Title : A Bipolar Disorder Lesson via a Bipolar Patient's Point-Of-View
When acquiring knowledge the item can be best to define terms either before or as they are being used. Let us begin by defining:
Bipolar (Affective) Disorder (manic-depression): a "mental disorder" exhibiting oscillating periods of elation in addition to "clinical depression." the item can be essentially a psychiatric diagnosis of elevated in addition to depressive cognition, moods, behaviors in addition to energy levels. The clinical term for the elated moods can be "mania". A gentler form can be "hypomania." Afterwards, bipolar individuals usually manifest either depressive symptoms or a "mixed state" in which features of both highs in addition to lows are simultaneously present. These up-in addition to-down events quickly slide through "average" mood zones enjoyed by the general population. For some folks,"rapid-cycling" between up-in addition to-down mood levels occurs. Fierce manic episodes can exhibit delusions, psychosis in addition to hallucinations. The bipolar mood range, in increasing levels of manic severity, are termed cyclothymia, hypomania (bipolar-II) in addition to mania (bipolar-I). Descending levels of clinical depression are cyclothymia, depression (bipolar-II) in addition to clinical depression (bipolar-I). Clinical depression alone can be termed "unipolar." [abridged-paraphrased Wikipedia "Bipolar Disorder" entry]
The bipolar continuum (spectrum) can be best illustrated verbally as follows:
MANIA (BIPOLAR-I)
HYPOMANIA (BIPOLAR-II)
CYCLOTHYMIA (HIGH)
AVERAGE MOOD HIGH
AVERAGE MOOD
AVERAGE MOOD LOW
CYCLOTHYMIA (LOW)
DYSTHYMIA (BIPOLAR II)
CLINICAL DEPRESSION (BIPOLAR I)
Patient moods are continuously variable as they ascend in addition to descend This kind of bi-directional spectrum, prompting Johns Hopkins leading Professor of Psychiatry, Dr. Kay Redfield Jamison in addition to Bipolar I patient, to call bipolar disorder "This kind of quicksilver illness."
"Average Mood" can be just another day at the office in addition to at home with no cause for either sadness or celebration.
"Average Mood High" might be a time when you marry, birth a baby, earn a raise or win the lottery.
"Average Mood Low" could range via the loss of a favorite pet to the passing of a family member.
"Cyclothymia High" might be a time of extra energy in addition to focus in addition to general exuberance without drug use.
"Cyclothymia Low" can be a habit of extra sleepfulness or sleeplessness in addition to a gloomy outlook.
"Hypomania" can be a period of excess energy, high productivity, many achievements in addition to goal-orientation.
"Dysthymia" can be sluggishness, loss of normal interests, negativity in addition to general malaise.
"Mania" can be a time of grandiosity, rapid in addition to pressured speech in addition to frightening, erratic behaviors.
"Clinical or Major Bipolar Depression" can be a total loss of interests in addition to wish, often featuring suicidality
Here are a few American statistics:
- Women suffer major depression twice as much as men
- 0% of all suicides result via clinical depression
- Men in addition to women suffer manic-depression equally
- 1 of 3 bipolar individuals will either attempt or complete the act of suicide
You have likely seen more than enough lists of manic in addition to depressive visible behaviors, nevertheless the item can be important to adhere to those listed from the "Psychiatrist's Bible," DSM-IV (Diagnostic in addition to Statistical Manual of Mental Disorders). The DSM-5 will be published in May 2013. the item can be via these basic definitions in which we can build a discussion in addition to understand what can be to follow. Here are the essential "Diagnostic Criteria for Manic Episode:"
- Abnormally, persistently elevated, expansive, or irritable mood
- Inflated self-esteem or grandiosity [w/uninhibited, skewed volition]
- Decreased need for sleep, e.g., feeling rested after only 3 hours of sleep
- More talkative than usual or pressure to keep talking
- Flight of ideas or subjective experience in which thoughts are racing
- Distractibility, i.e., attention too easily drawn to unimportant or irrelevant external stimuli
- Increase in goal-directed activity (either socially, at work, at school or sexually) or psychomotor agitation
- Excessive involvement in pleasurable activities in which have a high potential for painful consequences, e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments
- Mood disturbance sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others
- [Giving away money or cherished or valuable possessions]
I have included This kind of last, bracketed symptom, as in which has been my own personal experience during my bipolar I episodes in addition to also in which of many of my co-patients in addition to manic-depressive friends. Although This kind of frightening list can be not intended for use by "armchair psychiatrists," the item can be useful for spotting in addition to obtaining professional help for a mood-challenged friend or family member. Mania reminds me of the metamorphosis in which produces the "Incredible Hulk." My bipolar-I episodes always involve an obsession-either "seeking true love" or "starting my own high-tech energy company." Oh, the wonders of manic grandiosity!
