People with bipolar disorder experience periods of abnormal intense emotion. They also go through changes in sleep patterns, activity levels, and unusual behaviors. These distinct periods are referred to as mood episodes. Mood episodes are drastically different moods and behaviors that are typical for a person. Extreme changes in sleep, energy, and activity, go along with mood episodes.
Sometimes a mood episode includes a combination of both manic and depressive symptoms. This is called an episode with mixed features. People experiencing an episode with mixed features may feel terrified, hopeless, or just empty inside while at the same time feeling excessively energized.
Bipolar disorder can exist even when mood swings are less than extreme. Instead of mania, some people with bipolar disorder experience hypomania. During a hypomanic episode an individual may be highly productive and function well, while feeling elated in the mood department. The person may not feel that anything is wrong, but family and friends may recognize the mood swings and changes in activity levels as possible signs of bipolar disorder. Without proper treatment, people with hypomania may develop severe symptoms of mania or depression.
Bipolar I disorder has several classifications of numbers in the most current DSM-V manual based off of the severity of behavioral changes and the last time and episode has occurred. If your current or most recent episode was mild with mania, it’s defined under number 296.41. Mild with depressive: 296.51. Moderate and manic: 296.42. Moderate and depressed: 296.52. Severe with mania: 296.43. Severe with depression: 296.53. If the last episode had shown signs of psychotic features with mania or depression, those are defined under 296.44 and 296.54 respectively. Sections 296.45 and 296.55 cover the stages that are in partial remission but with mania, hypomania, or depression. If the symptoms are in full remission, details can be looked up in 296.46 and 296.56. If the current episode, or the most recent, had shown signs of mania, hypomania, or depression, but all other symptoms and conclusions are unspecified, they are found in the DSM-V manual under numbers 296.40 and 296.50.
Bipolar II disorder has only one number: 296.89. The number is usually followed with a status of the current severity, presence of psychotic features, course, and other specifies that cannot be coded. These non-coded inclusions should be indicated in writing after the DSM-V number. For example: 296.89 Bipolar II Disorder, current episode depression, severe with mixed features. Heritability Family studies have shown that bipolar I and II are somewhat genetically distinct. Relatives of bipolar II have a higher risk of also being diagnosed with bipolar II than those patients related to someone with bipolar I. Although these are not etiologically distinct, genetic influences are the stronger predictors of bipolar disorders. An individual who has an identical twin with bipolar disorder has a 70% chance of also having the disorder. A patient with a fraternal twin has more than a 10% probability. Relativity common polymorphisms of genes coding for the serotonin transporter protein and brain derived neurotrophic growth factor may have a small contribution to the development of bipolar disorder. Because of variable findings in these chromosomal regions, it is likely that bipolar disorder is caused by the presence of multiple genes conferring susceptibility through heretics. General acceptance is that bipolar disorder is a disorder with a strong genetic influence, so no specific gene has been identified as the one bipolar gene.
Some bipolar disorder symptoms are similar to other illnesses, which can make it hard for a doctor to diagnose. Many people have bipolar disorder along with another illness such as an eating disorder, anxiety disorder, or substance abuse. People with bipolar disorder are also at a higher risk for thyroid disease, migraines, obesity, heart disease, diabetes, and other physical illnesses. Bipolar disorder is treated using mainly three types of medications: mood stabilizers, antipsychotics, and antidepressants. Treatment typically involves a combination of at least one mood stabilizing drug or antipsychotic, plus psychotherapy. Commonly used drugs for bipolar disorder are lithium carbonate and valproic acid. Although doctors still don’t know precisely how it works, lithium carbonate has been remarkably effective in reducing mania. Lithium may also prevent the recurrence of depression but it’s more successful against mania.
Some drugs can level out emotions over the long term, and valproic acid is a mood stabilizer that is helpful in treating the manic or mixed phases of bipolar disorder, along with carbamazepine, another antiepileptic drug. These medications may be used alone or in combination with lithium to control any symptoms. Some drugs that are diagnosed can potentially become toxic if the doses are too high. Once prescribed, patients need to be monitored periodically with blood tests and clinical assessments by the prescriber.
While medications are usually the foundation of treating bipolar disorder, psychotherapy is also important to help patients understand and accept the personal and social disruptions of past episodes and better cope with future ones. Different forms of psychotherapy have been shown to help speed recovering and improve functioning in bipolar disorder, including cognitive-behavioral therapy, interpersonal therapy, family therapy, and group therapy. Because denial is usually an ongoing problem with bipolar disorder, routinely attending psychotherapy can help patients stay on their medications.
Even though many Americans have been diagnosed with bipolar disorder, and others who are living through life without knowing they have any kind of disorder, bipolar disorder has been shown that with proper techniques, coping mechanisms, therapy, and medications, it can be a manageable disorder to live with. If someone you live with has bipolar disorder, try to maintain a calm environment, and keep to a regular routine for daily activities. More and more drugs are being developed to also help combat any manic or depressive episodes. Even though this disorder can cripple certain people for periods of time, forms of psychotherapy can show patients how to cope with bipolar disorder in order to have a functioning lifestyle and maintain basic everyday activities.
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