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Bipolar Disorder

Bipolar Disorder

Changing feelings of happiness and sadness are part of life.  For someone with bipolar disorder, these emotional ups and downs are more intense and usually more frequent.  People with bipolar disorder have moods swings that can go from very low (depression) to very high (mania).  Bipolar disorder often develops in the late teens or early adult years.  Sometimes symptoms are so severe that the person cannot function normally.  Dr. Sam and her associate  Cindy Gelber,  use a uniquely holistic approach to help you take charge of bipolar disorder so that it no longer controls your life.

So how do you know if you actually have bipolar disorder?  It is a term that has come to be overused in both psychiatry and the media.  During a manic episode it is very common to feel  “high.” with heightened energy, creativity, and even a feeling of euphoria.  The feeling of being all-powerful, invincible, or destined for greatness. Manic people often talk a mile a minute, jumping from one idea to the next because of racing thoughts. They often sleep very little, are hyperactive and easily distracted. But while mania feels good at first, it has a tendency to spiral out of control. People often behave recklessly during a manic episode: gambling away savings, engaging in inappropriate sexual activity, or making foolish business investments, for example. They may also become angry, irritable, and aggressive–picking fights and lashing out when others don’t go along with their plans.

Hypomania is a less severe form of mania.  Those in a hypomanic state feel euphoric, energetic, and productive, but they are able to carry on with their day-to-day lives and they never lose touch with reality. To others, it may seem as if people with hypomania are merely in an unusually good mood. However, hypomania can result in bad decisions that harm relationships, careers, and reputations. In addition, it can often escalate to full-blown mania or result in a major depressive episode.

Common signs and symptoms of mania include:

  • Feeling unusually “high” and optimistic OR extremely irritable
  • Unrealistic, grandiose beliefs about one’s abilities or powers
  • Sleeping very little, but feeling extremely energetic
  • Talking so rapidly that others can’t keep up
  • Racing thoughts; jumping quickly from one idea to the next
  • Highly distractible, unable to concentrate
  • Impaired judgment and impulsiveness
  • Acting recklessly without thinking about the consequences
  • Delusions and hallucinations (in severe cases)

Bipolar Depression

In the past, bipolar depression was viewed as identical to regular or “unipolar” depression. But a growing body of research suggests that there are significant differences between the two, especially when it comes to recommended treatments. Most people with bipolar depression are not helped by antidepressants. In fact, there is a risk that antidepressants can make bipolar disorder worse–triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.

For example, bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings, and feelings of restlessness. People with bipolar depression also tend to move and speak slowly, sleep a lot, and gain weight. In addition, they are more likely to develop psychotic depression–a condition in which they’ve lost contact with reality–and to experience major disability in work and social functioning.

Mixed Episodes

A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression. Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood makes for a particularly high risk of suicide.

  • Bipolar I Disorder (mania or a mixed episode) – The classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Usually—but not always—Bipolar I Disorder also involves at least one episode of depression.
  • Bipolar II Disorder (hypomania and depression) – In Bipolar II disorder, the person doesn’t experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
  • Cyclothymia (hypomania and mild depression) – Cyclothymia is a milder form of bipolar disorder. It consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.

The Role Of Neurotransmitters

The cause of bipolar disorder is attributed to a wide range of both physical and environmental factors. The most prevalent physical, or biological cause is the fact that bipolar disorder (similar to major depression) is largely inherited. Studies suggest that a low, high or imbalanced level of the chemical substances (neurotransmitters) that convey messages from nerve to nerve result in the symptoms of bipolar disorder. Specifically involved are the neurotransmitters called serotonin, norepinephrine and dopamine. Mood stabilizing medications such as lithium and Abilify are most always a critical element of treatment and ongoing recovery for bipolar disorder.

How Can Therapy Help?

Psychotherapy can help you learn about yourself, and the specific triggers for your episodes. Together we will aim to change your thought patterns and behaviors to those which help sustain a healthy stable and positive mood. We will also work together on developing regular daily routines and sleep schedules to help protect you against manic or hypomanic episodes. Not only will you soon regain confidence in your mental stability and your future, but through family counseling those closest to you will get the support, education, and guidance they need as well.

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