Well, DSM-IV has been kind enough to help us understand what bipolar mania can be. Here the item does likewise for clinical depression from the form of "Diagnostic Criteria for Major Depressive Episode":
- Depressed mood (can be irritable mood in children in addition to adolescents) most of the day, nearly every day, as indicated either by subjective account or observation by others
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated either by subjective account or observations by others of apathy most of the time
- Significant weight loss or weight gain when not dieting (e.g., more than 5% of Centeng weight in a month), or decrease or increase in appetite nearly every day (in children, consider failure to make expected weight gains)
- Insomnia or hypersomnia almost every day
- Psychomotor agitation or retardation nearly every day (observable by by others, not merely subjective feelings of restlessness or being slowed down
- Fatigue or loss of energy almost every day
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or suicide attempt or a specific plan for committing suicide
- [Vegetative, catatonic; retarded or loss of motor skills; unable to commit the act of suicide]
Yet again, This kind of last, bracketed listing can be based on my personal experience in addition to in which of many of my co-patients in addition to manic-depressive friends. When taken together, all of these up-in addition to-down states are can be peppered with psychosis, hallucinations in addition to delusions, producing a psychiatrist's diagnosis in which much more difficult to make. Bipolar diagnoses are primarily made by psychiatrists (64%), psychologists (18%), in addition to general practitioners (13%). In suspected cases of mental issues the item only makes sense to cut to the chase in addition to make an appointment that has a psychiatrist. This kind of specially trained professional can be best able to treat a mood disorder patient. There are also "mixed episodes" during which an individual will suffer both manic in addition to depressive characteristics simultaneously-pure hell. Once correctly diagnosed, the patient in addition to doctor will need three years, on average, to sculpt a useful combination of psychotropic (psychiatric) drugs to achieve acceptable patient mood stability, the goal of which can be to reduce the frequency, duration in addition to intensity of episodes. These potent drugs have wicked side-effects in addition to must be a carefully selected combination chosen via the several major classes of psych medicines:
- Mood Stabilizers
- Antidepressants
- Antipsychotics
- Anxiolytics
- Anticonvulsants
When the bipolar patient can be manic, he or she can be feeling not bad in addition to can be unlikely to visit a doctor unless coerced by another individual. in which can be why psychiatrists often diagnose manic-depressive patients with unipolar (depressive) disorder because the only time he gets to see the patient can be when he or she can be feeling bad. the item can be fascinating in which nearly 70% of bipolar-disorder sufferers are misdiagnosed an average of 3.5 times before in which correct diagnosis can be dialed-in. The manic individual can be on a "high" in addition to feels wonderful-there can be "no need" for a doctor.
