Understanding Bipolar Disorder
Today, approximately 5.7 million U.S. adults in the U.S. have bipolar disorder, a serious mental illness. Also known as manic-depressive disorder, the illness is characterized by extreme mood swings.
Bipolar disorder typically develops during an individual’s late teen or early adult years, with half of all cases emerging before age 25.
Bipolar disorder is characterized as one of several types, depending upon the cluster of symptoms:
- Bipolar I— requires at least one full manic episode, with or without depressive episodes.
- Bipolar II – features cycles of depression and elevated moods (often referred to as hypomanic episodes) that do not reach the level of a full mania.
- Bipolar Disorder Not Otherwise Specified (BP-NOS) — does not fully meet criteria for Bipolar I or II or follow a fixed pattern.
- Cyclothymia – exhibits much milder symptoms of the disorder.
An estimated 10-20% of affected individuals also experience rapid cycling, characterized by at least four episodes in one year.
Manic symptoms include excessive excitement, restlessness, increased energy, racing thoughts, irritability, sleeplessness, and a tendency to engage in reckless and impulsive actions.
Depressive symptoms include sadness, crying episodes, weight loss or gain, feelings of hopelessness or helplessness, decreased energy, loss of interest in daily activities, and thoughts of death or suicide.
Sometimes psychotic symptoms may also be present, such as hallucinations or delusions; e.g., “I am the wealthiest person in the world.”
While the causes of bipolar disorder are not completely understood, several risk factors may influence its development.
An individual whose parent or sibling has the disorder is up to six times more likely to develop the illness. Researchers are seeking specific genes that play a causative role. MRIs have shown structural changes in the brains of affected individuals. Imbalances in neurotransmitters, important brain chemicals, may be another culprit, as well as hormone imbalances.
Trauma or extreme stress may influence the development of the disorder or trigger episodes.
Without treatment, bipolar disorder often worsens over time. Treatment is usually a combination of medication and psychotherapy.
Common medications used include:
- Mood stabilizers, including Lithium and various anticonvulsants.
- Atypical antipsychotics, such as Zyprexa or Abilify.
- Antidepressants, usually in combination with a mood stabilizer.
- Symbyax, FDA-approved specifically for bipolar disorder.
- Benzodiazepines, such as Klonopin or Ativan for anxiety and sleep disturbance.
Medication may be a lifetime commitment for a person with bipolar disorder.
Psychotherapy can help individuals learn to cope with the effects of the illness and avoid situations which might trigger episodes. Cognitive behavioral therapy (CBT) teaches individuals to change negative patterns of behavior and thought, while interpersonal and social rhythm therapy focuses on improvement of relationships and more stable daily routines. Psychoeducational approaches provide information to increase understanding and assist in recognition of warning signs.
Therapists also work with entire families or with groups of individuals with bipolar disorder. Family-focused therapy helps families with communication, symptom recognition, and more effective coping skills. Group therapy allows individuals to learn from others with the disorder, while practicing better interpersonal skills.
For individuals who have been resistant to other treatment methods, electroconvulsive therapy (ECT) has offered some benefit.
While there is no permanent cure for bipolar disorder, effective treatment can lead to better illness management and allow individuals to live normal lives.
Mental Illness a Leading Cause of Disability in the U.S.
When the subject of disabilities surfaces in our thoughts or conversations, it is common to first consider those caused by some type of physical ailment or affliction. Conditions such as arthritis, heart disease and back problems are certainly primary causes of long-term disabilities in our nation. However, mental illness is the leading cause of disability in U.S. citizens ranging in ages from 15 to 44, according to National Institute of Mental Health (NIMH) statistics.
What these numbers show is that many Americans and people around the world are affected by illnesses such as depression, bipolar disorder, schizophrenia and a host of other mood and anxiety disorders in the prime of their working lives. Unfortunately, these numbers show no sign of subsiding anytime soon. In fact, they continue to rise, as do the number of filings with the U.S. Social Security Administration (SSA) for disability benefits due to mental illnesses.
