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Bipolar Depression

[22 May 2010 | No Comments | 3 views | Author: Dee Braun, DrR, CA, CCT]
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Bipolar depression is one half of bipolar disorder. The distinguishing characteristic of bipolar disorder, as compared to major depression, is the presence of at least one manic episode. And, this is assumed to be a chronic condition because sufferers who have one manic episode have additional episodes in the future.

Bipolar depression typically begins in the adolescent or early adult years. Research has found that it has a genetic component. Approximately 80-90% of those who have bipolar depression have a family history of depression. However, despite ongoing research the exact genetic defect associated with the illness has not been identified.

Interestingly, persons with bipolar disorder or bipolar depression do not exhibit a random episodic illness but rather the episodes are predictable by the family which can help in diagnosis, treatment and copying mechanisms.

More than 2 million Americans have manic-depressive illness, otherwise known as bipolar disorder or bipolar depression. Like any other serious disorder bipolar depression creates problems for families, friends, employers and spouses. Without treatment people who suffer from bipolar depression often suffer the loss of marriages and jobs and have alcohol and drug abuse problems. Some resort to suicide after chronic and episodic mood swings.

The manic episodes, that are the hallmark of bipolar disorder, are recognized by the abnormally elevated, expansive or irritable mood that isnt related to substance abuse or a medical condition. These mood swings will last for at least 3 weeks. It may be helpful to describe bipolar disorder as mood states along a continuum. On end of the spectrum is severe depression, then moderate depression, then mild to brief mood disturbances that many call the blues. At the fulcrum is a normal mood. As the mood swings to the other end of the spectrum, the patient and family experience hypomania (a mild form of mania) and then mania.

Patients and sufferers dont experience the mood swings along the full length of the continuum with each episode but instead some have repeated episodes of depression and only the occasional episode of hypomania which may lead to mania. On the other extreme mania could be the main issue and depression is infrequent. Most patients dont move from severe depression through mania and back again.

There are specific observable features to both the depressive episodes and the manic episodes that families and friends can watch for. During a bipolar depression the patient is sad, anxious or feels empty. They complain of feeling helpless, guilty or worthless. Youll notice they lose interest in the usual activities and have a decreased energy level. The sufferer will have sleep disturbances, loss of or increased appetite and may have persistent thoughts of death.

During the manic phase of a bipolar disorder episode the sufferer will be charismatic, exhibit poor judgment and have an increased sex drive. They may exhibit provocative or obnoxious behavior, unrealistic belief in their own ability, decreased sleep and increased risk taking. Many sufferers also complain of extreme irritability, distractibility or increased energy.

Treatment of bipolar depression focuses on the life adjustment problems that develop because of the manic episodes and psychological counseling will help the sufferer recognize the onset of a manic episode so they are able to take corrective action. Psychological counseling and support partners are needed to help the sufferer understand and accept that they have a problem that will have an impact on their life management. A person diagnosed with bipolar disorder should be under the care of a psychologist and psychiatrist. The psychologist provides the support for the patient, family as well as education and coping skills training while the psychiatrist will monitor the symptoms and adjust the medication that is usually necessary to control the disorder.

Almost all people with bipolar disorder or bipolar depression can be helped. Even those with the most severe forms respond to treatments and medications to stabilize their mood swings. Doctors may use lithium to control the mania and depressive episodes or combine that with anticonvulsant medications such as carbamazepine or valproate. Other doctors can use the SSRI class of antidepressant drugs in conjunction with lithium. Anti-psychotic drugs and Seroquel have also been approved for use with bipolar disorder or bipolar depression. The American Diabetic Association warns that those taking anti-psychotic drugs or Seroquel will increase their risk of obesity, high blood pressure and diabetes, which is why they recommend periodic screening.

With appropriate diagnosis and treatment those with bipolar depression can live without overwhelming depression or life altering mania. With psychotherapy, medications and caring family and friends sufferers are often able to remain in stable marriages and hold down steady jobs.

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