Bipolar Illness
...lieved to be inherited in many cases. Despite vigorous research efforts, a specific genetic defect associated with the disease has not yet been detected. Bipolar disorder involves cycles of mania and depression. Signs and symptoms of mania include discrete periods of: Increased energy, activity, restlessness, racing thoughts, and rapid talking; excessive high or euphoric feelings; extreme irritability and distractibility; provocative, intrusive, or aggressive behavior; abuse of drugs, particularly cocaine, alcohol, and sleeping medications; unrealistic beliefs in one's abilities and powers and decreased need for sleep. Signs and symptoms of depression include discrete periods of: Thoughts of death or suicide; persistent sad, anxious, or empty mood; feelings of guilt, worthlessness, or helplessness; decreased energy, a feeling of fatigue or of being "slowed down"; loss of interest or pleasure in ordinary activities; difficulty concentrating, remembering, making decisions and sleep disturbances. There are different types of Bipolar Disorder. Bipolar I disorder is characterized by one or more manic episodes or mixed episodes (symptoms of both a mania and a depression occurring nearly every day for at least 1 week) and one or more major depressive episodes. Bipolar I disorder is the most severe form of the illness marked by extreme manic episodes. Bipolar II disorder is characterized by one or more depressive episodes accompanied by at least one hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes but are less severe, but must be clearly different from a person’s non-depressed mood. For some, hypomanic episodes are not severe enough to cause notable problems in social activities or work. However, for others, they can be troublesome. Cyclothymic disorder is characterized by chronic fluctuating moods involving periods of hypomania and depression. The periods of both depressive and hypomanic symptoms are shorter, less severe, and do not occur with regularity as experienced with bipolar II or I. However, these mood swings can impair social interactions and work. Many, but not all, people with cyclothymia develop a more severe form of bipolar illness. Treatment for bipolar disorder includes medication, psychotherapy, and, when necessary, electroconvulsive shock therapy (ECT). Lithium, Valproate, Carbamazepine and Olanzapine are all types of drugs that are commonly used to treat manic episodes. Antipsychotic medication is continued at the lowest effective dose until symptoms resolve. Antipsychotic medication should be discontinued because of serious long-term side effects. Patients should be evaluated periodically to assess the need for maintenance therapy. Ongoing psychotherapy is necessary for the following reasons: it helps patients maintain a positive self-image; ensures compliance with the schedule of medication; and helps patients deal with effects of the disorder on their social and work relationships. Hospitalization is required for severe episodes of mania and depression to protect patients from injuring themselves or others. Electroconvulsive therapy (ECT) is used primarily as an acute treatment for hospitalized patients who are suicidal, psychotic, or dangerous to others. It is effective in nearly 75% of patients who undergo this treatment. Receiving ECT during pregnancy is considered safe. Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is estimated to be 15-30%. When both parents have bipolar disorder, the risk increases to 50-75%. Symptoms of bipolar disorder may be difficult to recognize in children, as they can be mistaken for age-appropriate emotions and behaviors of children and adolescents. Symptoms of mania and depression may appear in a...