The SSA and Mental Illness Claims
The SSA has established specific criteria that qualify those suffering with mental disorders for disability benefits. Basically, it must be determined that an existing mental condition limits or impairs one’s ability to fulfill their work obligations. In most situations, assessments and evaluations must be performed by mental health professionals. Additionally, evidence must be submitted to the SSA that indicates the individual in question is unable to perform their assigned job duties as a consequence of their condition.
Getting Back on their Feet
It is important for those with mental health issues to make their employers aware of their situation. All too often, workers are hesitant or afraid to address their condition with their employers for fear of negative repercussions. But behavioral or productivity problems could lead to termination, which also often results in the loss of insurance, creating even more problems for these individuals in regard to receiving treatment.
When documented mental health issues are reported to an employer, they are obligated under Americans with Disabilities Act (ADA) regulations to accommodate that employee with whatever they need to successfully perform their job duties, or to make their working situation as comfortable as possible. In lieu of applying for disability benefits, this can allow an employee to continue to work while receiving mental health treatment and take measures that will eventually enable them to effectively manage their condition.
This blog is written and published by Lindner Center of HOPE.
Mood Disorders Can Be Treated Through a Variety of Therapies
The term “mood disorders” encompasses a relatively wide array of conditions, ranging from mild depression to bipolar disorders. While the severity levels, symptoms and characteristics may differ between the many ailments that reside within the mood disorders category, most of these conditions can be successfully treated with psychotherapy, medications and often a combination of both.
As varied as mood disorders are, the therapeutic methods used to treat these illnesses are equally as diverse. Once a patient is evaluated and a mental health professional determines a mood disorder exists, a very specific approach will be designed to address their particular circumstances.
Effective Therapies for Mood Disorders
Of the variety of psychotherapeutic methods used to treat mood disorders, these two have proven to be especially effective:
Interpersonal Therapy (IPT): This approach examines the patient’s personal relationships, how they respond to issues, communications and actions within those relationships and how their moods can be associated with those experiences. The origins of feelings and emotions triggered within the patient from interactions with the people in their lives are analyzed, helping the patient gain a better understanding of why they react the way they do. This leads them to develop the ability to process their experiences and exchanges with others in a healthier way.
Cognitive Behavioral Therapy (CBT): CBT consists of several different therapeutic approaches, such as Dialectical Behavior Therapy (DBT) and Rational Behavior Therapy (RBT). Generally, CBT is based on the philosophy that our thoughts determine our outlook, feelings and how we behave. When a patient is able to readjust their beliefs and thinking patterns, they will eventually develop the ability to process stimuli in a more logical, objective way and not perceive and judge situations according to past negative or misguided rationale.
In addition to these and other types of therapy, including group and family-focused therapies, various antidepressant medications are prescribed to help stabilize the moods of depressed or bipolar patients. Different dosages or combinations of medications may be tried before a patient responds positively and begins to show improvement. But once this is accomplished and an appropriate therapeutic method is decided upon, there is a good chance the patient will eventually emerge from their former state with a more favorable outlook and a new lease on life.
This blog is written and published by Lindner Center of HOPE.
Bipolar Disorder: Know the Facts
What is Bipolar Disorder?
Bipolar disorder, formerly known as manic depression or manic depressive disorder, is a psychiatric condition in which a person fluctuates between periods of being in a very good mood and periods of being in a very irritable and depressed mood. These “mood swings” between states of extreme activity or high spirits (mania) and depressive states can occur quite suddenly. There can also be periods of milder mania, known as hypomania. Individuals with bipolar disorder can also experience “mixed state” episodes, in which they feel both mania and depression simultaneously. In between these mood swings, there are often periods of being in a “normal” mood-state, but for some, rapid cycling occurs, which means that they rapidly swing back and forth between mania and depression, with few or no “normal” periods. The onset of bipolar disorder symptoms usually presents itself in late adolescence or young adulthood. These symptoms can sometimes emerge in childhood, however, in a condition known as pediatric bipolar disorder.
