Bipolar Disorder

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Bipolar disorders are classified as mood disorders which include characteristics of extreme mood shifts – highs and lows -- including depressive symptoms and manic episodes separated by relatively normal periods of mood.

Because of the existence of co-occurring disorders, bipolar disorder is often misdiagnosed or mistreated. According to the National Institute of Mental Health, nearly 6 million adult Americans suffer from bipolar disorders, with the median age of onset being 25 years old, although children and teens do suffer from symptoms as well.

Additionally, more than two-thirds of people diagnosed with bipolar disorders have a relative with similar symptoms and characteristics.

People with bipolar symptoms are at a greater risk of suicide if left untreated.

Quick Reference


Types of Bipolar Disorders

There are two main subtypes of bipolar disorders including:

Bipolar I - this diagnosis requires at least one episode of mania followed by one depressive episode. Manic episodes can be characterized by reduced need for sleep, euphoria, increased talking and restlessness, increased activity, as well as extreme pleasure-seeking activities that could be destructive – shopping sprees, hypersexuality, excessive gambling, as well as psychosis and hallucinations in some. Many types the manic episodes are severe and impair social, work and relationship functions.

Bipolar II – characterized by severe depressive episodes typically lasting two weeks or more followed by a hypomanic episode. Hypomanic episodes are less intense and severe than manic episodes, but may include increased energy, restlessness and less need for sleep and more goal-oriented behavior. Bipolar II symptoms do not include psychosis or hallucinations as they do with Bipolar I. Hypomanic symptoms may present as a good mood, or irritability and anger.


Causes of Bipolar Disorder

While they are no definitive causes of anxiety, there are several factors that can trigger anxiety disorders.

Those include:

Genetics -
The causes of bipolar disorders aren't fully understood, but studies have found that bipolar disorders are common in people whose first-degree relatives – parents, siblings – also have the illness.

Brain structure
Recent studies have shown that those who suffer from bipolar disorder appear to have changes in brain structure. While more research is needed, findings may help with determine the cause of the disorder.

Risk factors
These factors may increase your risk of developing a bipolar disorder:
Drugs or alcohol. Drug or alcohol use or abuse or withdrawal can trigger bipolar symptoms.

Stress – Episodes of high stress such as the death of a loved one and trauma can also trigger bipolar symptoms.

 


Bipolar Symptoms in Children and Teens

Children and teens can be diagnosed with bipolar disorders, although the prevalence of the first episode is unlikely before the age of 12. While adolescents exhibit the same symptoms as adults, however, because adolescents may not have the adequate vocabulary to express their emotions connected to the symptoms, they may have psychosomatic symptoms and complain of physical pain such as stomachaches and headaches. Additionally, adolescents with bipolar disorder may be misdiagnosed with Attention Deficit Hyperactivity Disorder (ADHD) which sometimes share similar symptoms of hyperactivity, lack of focus and concentration and irritability, which can make diagnosis difficult.


Assessment for Bipolar Disorder

A diagnosis of Bipolar Disorder requires an evaluation and diagnosis by a licensed clinician such as a psychiatrist or psychologist who specializes in bipolar disorders. At Clarity Clinic, we specialize in bipolar assessments and treatment for children, teens, and adults aimed at understanding the severity, length and frequency of the symptoms, including mania and hypomania, to ensure a property diagnosis.
Treatment for Bipolar Disorder
Because bipolar disorder is a life-long condition, proper and continuous medication management by a licensed psychiatrist is key in managing symptoms. Bipolar disorder can be hard to diagnosis because of symptoms that can mimic major depressive disorder, ADHD and borderline personality disorder. Working with a trained psychiatrists who specializes in the treatment and up-to-date research of bipolar disorder is important to ensure a proper diagnosis and to find the right treatment plan. In addition to medication, effective treatment includes psychotherapy to help clients process the diagnosis and finding tools to identify and manage the symptoms. Additionally, many who suffer from bipolar symptoms have co-occurring substance abuse struggles, which may require collaborative care with addiction specialists as well.

Medication Management
Studies have indicated that the most effective first-line of treatment is medication to reduce and manage symptoms. However, sometimes people begin to feel better and figure they don’t need medication, but disregarding your medication can trigger a full-blown manic episode or increase suicidal ideations, requiring hospitalization.
Medications to treat bipolar disorder include:

Psychotherapy
After symptoms have been stabilized through medication, psychotherapy is a second line of treatment to help people process the diagnosis, repair any relationship struggles that have been affected by symptoms, as well as identify and work through lifestyle changes needed to manage symptoms. Our psychotherapists work in conjunction with the treatment team to individually tailor the treatments and therapies, which may include cognitive-behavioral psychotherapies, family therapy and substance abuse treatment.

