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Bipolar Disorder Can Be Treated Successfully

Kaneria Lg HSRakesh M. Kaneria, MD, is a psychiatrist at Atrium Medical Center in Middletown.

Q. What is bipolar disorder? How can I recognize it? How is it treated?

A. Affecting more than 10 million men and women in the United States, bipolar disorder is a chronic mental illness that causes shifts in mood and energy. It generally develops during the late teen and early adult years, but may also occur during childhood and later life. The cause is unknown, but it is thought to be a combination of genetics and other factors, which can include brain chemicals and one’s environment.

Bipolar symptoms can significantly interfere with an individual’s functioning at all levels. In severe cases, bipolar disorder can result in suicide. When managed carefully and appropriately by a trained health care provider, people with bipolar disorder often lead full and productive lives.

Bipolar disorder is also called “manic depression” because people with this disorder experience highs, known as manic or hypomanic episodes, and lows, known as depressive episodes. During periods of mania, a person may suffer from symptoms such as feeling very happy or irritable, feeling extremely self-confident, being very active, sleeping much less, talking a lot and fast, having racing thoughts, being easily distracted and having impaired judgment. During periods of depression, a person may experience sad mood, hopelessness, guilt, problems with concentration, tiredness and changes in eating and sleeping. Some individuals with bipolar disorder have mixed states, when they have symptoms of both mania and depression present at the same time. In severe cases, people experience psychosis, where they sense something that is not actually present and/or have unusual or unrealistic beliefs.

While bipolar disorder is generally a life-long disease, people tend to have episodes that increase in frequency and severity over time. However, some can go for extended periods with no symptoms. Bipolar symptoms vary from person to person, and even within the same individual from episode to episode.

Research shows that some people will suffer from symptoms for years before the proper diagnosis of bipolar disorder is made and the appropriate treatment is started. Thus, recognizing bipolar disorder can be difficult. Awareness of mood changes, both highs and lows, is key. They may be self-recognized or observed by a relative or friend. Other signs to consider include inability to complete tasks, extreme irritability, trouble with work or home relationships, drug or alcohol abuse, risky behavior (typically sexual or financial in nature) and sleep problems.

It is important to remember that we all go through a range of emotions in everyday life. However, in bipolar disorder, the mood states can last for longer periods of time, like weeks. Bipolar symptoms also can significantly affect an individual’s ability to function.

Currently no medical test can diagnose bipolar disorder. Your health care provider should conduct a thorough diagnostic evaluation, including a history of symptoms and family history of bipolar disorder. A physical examination and some lab tests may also be conducted to rule out other potential causes.

Medication is a treatment cornerstone. Commonly prescribed treatments include mood stabilizers, atypical antipsychotics and psychotherapy. Mood stabilizers (such as lithium and valproate) and atypical antipsychotics (such as aripiprazole, risperidone, olanzapine and quetiapine) are approved by the Food and Drug Administration for certain phases of bipolar disorder. Although controversial, antidepressants are used to treat depression in individuals with bipolar disorder. Often more than one medication is required to lessen symptoms. Psychotherapy can help an individual remain stable for periods of time, as it provides better ways of coping and restructures thinking and behavior. Whatever treatment methods are used, the benefit-risk profile needs to be considered by the health care provider and the patient.

Acute treatment focuses on current bipolar symptoms and continues until they are resolved for a period of time. Continuation treatment aims to prevent symptoms from the same mood episode from returning. Maintenance treatment prevents a recurrence of symptoms.

Bipolar disorder undoubtedly changes the course of one’s life. But with appropriate, individualized treatment, people with bipolar disorder can have a positive outlook on life.

This information is for educational purposes only. Please talk to your physician for advice in all matters related to your health.

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