Because bipolar or depressive disorders involve relative amounts of neurotransmitters (serotonin, dopamine, norepinephrine) from the brain's limbic system (in which portion of the brain responsible for emotion, behavior, motivation in addition to long-term memory), a paucity of them results in depression in addition to a surplus of them results in mania. Neurotransmitters are what transmit electrical signals between nerve endings, in addition to, in This kind of case, those of the neurons found from the brain. Unfortunately, there are no physical tests, no "dipsticks," blood tests, imaging, invasive or non-invasive medical techniques for determining the relative levels of these biochemicals. Bipolar disorder can be every bit a physical disease as are diabetes, cancer in addition to heart disease. Here are the ways psychiatrists must achieve their diagnoses for their mood patients:
- Questioning the patient
- Questioning family, significant others
- Establishing a patient history
- Behavioral observation
- Reading Centeng language
- Evaluating speech characteristics
- Combining the results of these presentations with knowledge in addition to experience
Although bipolar disease can strike anyone at anytime, the item usually can be traced to either a genetic component or a crippling physical, mental, or emotional stressor like child abuse or PTSD (Post Traumatic Stress Disorder) in which produces tremendous amounts of anxiety in addition to stress. On the genetic side, children having a sibling or parent with manic-depression have up to six times the likelihood of inheriting the disorder. additional predispositions in addition to correlations for having bipolar disorder are having a Germanic heritage, a high IQ, or being an artist or scientist. Musicians, composers, poets, painters, philosophers, photographers, comedians, TV personalities, sculptors, etc., have an elevated risk of being bipolar when compared with the general population. My casual study of 277 famous persons revealed 84% were in those fields in addition to suffer(ed) mood disorders. I can identify at least several triggers in which launch bipolar episodes:
- Stressors (including major life events); physical, mental in addition to emotional
- Substance abuse
- Sleep deprivation in addition to severe circadian rhythm disruption
- Seasonal change
- Medicinal side-effects
When the item comes to religion, much of Christendom judges those having mental disorders as being sinful, shameful, lacking faith, weak, self-centered, selfish, storytellers, guilty or demon-possessed. Or "in which can be just an excuse, you are trying to get attention." These judgments result in private upbraiding, public ridicule, shunning or excommunication. The affected person's beliefs fail when his mind fails. additional significant world religions either quarantine or eradicate mentally persons (defectives) by using any means possible, including homicide. the item can be interesting to note the statistical incidence of people's mood disorders can be unaffected by any particular religious belief or affiliation.
Depression can be the number three reason for doctor visits in America today in addition to the class of psychiatric drugs prescribed can be second only to analgesics (painkillers). the item has historically taken an average of four doctors in addition to ten years to correctly diagnose a case of bipolar disorder. Even today only 49% of those with manic-depression receive treatment. Most of the remainder, unaware of their disease, will unwittingly self-medicate with "feel-not bad" drugs, food, alcohol in addition to wanton (hyper) sex. Denial can be a mental patient's best friend. Bipolar disorder can be very much like a "mood roller-coaster," with rapid ascents into mania, yet slower descents into suicidal depression stemming via a loss of confidence, identity in addition to neurotransmitter imbalances. Our thoughts race at disturbing speeds while manic. When depressed we feel envious of anyone who can be not in our place. We must train others to understand us in addition to help us no matter how impossible in which seems. in addition to we must live "from the moment" every day. Our only real duty can be to avoid mood swings in which steal our reason in addition to cause the loss of wish in which constitutes our desire for death.
Fortunately, these numbers are gradually trending better due to higher levels of awareness in addition to today's many campaigns against stigma in addition to discrimination targeting the mentally ill. Stigma of the disorder can be fueled by the well-liked media characterization of bipolar individuals as being crazed homicidal maniacs having murderous/suicidal intent. Stigma means "disapproval in addition to disgrace." the item alienates its victims, creates undeserved prejudice against them, in addition to produces a societal shame in which delivers a powerful blow to those already suffering a horrific mental disease. Stigma can be every bit as inappropriate for the mental patient as the item could be for the heart or cancer patient!The sufferer considers herself a public "killjoy," in addition to hides the item as best she can. She in addition to others like her often cannot summon the self-esteem in addition to confidence to share their emotional battles. Every societal aberrance appears to have its own equal in addition to opposite form using the word "phobia." Should those guilty of fear of the mentally ill be branded "psycho-phobes?" the item has been my experience in which, like "mean" drunks in addition to "happy" drunks, there are both "mean" in addition to "happy" individuals who suffer episodes of bipolar disorder. The "mean" in addition to violent ones are only those who abuse drugs in addition to alcohol. After all, violent persons aren't born, they're made.
