Description Bipolar disorders (Manic- Depressive Illness) are those in which individuals experience the extremes of mood polarity

(Keltner, et. al). Stress, substance abuse, medication, seasonal changes and sleep deprivation can cause or trigger the condition Manic Episodes o This is characterized by an elevated, expansive or irritable mood and are fundamentally diagnose as Bipolar 1. For it to be considered as BP1, the symptoms are occur at least 1 week. o Symptoms usually begin suddenly, escalate rapidly and last from few days to several months. Hypomanic Episodes o Same as manic episodes but with severe level of impairment. Patient with this disease feels good about himself and life which is considered normal. Depressive Episodes o Bipolar depression Symptoms are atypical. Hypersomia, hyperphagia and weight gain and might have craving for carbohydrates and might experience leaden paralysis and is common in younger age. o Unipolar depression Paranoid thoughts, irritable and may experience hallucinations.

Four Types of Mood Episodes Bipolar 1 Disorder Swings between manic episodes and major depression. Bipolar 2 Disorder Never experienced a manic episode but only a hypomanic episode. Cyclothymic disorder Swings from one side to the other but never reaches the extremes of arc. Signs and Symptoms Manic Episode Depressive Episode

Elevated mood Gradiosity, inflated self-esteem Irritability Anger Insomnia Anorexia Flamboyant gestures Flight of ideas, racing thoughts Distractibility Hyperactivity Involvement in pleasurable activities Loud, rapid speech; talkative High energy Increased interest in sex High rate of suicide Excessive makeup Other symptoms Labile mood Delusions Hallucinations Depressed mood Low self-esteem

Withdrawal Passivity Insomnia, daytimesleepiness Anorexia Sluggish thinking Difficulty concentrating, distractibility Inertia Diminished interest in activities, inappropriate or excessive guilt Decrease in speech Fatigue Decreased interest in sex High rate of suicide Other symptoms Memory loss Abnormal thoughts about death Weight loss

Treatments

Bipolar disorder requires long-term treatment. Bipolar disorder is a chronic, relapsing illness. Continuing treatment even when youre feeling better is important to prevent new episodes and stay symptom-free. There is more to treatment than medication. Medication alone is usually not. To make treatment more effective, combination of medication, therapy, lifestyle changes, and social support is a good strategy. Its best to work with an experienced psychiatrist. Due to its complexity the diagnosis can be tricky and treatment is often difficult. Medication should be closely monitored. A psychiatrist who is skilled in bipolar disorder treatment can help.

Medications

Lithium It is not only for bipolar disorder but it is also use to even out mood swings. Lithium will usually reduce severe manic symptoms in one to two weeks. It may take weeks to several months before the condition is fully controlled. People taking lithium must have regular blood tests. If too little is taken, lithium will not be effective. If too much is taken, severe side effects may occur. side effects such as drowsiness, weakness, nausea, fatigue, hand tremor, or increased thirst and urination. Kidney changes may also develop during treatment, such as increased urination. Lithium can also cause changes in the thyroid gland, so thyroid function monitoring is a part of the therapy. To restore normal thyroid function, thyroid hormone may be given along with lithium. Lithium needs to be prescribed with caution when a person has thyroid, kidney, or heart disorders, epilepsy, or brain damage. Lithium increases the risk of congenital malformations in babies. Caution should be used in women of childbearing age and lithium should be avoided during the first three months of pregnancy if at all possible. Lithium is a salt. Anything that lowers the level of sodium in the body may cause a lithium buildup and lead to toxicity. Examples include reduced intake of table salt, a switch to a low-salt diet, heavy sweating from an unusual amount of exercise or a very hot climate, fever, vomiting, or diarrhea. Signs of lithium toxicity may include nausea, vomiting, drowsiness, mental dullness, slurred speech, blurred vision, confusion, dizziness, muscle twitching, tremor, irregular heartbeat, and seizures. A lithium overdose can be lifethreatening.

Anticonvulsants Valproic acid Main alternative therapy for bipolar disorder. It is as effective as lithium for acute mania, and may be superior to lithium in certain subtypes of bipolar illness such as rapid-cycling and dysphoric mania. Can cause gastrointestinal side effects headache, double vision, dizziness, anxiety, or confusion. Valproic acid has rarely caused liver problems, so liver function tests should be performed before therapy and at frequent intervals afterward, particularly during the first 6 months of therapy. Caution should be used in women of childbearing age as Depakote is associated with specific birth defects when used in the first trimester of pregnancy.

Other anticonvulsants used for bipolar disorder include carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax). Lamotrigine may be particularly effective in bipolar depression. Atypical antipsychotic medications are sometimes prescribed for bipolar disorder. They may be used early in treatment to manage mania, or they may be used longer-term. Many people who have bipolar disorder take more than one medication. Along with lithium and/or an anticonvulsant, they may take a medication for accompanying agitation, anxiety, insomnia, or depression. It is important to keep taking the mood stabilizer when taking an antidepressant because treatment with an antidepressant alone increases the risk that the patient will switch to mania.