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Bipolar Disorder

UNDERSTAND AND PREVENT BIPOLAR DISORDER

 

This course is about a mood disorder that is so commonly discussed in the media of late-bipolar disorder. Although this disorder is not as common as depression, the number of bipolar disorder diagnoses appears to be rising, mainly because of new research and consideration of symptoms that do not meet the full criteria for bipolar but do have many similar symptoms that cause significant impairment. Such symptomatology may comprise other bipolar categories that are considered part of the “bipolar disorder spectrum.” 

(26) Bipolar Disorder

Bipolar and Sex

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Are people from different ethnic backgrounds more susceptible to bipolar disorder?

The concept of medicine being guided by ethnic or racial differences has recently ignited controversy over the FDA’s approval of BiDil in the treatment of heart failure in blacks.

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(27) Bipolar Disorder

The REAL Cause of Bipolar Disorder

Bipolar-Disorder26

I have recently been diagnosed with bipolar disorder. What are the risks my children will inherit it?

The lifelong prevalence worldwide is anywhere from 0.3 to 1.6% for bipolar I disorder and larger for bipolar II disorder, with rates adding an additional 0.5 to 4% to the total number, depending on the epidemiological study.

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(28) Bipolar Disorder

"Up/Down" Bipolar Disorder Documentary FULL MOVIE (2011)

About the movie:

There are approximately 5.7 million people in the United States with bipolar disorder. In an attempt to eliminate the mystery and misinformation surrounding the illness, many throughout the country diagnosed with this condition were interviewed extensively. They diligently explain the struggle to balance themselves between floating to a state of euphoria and sinking to a devastating depression.

In short, "Up/Down" is a personal analysis of bipolar disorder from those living with it. Looking for something with a more scientific or clinical angle?
"Bipolar disorder is just one of many mental illnesses that is still highly stigmatized in our culture today, and 'Up/Down' could certainly be instrumental in changing that fact."
-Microfilmmaker Magazine, Issue 65

BD27

Is there a link between epilepsy and bipolar disorder?

Questions about a possible link between epilepsy and bipolar disorder naturally arise due to the fact that anticonvulsants also treat bipolar disorder. From a historical standpoint epilepsy was first thought to be a purely mental or psychological disease, although at that time neurologists were the only specialists who treated both neurological as well as psychiatric conditions, and most medical people felt that psychiatric disorders were fundamentally neurological in origin.

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(29) Bipolar Disorder

How to Recognize the Symptoms of Bipolar Disorder

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I have recently been diagnosed with depression, but I have a family history of bipolar disorder. What is my risk of becoming manic if I take antidepressant medication?

Part of a comprehensive mental health evaluation involves a detailed past personal psychiatric history as well as a family psychiatric history. The family psychiatric history is important because many psychiatric conditions have a heritable component and can inform the clinician as to risks for certain conditions.

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(30) Bipolar Disorder

The REAL Cause of Bipolar Disorder

BD30

I have been treated for bipolar depression in the past. Can I prevent an episode in the future?

The likelihood of an individual with bipolar depression having another episode of depression as opposed to a manic episode is very high, just as the likelihood of a bipolar individual with a recent manic episode is at greater risk for the next episode being mania. In the majority of bipolar II patients, for every day spent hypomanic they will spend, on average, thirty-seven days depressed. More than half of people who have been depressed will have another episode at some point in the future. The risk for future episodes increases with more episodes of depression. The single biggest measure you can take to prevent a future episode is to stay on medication rather than to stop it.

Other ways to lower the risk for recurrence include reducing stress levels and developing problem-solving strategies. Exercise, good nutrition, and adequate sleep promote a healthy sense of wellness, which can ward off negative effects of stress. In addition, a lack of adequate sleep can be associated with increased irritability, malaise, and poor functioning during the day, which may precipitate either mania or depression in someone who is vulnerable. Some people find that the use of relaxation techniques such as meditation or yoga reduces stress levels.

Psychotherapy helps an individual develop new coping styles and insights into his or her responses to stressful events. Increased self-awareness and self-esteem provide reduced vulnerability to situations that could precipitate an episode. Also, early recognition of the signs and symptoms of either mania or depression allows for early treatment intervention, which can hasten recovery. The single most important recommendation, however, is to stay on your medication and seek help as soon as possible when you perceive yourself slipping back into depression so that your medication can be reevaluated.

