A REVIEW OF BIPOLAR DISORDER
INTRODUCTION
Bipolar disorder (which was earlier called manic depression, or manic-depressive illness) is a mental health disorder that includes unusual shifts in - mood, energy, and levels of activity. Disorder also affects concentration, and also the ability of carrying out day-to-day tasks.
We may distinct three types of bipolar disorder; what is in common is that all of them include clear changes in mood, energy, and activity levels. Moods may vary from ’’ups’’ (when the patient is elated, irritable, or has energized behavior – also known asmanic episodes) to very ’’downs’’ (when the patient is sad, indifferent, or in hopeless periods – also known asdepressive episodes). Hypomanic episodes are less severe manic periods. (1)
Bipolar I disorder. Patient had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. Sometimes, mania may trigger a psychosis (break from reality).
Bipolar II disorder. Patient had at least one major depressive episode and a minimum of one hypomanic episode, but never had a manic episode.
Cyclothymic disorder. Patient had at least two years - or one year in children and teenagers - of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
Other types. These include, for example, bipolar and other similar disorders caused by certain drugs or alcohol or due to a medical condition, such as stroke, multiple sclerosis or Cushing's disease. (2)
EPIDEMIOLOGY
One of the large surveys, that included 11 countries, found the overall lifetime prevalence of bipolar spectrum disorders was 2.4%, with a prevalence of 0.6% for bipolar type I and 0.4% for bipolar type II. (3)
In one of the epidemiological investigations in England, the recent Adult Psychiatric Morbidity Survey 2014, was found lifetime prevalence of bipolar disorders was 2%. (4)
Meta-analysis of 25 studies, that has been conducted recently - found a pooled lifetime prevalence of 1.06% and 1.57% for types of bipolar disorder I and II, reXXXXXXXXXX; it should be mentioned that XXX majority XX XXX included studies were from North or South XXXXXXX. (5)
X similar prevalence has XXXX found in the UK, XXXXXXX and Italy. (6)
And what XX XXX reason XXX international variations in XXX XXXXXXXXXX XX XXXXXXX? It XX XXX XXXXXXXX clear, but it XX thought that - XXXXXXXXX, cultural XXXXXXX XXX variations in XXXXXXXXXX XXXXXXXX XXX study methodology XXX XXXX have an impact.
XXXXXXX XXXXXXX XXXXXX XXXXX distribution in XXXXXXX, regarding sex. (X)
With XXXXXXX XX age, it appears XX be XXXX the XXXX age XX XXXXX XXX bipolar XX in the XXXXX XXXXXXXX, even if findings XXXX XXXXXXX XX–XX XXXXX. (3)
ETIOLOGY AND XXXXXXXXXXXXXXX
XXXXXXXXXXX factors XXX named in XXX following.
XXXX if a XXXXXXXXXXXXXXX link XX bipolar disorder has XXX been XXXXXXXXX determined, XXXXXXXX XXXXX that bipolar disorder tends to ’’XXX’’ in families, and XX - heritable.
Patients XXX inherit a XXXXXXXX to develop the XXXXXXX, XXX this may XX ’’triggered’’ byXXXXXXX XX XXXXXXXXXXX, XXX example – distressing life XXXXX.
Development XX the brain, structure, XXX XXXXXXXXX XXXXX XXX XX messengers XXXXXXX XXXXX cells (also XXXXX as neurotransmitters), XXX XXXX thought to XXXX a XXXX in XXX development of bipolar XXXXXXXX. (X)
XX XXXXXXXXXXXXXX disorder -specifically mania,catecholamine hypothesis XXX been XXXX; XXXXXXXXXX assumed XXXX XXXXX is XXX to an excess, and XXXXXXXXXX XX due to a XXXXXXXXX of catecholamines.
A XXXXXXXXX ofXXXXXXXXX hypotheses XXXX been XXXXXXXX. XXXXX is one hypothesis, known XX’’permissive hypothesis’’of serotonin function, that claims that XXX serotonergic XXXXXXXX XXXXXXXX XXX XXXX -manic and XXXXXXXXXX XXXXXX XXXXXXX defective dampening XX XXXXX neurotransmitters (XXXXXX norepinephrine and dopamine). (X)
XXXXXXXXX
It is often XXXXXXXXX for XXXXXXX XXXXXXXX to be XXXXXXXXXX XXX XXXXXXXXX.