How can you tell if you or a loved one is suffering from bipolar disorder?
The symptoms of bipolar disorder are very similar in both adults and children. In order to recognize the possibility of bipolar disorder in yourself or a loved one, you need to understand the symptoms of both manic episodes and depressive episodes.
Manic episodes feature either an elevated mood or a very irritable mood which lasts for at least a week, and is accompanied by at least three of these symptoms:
- Very rapid speech, and talking more than normal
- Taking more risks than usual, being more impulsive, and exhibiting inappropriate talk or behavior toward sex or spending
- Sleeping very little
- Short attention span
- Inflated ego – feeling more powerful and important than usual
- Intent focus on a goal, to the point of obsession
- Racing thoughts
The symptoms of a depressive episode include being in a depressed mood, or loss of interest in activities that the person usually enjoys. This low mood is accompanied by at least four of the following symptoms, experienced on a daily basis, for at least fourteen days:
- Loss of energy, fatigue
- Feeling hopeless, extremely pessimistic
- Loss of concentration
- Feeling “slowed down,” or irritable and restless
- Feelings of guilt and/or worthlessness
- Sleeping too much or too little
- Extreme weight loss or weight gain
- Suicidal thoughts, or thoughts of dying
Adults typically have more mixed episodes, and slower changes between mania and depressive moods. Young people and children typically cycle faster between moods and have fewer mixed periods.
How can I be tested for bipolar disorder?
Currently, there are no brain imagery tests which can diagnose bipolar disorder; however, brain imaging is being used to learn what occurs in the brain of someone with the condition. Since the symptoms of this disorder can so closely resemble those of other conditions, it is vital that you or your loved one is examined by a psychiatrist or therapist who is qualified to do so. The doctor will ask questions about sleeping habits, eating habits, moods, behavior, and other things. He or she may also conduct tests to make sure that there is not another medical reason for the symptoms before diagnosing a patient with bipolar disorder. Family history of psychiatric illnesses will be considered, as will the patient’s complete history of symptoms.
Can bipolar disorder be inherited?
While the exact cause of bipolar disorder is not known, it is thought to be caused by chemical changes or imbalances in the brain. Bipolar disorder often runs in families, with children who have a parent or sibling with bipolar disorder being four- to six-times more likely to be diagnosed with the condition than children who have no family history of bipolar disorder. It is also suspected that these chemical changes or imbalances are genetic, and can thus be inherited. Bipolar disorder is not, however, contagious.
This blog is written and published by Lindner Center of HOPE.
Mood Disorders In Children & Adults
One in every ten Americans suffers from a mood disorder. While there are many different types, some of the more common mood disorders include major depressive disorder, bipolar disorder and dysthymia.
Mood disorders can develop at any age, but are most likely to first appear during childhood and become more severe as individuals become adults. However, doctors are now finding more severe levels of mood disorders in children as young as six years old.
Making a Diagnosis
Diagnosing mood disorders in children can be a challenge; as symptoms such as irritability, periods of sadness and frequent mood swings are not as prominent within younger patients as they are in adults.
When it comes to treatment options, both children and adults seem to react best to a combination of psychotherapy and medication. Psychotherapy is an important component to an individual’s treatment plan and can occur in various forms.
A significant difference between children and adults when it comes to treatment is adults typically start on medications prior to psychotherapy, while children usually begin with therapy.
Finding the Right Treatment Center
One of the premier facilities for diagnosing and treating mood disorders is the Lindner Center of HOPE. Located in the greater Cincinnati area, the Lindner Center has both outpatient and residential facilities. In addition to featuring the latest resources and equipment available for treating mood disorders, the Lindner Center is run by Dr. Paul E. Keck and Dr. Susan L. McElroy, two of the most renowned and respected individuals in the field of psychiatry.
For more information on the Lindner Center of HOPE and its mood disorder treatment programs, call 888-536-HOPE.