Bipolar individuals, on average, will suffer 8 to 10 episodes over their lifetimes. the item can be living hell on earth without a cure. the item can only be managed. The impact on society includes these facts:
- Manic-depression can be nearly the 2nd-highest reason for federal disability awards
- Unemployment for mood disorder sufferers can be 50% higher than the U.S. average
- Bipolar patient lifespans are 9.2 years shorter than the nominal U.S. age of 78 years
Because drug therapy often requires 2-3 weeks to begin exhibiting a therapeutic effect, hospitalization may be indicated for the patient's safety during a mood disorder episode. Sadly, "brand-new in addition to increased" healthy patient outlooks, beliefs in addition to budding increased behavioral habits, when compared with previous behaviors, can actually spook family in addition to friends in addition to cause a separation of ways. Co-dependencies vanish. Outpatient counseling can be often required to either prevent This kind of ordeal or deal with its aftermath. A brand-new setting may be a big boon to the psychiatric patient. Whether manic or depressed, the individual's feelings must be moderated-restored to a stable range. Julie A. Fast has described a "centered" bipolar's life as being possible, wonderful, having fun in addition to enjoying one's talents. I have also found these aspects of stability to be true in addition to have reached my treasured state of serenity..
For me, clinical depression, a crafty adversary, produces the worst suffering. Its simplest definition can be "anger turned inward." A depressed patient must find a non-injurious, non-damaging way to vent those demons of anger to slam the brakes on a dangerously deepening depression.
Imagine awaking after being buried 6 feet under, the utter hopelessness of your shouts going unheard, unable to roll over in your coffin, claustrophobic. Clinical depression's hopelessness can be worse! Suicide easily becomes a viable, attractive option. from the words of Marybeth Smith, "... I just want to end the pain." The wild mood swings of bipolar disorder in a sufferer have nothing to do with volition, choices or will. With depression, one may unknowingly begin to sink into the abyss of hopelessness.
"You can always think your way into a depression nevertheless cannot always think your way out [of one]." - Dr. Lewis Britton
At in which point the only option can be either drug therapy or ECT. Because psychiatric treatment usually involves only 15-minute "meds checks," a patient must request a referral for a psychologist who can provide the "talk therapy" needed for the patient to work out thinking, behaviors, lifestyle in addition to myriad additional issues. Patients must be ascertain whether or not their psychiatrists in addition to psychologists will communicate with one another to create a holistic continuum of care. The patient must learn habits of living including eating, exercise in addition to sleeping habits. Mood disorder behaviors are non-volitional in addition to re-learning healthy physical, mental in addition to emotional habits can be a must for preventing further mental mayhem. Friends in addition to family can neither sympathize nor empathize, never having "been there."
Serenity can be my ultimate mental health goal. I have nearly achieved the item by eliminating nearly most stressors in my life in addition to the item feels great. No problem distracts or bothers me anymore, most likely due to having already survived the worst in which can happen to me at both extremes of bipolar mania in addition to depression. In addition to Psychiatric in addition to Psychological help are voluntary support groups, both physical in addition to online. Internet forums in addition to communities, if their members stay on-track, can be quite helpful for depressed in addition to manic-depressive folks as episodes, doctors, medications in addition to the like are hashed over in addition to common ground can be established for self-revelation, sharing in addition to caring.
I am often asked whether there can be 1) a greater number of mentally ill persons today, 2) if the bar can be being lowered by the Psychiatric community to drum up more patients, or 3) whether there have always been so many of us from the past who were misunderstood, misdiagnosed or ignored. I am inclined to say in which the item can be an amalgam of all three at the risk of sounding simplistic or "politically correct." I say This kind of because I believe all three propositions can easily be tied to the increasingly rapid advance of technology's increasing impact on mankind over the decades. nevertheless I'm certainly open for any suggestions to the contrary.
In conclusion, "manic-depression" remains a "hot-button" topic today among health professionals, the media, patients in addition to a confused public. Well-meaning websites in addition to blogs litter the internet with both accurate in addition to erroneous content in addition to advice, in addition to these venues must be fact-checked in addition to negotiated with care. Although not up to academic standards, a Wikipedia search of "bipolar disorder" can be probably the most handy in addition to accurate source for the average inquisitor. Having read the item myself, This kind of mental patient recommends the item for all concerned.
Source : A Bipolar Disorder Lesson via a Bipolar Patient's Point-Of-View by Jeff C. Baker
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