XXXX might XX XXXXXX by the fact that XXXX symptoms may feel good to a XXXXXXX, XXXXX XXXXX lead to XXXXXX of the problem.
XXXXXXX disorder is difficult to diagnose, XXXX because XXX XXXXXXXX may appear to be XXXX XX XXXXXXX illness, or XXXXXXXXXX XX other problems XXXX as XXXXXXXXX abuse, poor XXXXXX performance, or XXXXXXX in XXX workplace.
XXXXXXXX of bipolar XXXXXXXX are XXXXXXX into XXX XXXXXXXXXX: mania XXX depression. (X)
Mania. The XXXXXXXX of XXXXX, XXXXX can last up to XXXXX XXXXXX, if XXXXXXXXX, include:
- Excessive XXXXXX, XXXXXXXX, restlessness, racing thoughts XXX XXXXX talking (XXXX called "XXXXXXXXX XXXXXX")
- Extreme “high” or XXXXXXXX feelings—a XXXXXX may feel “on XXX XX XXX world” XXX XXXX bad news or XXXXXX events, XXX't XXXXXX this
- XXXXX XXXXXX irritated or XXXXXXXXXX
- Decreased XXXX XXX XXXXX—an XXXXXXXXXX may XX days with XXXXXX or no XXXXX without XXXXXXX XXXXX
- XXXXXXXXXXX XXXXXXX in XXX’s XXXXXXX XXX XXXXXX—a XXXXXX XXX XXXXXXXXXX feelings XX exaggerated XXXX-confidence or unwarranted optimism. This XXX XXXX XX XXXX ambitious work plans and XXX XXXXXX that XXXXXXX XXX XXXX XXX or her from accomplishing any XXXX
- XXXXXXXXXXXXXXXXXXXX XXXX XXXXXXXX—a person may XXXX XXXX XXXXXXXXX XXXXX XXX lead XX XXXXXXXXXXX XXXXXXXXXXX in activities, XXXXXXXX and XXXXXXXXX, XXXXXXXX XXXXXXX, XXXXXXXX XXXXXX, and/or XXXXXXX XXXXXXXX XXXXXXXX
- Unusual sex drive or XXXXX XX XXXXX (particularly XXXXXXX, alcohol or XXXXXXXX XXXXXXXXXXX)
Depression. An XXXXXXX of depression can XXXX before or XXXXX a manic, hypomanic, or normal XXXXXX XX mood. XXXXXXXX include:
- Persistent XXX, anxious or empty XXXX
- XXXXXXX in XXXXX such XX, XXXXXXX XXX much or too little, or XXXXXX in XXX XXXXXX-of-the-night or unusually early in the XXXXXXX
- Reduced appetite and weight XXXX, or XXXXXXXXX XXXXXXXX XXXXXXXXXXX by XXXXXX XXXX
- XXXXXXXXXXXX or restlessness
- Difficulty concentrating, XXXXXXXXXXX or XXXXXX XXXXXXXXX. XXXXX may XXXXX impact a XXXXXX's ability to XXXXXXX work, school or other XXXX obligations
- XXXXXXX or XXXX XX energy
- Persistent XXXXXXXX XXXXXXXX XXXX XXX't respond to XXXXXXXXX, such as XXXXXXX XXXX or XXXXXXXXX XXXXXX (XXXX upset stomach or XXXXXXXX)
- XXXXXXX guilty, hopeless or XXXXXXXXX
- Thoughts of death or XXXXXXX, XXXXXXXXX suicide attempts
XXXXXXXXXX
Proper diagnosis of XXXXXXX XXXXXXXX may XX time consuming; but XX XXXXXXX is diagnosed XXX XXXX treated properly, it may XXXX XXXXXX (XXXX bipolar XXXXXXXX) XXXX XXXXXXX XXX active XXXXX. (X)
XX determine XX XXXXXXX XXXX bipolar XXXXXXXX, a process of evaluation XXX include:
XXXXXXXX exam. XXXXXX may XX a physical XXXX and lab XXXXX XX XXXXXXXX any medical problems XXXX XXXXX XX XXXXXXX XXXXXXX’s symptoms.
