Bipolar Disorder, Manic Depression
In Bipolar Disorder, both the ups and the downs are extreme and disabling. The illness almost always begin sometime between puberty and age thirty-five and continues for life. Very rarely, the first episode begins in childhood almost always these early onsets occur in someone who has a strong family history suggesting genetic loading. Usually, the earlier in life Bipolar Disorder appears the more difficult will be its lifetime course unless there is active treatment over many years to minimize the risk of recurrence.</p>
Having a first manic episode after age fifty is so unusual that Bipolar Disorder is unlikely to be the cause. A thorough medical workup is necessary to rule out the possibility of medical condition (a brain tumor, an infection, an endocrine disturbance) or substance use (including a medication side effect) that might be masquerading as mania.</p>
For men with Bipolar I Disorder, the first episode is more likely to consist of mania, whereas for women it is more likely to be depressive. No one knows why. The average number of mood episodes is four in the first ten years of the illness. Some people have almost equal numbers of manias and depressions, whereas others have almost exclusively manic or exclusively depressive episodes. The most common pattern is for a mania immediately to precede or immediately to follow a depression. One of the challenges in the treatment of both mania and depression it to avoid triggering the switch to the opposite type of episode. Depression in bipolar disorder are in most ways just like the unipolar depressions , except that they are more likely to be of the typical type to occur seasonally in late fall, and to dollow childbirth.</p>
An untreated manic episode is likely to last only a few weeks to months, whereas an untreated depressive episode usually persist for six months or much longer. Most people completely recover between episodes and then go on for months or years without any symptoms until next episode. Some people, however, never completely get back to a normal mood and instead endure a chronic low grade state of being either up or down (or both) between episodes.</p>
The most dreaded course is “rapid cycling” which is like being on a roller coaster, perpetually in some sort of episode going without respite from highs to lows and back again. Rapid cycling is more likely in women, particularly if they have thyroid problems. It is also promoted by exposure to antidepressant medications, especially if you are not also talking a mood stabilizing medicine to cover thsi risk. Identifying, preventing, and aggressively treating rapid cycling is simply crucial it is especially difficult to break the rhythm once it has built a head of steam.</p>
According to the diagnostic manual, you have Bipolar I Disorder if:</p>
You have had one or more manic episodes in which you feel abnormally “high”, hyper, wired, or unusually irritable. These get you into trouble, make you unable to function at work or at school, or result in your being admitted to the hospital.</p>
During these manic episodes, at least three of the following symptoms are present:
1. You feel overly self confident or even grandiose.
2. You need much less sleep than usual.
3. You cannot stop talking.
4. Your thoughts are racing.
5. You are easily distracted.
6. You are much more active sexually or socially, or are much more productive at school or at work than is usual for you, or you feel agitated much of the time.
7. You get involved in pleasurable activities without considering the consequences.
8. You also have had one or more depressive episodes.</p>
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In Bipolar Disorder, both the ups and the downs are extreme and disabling. The illness almost always begin sometime between puberty and age thirty-five and continues for life. Very rarely, the first episode begins in childhood almost always these early onsets occur in someone who has a strong family history suggesting genetic loading. Usually, the earlier in life Bipolar Disorder appears the more difficult will be its lifetime course unless there is active treatment over many years to minimize the risk of recurrence.</p>
Having a first manic episode after age fifty is so unusual that Bipolar Disorder is unlikely to be the cause. A thorough medical workup is necessary to rule out the possibility of medical condition (a brain tumor, an infection, an endocrine disturbance) or substance use (including a medication side effect) that might be masquerading as mania.</p>
For men with Bipolar I Disorder, the first episode is more likely to consist of mania, whereas for women it is more likely to be depressive. No one knows why. The average number of mood episodes is four in the first ten years of the illness. Some people have almost equal numbers of manias and depressions, whereas others have almost exclusively manic or exclusively depressive episodes. The most common pattern is for a mania immediately to precede or immediately to follow a depression. One of the challenges in the treatment of both mania and depression it to avoid triggering the switch to the opposite type of episode. Depression in bipolar disorder are in most ways just like the unipolar depressions , except that they are more likely to be of the typical type to occur seasonally in late fall, and to dollow childbirth.</p>
An untreated manic episode is likely to last only a few weeks to months, whereas an untreated depressive episode usually persist for six months or much longer. Most people completely recover between episodes and then go on for months or years without any symptoms until next episode. Some people, however, never completely get back to a normal mood and instead endure a chronic low grade state of being either up or down (or both) between episodes.</p>
The most dreaded course is “rapid cycling” which is like being on a roller coaster, perpetually in some sort of episode going without respite from highs to lows and back again. Rapid cycling is more likely in women, particularly if they have thyroid problems. It is also promoted by exposure to antidepressant medications, especially if you are not also talking a mood stabilizing medicine to cover thsi risk. Identifying, preventing, and aggressively treating rapid cycling is simply crucial it is especially difficult to break the rhythm once it has built a head of steam.</p>
According to the diagnostic manual, you have Bipolar I Disorder if:</p>
You have had one or more manic episodes in which you feel abnormally “high”, hyper, wired, or unusually irritable. These get you into trouble, make you unable to function at work or at school, or result in your being admitted to the hospital.</p>
During these manic episodes, at least three of the following symptoms are present:
1. You feel overly self confident or even grandiose.
2. You need much less sleep than usual.
3. You cannot stop talking.
4. Your thoughts are racing.
5. You are easily distracted.
6. You are much more active sexually or socially, or are much more productive at school or at work than is usual for you, or you feel agitated much of the time.
7. You get involved in pleasurable activities without considering the consequences.
8. You also have had one or more depressive episodes.</p>
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