Living with someone who has bipolar
Living with a loved one or friend who has bipolar can be emotionally exhausting trying to navigate different mood swings and impulsive behaviors. The uncertainty of the illness can be hard on interpersonal relationships and the roller coaster of emotions – fear, uncertainty, shame, confusion, helplessness – can take its toll on the emotional stability of those dealing with the persona who is ill. However, education about the disorder, as well as therapy to help you process these emotions can help. Some suggestions to help you support your loved one, as well as yourself include:

Identify triggers and symptoms – recognize mood swings triggers – particularly environmental stressors – and identify soothers that can help stabilize the mood swings.
Maintain a strong support system – because bipolar disorder can be overwhelming for family and friends, identifying and maintaining a strong support system that you can turn to, is key to helping when you are struggling. Additionally, bipolar support groups can be beneficial in connecting with others who are dealing with similar concerns/issues.

Enforce medication – because medication is the first-line of treatment for those struggling with bipolar, it is important for them to maintain their regime to ensure stabilization of systems. Many times, those who go off their medication without doctor approval, they can go into extreme manic or depressive episodes that lead to strong suicidal ideations and hospitalizations.

Communication – communication is key in understanding your partner’s symptoms and moods and determining what he/she needs to help with stabilization.

Clarity Clinic

At Clarity Clinic, we have highly trained staff who specialize in diagnosing and treating bipolar disorders. To schedule an appointment, click on one of the specialists below to schedule an initial evaluation to and discuss assessment, diagnosis and treatment options.

Additional Resources
For more information on bipolar disorders, below are several additional resources to help learn more:
http://www.dbsalliance.org/site/PageServer?pagename=home
https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder

Signs and Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a reference manual used by health care professionals as the authoritative guide to the diagnosis of mental disorders – there are two main subtypes of bipolar disorders – Bipolar I and Bipolar II.
Bipolar disorders are not more prevalent in men or women, but studies have shown the men have more manic episodes than depressive symptoms and women have more depressive symptoms than manic episodes.* (http://www1.appstate.edu/~hillrw/BipolarNeuro/BiPolar/pages/type1.html)

Bipolar I
While a bipolar disorder diagnosis must come from a licensed and experienced clinician, the DSM provides an overview of signs and symptoms including:

Manic Episodes
Prevalence of a Manic Episode for at least one week that is significantly different than normal behavior. Manic episodes could include psychosis and hallucinations.
· Manic symptoms can include:
o Feeling of grandiosity or inflated view of one’s self
o Decreased need for sleep or feeling rested after a short amount of sleep
o Increase talkativeness
o Racing thoughts
o Distractibility or limited focus and concentration
o Increase in goal-directed activity
o Increase in risky or exaggerated behaviors – i.e., hypersexuality, excessive gambling, shopping sprees.
o Severe mood changes that affect social, work and relationship functions

Major Depressive Episodes

Prevalence of a Major Depressive Episode with symptoms present nearly every day for two weeks
Major Depressive symptoms can include:
o Depressed or down mood for most of the day
o Little to no interest in activities or tasks
o Decrease in appetite and/or weight
o Trouble sleeping or desire to sleep all the time
o Lack of energy
o Feelings of low self-worth
o Lack of concentration or focus
o Reoccurring thoughts of suicide or death with plans or attempts.

Bipolar II
A bipolar II diagnosis includes both hypomania and depressive symptoms. Unlike Bipolar I, the hypomania symptoms are not significant enough to cause hospitalization or significant impairment in social, work or relationship functions, although the symptoms may be observable by others as slightly different than normal functioning. Hypomanic symptoms do not include psychosis or hallucinations.

While a bipolar disorder diagnosis must come from a licensed and experienced clinician, the DSM provides an overview of signs and symptoms of bipolar II including:

Hypomanic Episodes
A distinct period that is markedly different than normal behavior and can manifest as inflated mood or irritability and anger. The behavior must be consistent lasting a minimum of 4 consecutive days.
Hypomania symptoms can include:
o Feeling of grandiosity or inflated view of one’s self
o Decreased need for sleep or feeling rested after a short amount of sleep
o Increase talkativeness
o Racing thoughts
o Distractibility or limited focus and concentration
o Increase in goal-directed activity
o Increase in risky or exaggerated behaviors – i.e., hypersexuality, excessive gambling, shopping sprees.

Major Depressive Episodes

Prevalence of a Major Depressive Episode with symptoms present nearly every day for two weeks
Major Depressive symptoms can include:
o Depressed or down mood for most of the day
o Little to no interest in activities or tasks
o Decrease in appetite and/or weight
o Trouble sleeping or desire to sleep all the time
o Lack of energy
o Feelings of low self-worth
o Lack of concentration or focus
o Reoccurring thoughts of suicide or death with plans or attempts.

Clarity Clinic