Psychiatric assessment. Doctor XXX XXXXX patient XX a psychiatrist, XXXX whom XXX patient XXXX XXXX about XXXXXXXX, XXXXXXXX XXX behavior patterns. Patient XXX XXXX XXXX out a psychological self-assessment or questionnaire. XXXX XXX XXXXXXXXXX of a XXXXXXX, members of XXX XXXXXX or close friends may be XXXXX in order XX provide XXXXXXXXXXX XXXXX XXX symptoms.
XXXX XXXXXXXX. XXXXXXX XXX XX asked XX XXXX a XXXXXX (XX XXXXX bases) of moods, XXXXX XXXXXXXX or XXXX other factors which could help with diagnosis XX disorder, and XXXX defining the right XXXXXXXXX.
Criteria for XXXXXXX XXXXXXXX. XXXXXXXXXXXX XXX compare patient’s XXXXXXXX XXXX the criteria for bipolar XXX XXXXXXX disorders in theDiagnostic XXX XXXXXXXXXXX Manual of XXXXXX Disorders(XXX-X), XXXXXXXXX by the American Psychiatric XXXXXXXXXXX. (XX)
The clinician XXXX also assess XXX XXX XXXXXXXX XX psychotic XXXXXXXX, cognitive XXXXXXXXXX, risk of suicide, XXX also -XXXX of violence to persons or XXXXXXXX, risk-XXXXXX XXXXXXXX, XXXXXXXX inappropriate XXXXXXXX, and substance abuse. It XX XXXX XXXXXXXXX to XXXXXX for the XXXXXXX's ability XX XXXX for XXXXXXX or XXXXXXX, childbearing XXXXXX or XXXXX, XXXXXXX, XXXXXXXXX resources, and XXXXXXXXXXXX supports. Once XXXXX, accurate assessment XXXXXXX XX XXXXXXX sources’ information because XXXXXXXXX self-XXXXXX of XXXXXXXX may conflict XXXX XXXXXXXXXXX XX others.
MANAGEMENT
The XXXXXXXX XXXXXXXXX XXX the XXXXXXXXX XX Patients with Bipolar XXXXXXXX XXX developed by The American Psychiatric XXXXXXXXXXX (APA). (XX) There XXX XXXXXXXXXX XX psychiatric management XXXXXXXX in the following.
XXXXXXXXX 1. XXXXXXXXX and XXXXXXXX a therapeutic XXXXXXXX.-This is crucial XXX managing XXXXXX episodes XXX maintaining adherence.
XXXXXXXXX 2. Monitor the patient's psychiatric status.-XXXX XX XXXXXXXXX for early XXXXXXXXX of XXXXXXXXXX.
XXXXXXXXX 3. Provide XXXXXXXXX XXXXXXXXX XXXXXXX disorder.-Discussion on an XXXXXXX process, use XX educational XXXXXXXXX, XXX XXX of XXXXXXXXXX XXXXXXX by peers XX XXXXXX XXX XXXXXXX.
Principle X. XXXXXXX XXXXXXXXX XXXXXXXXX.-XXXXXXX ambivalences XXXXX XXXXXXXXX and XXX of XXXXXXXXXXXXX XXXXXXX XX XXXXXX.
Principle X. Promote XXXXXXX XXXXXXXX XX activity and wakefulness.-XXXXX XXXXXXX XXXX an effect XX mood.
Principle 6. XXXXXXX understanding XX and XXXXXXXXXXX XX XXX XXXXXXXXXXXX effects XX bipolar XXXXXXXX.-XXXXXXX the XXXXXXX effect of the XXXXXXX in XXX psychosocial spheres.
Principle X.XXXXXXXX new episodes XXXXX.-XXXX XXXXXXXX mastery and reduces XXXXXXXXX.
Principle X. Reduce XXX XXXXXXXXX and XXXXXXXX of XXXXXXX XXXXXXXX.-XXXXX XXXXXXXXX, XXXXXXXXXX XX XXXXXXXXX, XXX adherence are critical.
XXXXXXXXX X. Promote acceptance XX the XXXXXXXXX.-XXXXXX stigmatization, promote a XXXXX of “XXXXXXX” XXXXXXX medication, XXXXXXX XXXXXXXXX of siubstances.
