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Bipolar Disorder

(Manic-Depressive Illness; Manic Depression; Manic Disorder; Manic Affective Disorder)

Definition

Bipolar disorder is a mental health condition marked by extreme swings in mood, energy, and the ability to function. The mood changes of bipolar disorder are more dramatic than normal ups and downs. They can hurt relationships and cause poor job or school performance.
The two mood extremes of bipolar disorder are mania and depression. In mania, one of the defining symptoms is an increase in energy and a decreased need for sleep. The mood may be overly happy or irritable. In depression , a down mood with fatigue takes over, often accompanied by irritability.
There are four forms of this condition:

Causes

The cause of bipolar disorder is unknown. This condition tends to run in families. Specific genes may play a role. It is most likely many different genes that act together.
The Brain
Color coded brain
Bipolar disorder may be a result of genetic influences on the brain.
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Risk Factors

A family history of the disorder increases your chance of developing it. Tell your doctor if you have a family member with bipolar disorder.

Symptoms

Symptoms include:
Mania may cause:
Depression may cause:
Severe episodes of mania or depression may sometimes be associated with psychotic symptoms, such as:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. In some cases, lab tests are ordered to rule out other causes of your symptoms. You may be referred to a mental health specialist. Diagnosis of bipolar disorder is based on:
Mania is diagnosed if:
A depressive episode is diagnosed if:

Treatment

Talk with your doctor about the best plan for you. Options may include:

Medications

The primary treatment is with medications called mood stabilizers. There are many different types and combinations of medications, which must be tailored by your doctor to target your symptoms. Examples of common medications used to treat bipolar disorder include:
  • Mood stabilizers
  • Antiseizure medications
  • Benzodiazepines
  • Antidepressants
  • Antipsychotics
The plan is based on the pattern of the illness. Treatment may need to be continued indefinitely. It should prevent significant mood swings.

Psychotherapy

Psychotherapy is often an integral component of a comprehensive treatment plan. Therapy may include:

Electroconvulsive Therapy

Electroconvulsive therapy may be effective when medications fail. It can be used for both mania and depression.

Prevention

There are no current guidelines to prevent bipolar disorder. Taking your daily medications and following your treatment plan can help prevent future mood swings.

RESOURCES

Depression and Bipolar Support Alliance http://www.dbsalliance.org

National Institute of Mental Health http://www.nimh.nih.gov

CANADIAN RESOURCES

Canadian Psychiatric Association http://www.cpa-apc.org

Mood Disorders Society of Canada http://www.mooddisorderscanada.ca

References

Bipolar disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 20, 2014. Accessed September 3, 2014.

Bipolar disorder fact sheet. National Alliance on Mental Illness website. Available at: http://www.nami.org/factsheets/bipolardisorder%5Ffactsheet.pdf. Updated April 2013. Accessed September 3, 2014.

Bipolar disorder in adults. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml. Updated 2012. Accessed September 3, 2014.

4/29/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Nivoli AM, Colom F, Murru A, et al. New treatment guidelines for acute bipolar depression: a systematic review. J Affect Disord. 2011;129(1-3):14-26.

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