Leslie’s comments:

Experiencing bipolar depression is devastating and I live in fear that I will have another episode. In order to prevent it I stay on my medication and see a psychotherapist every week but there are times when even with these measures in place that I seem to begin slipping into a depression. I am very frightened by it and it is difficult to even go to work during these times. I begin questioning my medication; I begin questioning my purpose in life; I question whether I’ll ever feel better again. And that’s not even a full-blown depression; that’s just dipping my toe into that darkness.

What is my risk for bipolar disorder if diagnosed with cyclothymia?

Considered a less-severe form of bipolar disorder, cyclothymia is characterized by swings between hypomanic episodes and short periods of depression (that do not meet the criteria for major depression). The prevalence of cyclothymia is between 0.4% and 1% of the U.S. population, usually starting in adolescence or young adulthood. Although the presence of cyclothymia does not mean you have “early” bipolar disorder or will definitely get bipolar disorder, your risk for developing the disorder is anywhere between 15% and 50%.

More importantly, the condition must be recognized when seeking treatment, as pharmacologic treatment with an antidepressant for the depressive periods can result in a switch to mania, thus making the onset of bipolar disorder more likely. If you need medication, your doctor will likely prescribe a mood stabilizer, in accordance with the guidelines for treatment of bipolar disorder. Psychotherapy can possibly reduce the risk for major depression and mania, much in the way it is used to reduce risk for relapse in bipolar disorder.

Is it true that people with creative or artistic minds are at greater risk for bipolar disorder?

Probably the most well-known case of artistic genius associated with mental illness is that of Vincent VanGogh. During his lifetime the clear distinction between manic-depressive disorder (now known as bipolar disorder) and schizophrenia was not well established. Emil Kraeplin was the first clinician to clearly delineate these disorders phenomenologically.

That is, he was the first to make careful observations about their different behavioral manifestations and course. Previously, the distinction between psychotic patients who made a full recovery and those who seemed to generally deteriorate over the course of their lives was thought due to disease versus an inherited condition. Although Van Gogh seemed to suffer from cyclical episodes, the question of Van Gogh’s diagnosis remains speculative.

Ernest Hemingway is often cited as another example of a genius who suffered from bipolar disorder, despite the fact that there is no evidence that he ever suffered from mania, other than his propensity to engage in risk-seeking behavior. Like most risk takers, he suffered from numerous concussions throughout his life. He was also a heavy drinker and began taking several prescription medications in his last two decades. His own psychiatrist, who never diagnosed him with manic depression, treated him for recurrent depression.

The current DSM system has been in existence only twenty-five years; to apply it to ancient descriptions of artists’ lives is not only complex but also culturally and historically misinformed. The need to believe in the link between artistic genius and madness remains a biased proposition from the start, and thus anytime an example of it shows itself people immediately believe it to be true. What about current-day artists and current-day diagnostic categories? A 1986 study demonstrated a link between artistic creativity and bipolar disorder among writers, showing that among a group of writers, 13% suffered from bipolar disorder as opposed to 2% of the general population, and 80% suffered from a mood disorder in general. More recently, a study by Kay Redfield Jamison of forty-seven British writers, painters, and sculptors from the Royal Academy found that 38% had been treated for bipolar disorder. Other studies have shown that artists report intense productively creative episodes followed by lows in output.

Unfortunately, these studies suffer from small sample sizes and biases toward highly recognized award-winning individuals. Dr. Jamison has been reluctant to state that there is a definitive association, commenting that perhaps her own creativity was a consolation prize for her own bipolar illness.

Whether or not there is a link, the biggest concern that artists and writers have is that treatment of their illness will in turn sap their creativity. Given that most artists and writers do not have the luxury of relying on manic episodes to be at their creative best, it is doubtful that the highs and lows of bipolar disorder contribute much to one’s creativity. Manic episodes may, however, negatively contribute to focus, concentration, and energy. There is no evidence that treatment will affect one’s productivity. In fact, ample evidence shows that lack of treatment and continued episodes of highs and lows contribute greatly to one’s morbidity and mortality, as Peter Kramer argues in his most recent book, Against Depression. Manic conditions may be viewed by the public in a romantic fashion as an indicator of a creative mind, but for those who suffer from such conditions, the reality is very much different. Bipolar conditions are as debilitating and painful as any other serious medical condition and must be treated as such.

 

 

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