Principle XX. XXXXXXX XXXXXXXXX XXXXXXXXX.-Enhance self esteem, resolve interpersonal XXXXXXXXXXXX, XXX promote vocation.
XXXXXXX HISTORY XXX COURSE
XXXX XXXXXXXXXXXXXX of XXX XXXXXXX course XX XXXXXXX disorder XX high rate XX relapse XXX recurrence, (12) at rates XX XX to 90 XXXXXXX. (XX)
In XXXXXXXXXXX XXXXXXX XXXXXXX extending up to XXXX XXXXX, XXXX XXXX half XX patients XXXXXXXX XXXXX an XXXXXXX XXXXX episode had XXXXXXXXX a XXXX response XX treatment. Full XXXXXXXXXX XXXXXXXX between XXXXXXXXX episodes XXXXX lags XXXXXX XXXXXXXXXXX XXXXXXXX. (14)
XXX XXXXXXXXXX probability XX recurrence during XXX XXXXX XXXX XX XXXXXX-up XXX XXXX XXXX XX XXXXXXX, by the end XX XXX XXXX years XXX XXXXX XX percent, and XX XXXX years was XXXXXX XX percent.(15, 13)
TREATMENT
XXXXXX XXXXXXXXX XXX help XXXXXX XXXX XXXXXXX XXXXXXXX XXXX XXXXXXX XXX active XXXXX, XXXX XXXX with the most XXXXXX XXXXX of XXXXXXX XXXXXXXX. Treatment plan XXXX XX XXXXXXXXX usually XXXXXXXX combination XX XXXXXXXXXX and psychotherapy.
It’s a lifelong illness, but the continious treatment may XXXX XXXXXX manage these symptoms.
Medications.XXXXXXXXX XX XXXXXX to XXXXXXX medications be tried to XXXX medication XX found. Medications XXXX for XXXXXXXX bipolar XXXXXXXX XXXXXXX mood XXXXXXXXXXX and XXXXXX-generation (“atypical”) antipsychotics, and also those XXXX are XXXXX prescribed usually XXX treating sleeping XXXXXXXX and XXXXXXX. Sudden XXXXXXXX XX using medications, without XXXXXXXXXXX with doctor XXXXXX XX XXXXXXX, XXXXXXX of ’’rebound’’ syndrome or worsening XXXXXXXX.
Psychotherapy.XX XXX XX effective part XX XXXXXXXX XXXXXXXX; it XXXXXXXX different XXXXXXXXXX that may XXXXXXX XXX XXXXXXX XXXXXXXX, in XXXX way XXXXXXX them to identify and change troubling XXXXXXXX, XXXXXXXX, XXX XXXXXXXXX.
XXXXX XXXXXXXXXX XXXXX helpful XXX XXXXX in the following. XXXXXXXXXXXXXXXXX Therapy (ECT). XXXXXXXXXXXX magnetic XXXXXXXXXXX (XXX). XXXXXXXXXXX. (X)
CONCLUSION
Bipolar XXXXXXXX XX a complex lifelong illness, XXXX several factors XXXXXX XX XXXX XXXX in its XXXXXXXXXXX. XX often may be difficult XX XXXXXXXXX and diagnose. XX might be XXXX-XXXXXXXXX, XXX the XXXXXX diagnosis and treatment can XXXX patients XXXX XXXXXXX XXX active XXXXX.
A XXXXXXXXXXX alliance is crucial XXX XXXXXXXXXXXXX and managing the XXXXXXX.
XXXXXXXXXXX for treating bipolar XXXXXXXX XXXXXX be XXXX in accordance XXXX advice XX a XXXXXX, XXX XXXXXX be avoided stop XXXXX XXXXXXXX, because XX XXX following consequences.
Despite XX XXX XXXXXXX of XXXXXXXXXXXXX, many questions XXXXX bipolar XXXXXXXX XXXXXXX XX XX XXXXXXX an XXXXXX; on XXX other side, many XX them XXXXXX us revolutionise our XXXXXXXX XX the treatment, XXX in this XXX provide a better XXXXXXX XX life XX patients.
XXXXXXXXX
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