44. Both men and women are equally affected.
Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized at first as a serious disorder, and people who have it may suffer needlessly for years. This disorder is not a character flaw, and it is not anyone’s fault. It is a serious mood disorder that affects a person’s ability to function in every day activities. It affects one’s work, family and social life.
It is now estimated that upwards of one million children in the United States are suffering from early onset bipolar disorder, and that more than half are not getting the proper help that they need. Though this statistic may be somewhat shocking, it is also evidence of a well needed change in the way we think about bipolar. Originally, it was thought that bipolar was strictly an adult disease. Children with bipolar were often labeled with learning disabilities and often as simply bad kids when in reality these children are suffering from a serious and frightening disease. Bipolar is becoming more common in children, and is being researched. As these researchers learn more about these children, they are realizing that this disorder is even more frightening in children. In manic children they have found a more severe, chronic course of illness. Many children will be both maniac and depressed at the same time and will often stay ill for years without intervening well periods and will frequently have multiple cycles of highs and lows.
Another major problem with bipolar disorder in children is that no clear treatment path has been established. While it is known that medicines used for hyperactive children does not work at all and can actually make the disorder worse, it is not known how other medications affect the bipolar child. Mood stabilizers are much more effective in children, but because there are so many varying types, it takes a long time to find the right drug for the child. These stabilizers are only half of the drug cocktail these children need though. There is also the need for an anti depressants that will not send these kids flying into mania, and they also need a medication that calms their manic rampages with out sending them into depression.
As of now there is not even a test to properly diagnose children with bipolar because the standard adult test often does not apply to them because of the rapidness of their cycling. More research must be done to ensure these children a more normal life because with the genetic nature of bipolar disorder, this disease is only going to spread further and affect more people who will need this help.
Observation of families has shown that children of one parent with bipolar disorder are seven to twenty times more likely to have manic depression than children of parents who do not have bipolar disorder. include the following: Sad mood, Fatigue or loss of energy, Sleep problems (insomnia, excessive sleeping, or shallow sleep with frequent awakenings), Weight changes (either gain or loss), Diminished ability to concentrate or make decisions, Agitation or markedly sedentary behavior, Feelings of guilt, pessimism, helplessness, and low self-esteem, Loss of interest or pleasure in life,Thoughts of, or attempts at, suicide, or threatning others.
Episodes of depression in bipolar disorder are less likely to have a specific trigger than are those with major depression disorder. Bipolar depression does not typically last as long as major depressions although left untreated some bipolar disorder episodes can still last six to 12 months. Bipolar depressive episodes develop more gradually than those caused by major depression. Depressive symptoms in bipolar disorder patients also tend to be atypical, i.e., one sees an increase in sleep and appetite, a feeling of heaviness and slowness in the body, a tendency to feel rejected, and a preservation of volatile mood.
The acute manic phase is always characterized by mood elevation, either presented as euphoria, irritability, or both. The episode lasts for at least a week or for any duration if it was severe enough to cause hospitalization. In addition, certain other symptoms are present to assist in making a diagnosis.
Distractibility is the most common symptom and is usually characterized by the inability to pay attention to any activity for very long; Insomnia in mania typically means having high energy and requiring less sleep. This differs from insomnia in depression, in which the patient has low energy plus an inability to sleep,
Patients with this symptom have an inflated sense of themselves, which, in severe cases, can be delusional. Close to 60% of all manic patients experience feelings of omnipotence. Sometimes they feel that they are godlike or have celebrity status, Flight of ideas. Thoughts literally race, Activity. An increase in intensity in goal-directed activities occurs, which is related to social behavior, sexual activity, work, school, or combinations, Speech. Excessive talking is present, Thoughtlessness. Excessive involvement in high-risk activities is present such as unrestrained shopping, promiscuity. Mood disturbance may be severe enough to damage one’s job or social functioning or relationships with others, or which require hospitalization to prevent harm to others or to the self.
Bipolar disorder affects both sexes equally, but there is a higher incidence of rapid cycling and mixed states in women. On the other hand, early onset bipolar disorder tends to occur more frequently in men and is associated with a more severe condition.
It is important to note that an estimated 15% to 20% of patients who suffer from bipolar disorder and who do not receive medical attention commit suicide.
A small percentage of bipolar disorder patients demonstrate heightened productivity or creativity during manic phases. More often, however, the distorted thinking and impaired judgment that are characteristic of manic episodes can lead to dangerous behavior, including the following: A person may spend money with abandon, causing financial ruin in some cases. Become angry, paranoid, and even violent behaviors are not uncommon during a manic episode. Some people are openly promiscuous. Often such behaviors are followed by low self-esteem and guilt, which are experienced during the depressed phases. During all stages of the illness, patients need to be reminded that the mood disturbance will pass and that its severity can be diminished by treatment.
Up to 60% of bipolar disorder patients abuse substances (most commonly alcohol, followed by marijuana or cocaine) at some point in the course of their illness.
Patients do not work out their negative behaviors such as spending sprees or even becoming verbal or physical aggression in a room by themselves. They have a direct effect on others around them. It is very difficult for even the most loving families or caregivers to be objective and sympathetic with an individual who periodically and unexpectedly creates havoc around them. Many patients and their families, therefore, cannot admit that these episodes are part of an illness and not simply extreme, but normal, characteristics. Such denial is often strengthened by patients who are highly articulate and deliberate and can intelligently justify their destructive behavior, not only to others, but also to themselves.
Bipolar disorder is usually diagnosed and treated by a psychiatrist or a psychologist with medical assistance. In addition to an interview, several clinical inventories or scales may be used to assess the patient’s mental status and determine the presence of bipolar symptoms. The tests are verbal and/or written and are administered in both hospital and outpatient settings.
Bipolar symptoms often present differently in children and adolescents. Manic episodes in these age groups are typically characterized by more psychotic features than in adults, which may lead to a misdiagnosis of schizophrenia .Children and adolescents also tend toward irritability and aggressiveness instead of elation. Further, symptoms tend to be chronic, or ongoing, rather than acute, or episodic. Bipolar children are easily distracted, impulsive, and hyperactive, which can lead to a misdiagnosis of attention deficit hyperactivity disorder. aggression. often leads to violence, which may be misdiagnosed as a conduct disorder. Treatment of bipolar disorder is usually by means of medication.
A combination of mood stabilizing agents with antidepressants, antipsychotics, and anticonvulsants is used to regulate manic and depressive episodes. Calcium channel blockers, typically used to treat angina and hypotension have been found effective, in a few small studies, for treating rapid cyclers. Calcium channel blockers stop the excess calcium build up in cells that are thought to be a cause of bipolar disorder. They are usually used in conjunction with other drug therapies such as carbamazepine or lithium.
While most patients will show some positive response to treatment, response varies widely, from full recovery to a complete lack of response to all drug and ECT therapy. Drug therapies frequently need adjustment to achieve the maximum benefit for the patient. Bipolar disorder is a chronic recurrent illness in over 80% of those afflicted, and one that requires lifelong observation and treatment after diagnosis. Patients with untreated or inadequately treated bipolar disorder have a nine year decrease in life expectancy. With proper treatment, the life expectancy of the bipolar patient will increase by nearly seven years and work productivity increases by ten years.
If you suspect you have Bipolar Disease or know someone who you think may have, it is very important to get examined by a doctor and get medical treatment. It is a matter of life or death.
