Tuesday, July 17, 2007

Bipolar disorder

Most Scientists believe or agree that multiple factor cause bipolar disorder. Evidence suggests a strong hereditary component. The disease affects men and women about equally, but men who have it experience more manic episodes, are hospitalized most frequently for treatment, and are more likely abuse alcohol and drugs.
Bipolar disorder generally surfaces in teens and young adults, but various age-related conditions can influence diagnosis. For example, in children, determining weather the signs and symptoms are due to bipolar disorder or another condition such as attention deficit hyperactivity disorder can be challenging. In adolescence, hormonal influences can trigger similar signs and symptoms.
An older adult with bipolar disorder may seek help for depression but not report elevated moods. Also, signs and symptoms of comorbid conditions such as an endocrine disease, electrolyte imbalance, adverse drugs reactions, or a neurological disorder can mimic those of bipolar disorder. If the patient gets a mental health diagnosis at all, it may be inaccurate, and inappropriate treatment could cause implication.

Reaching a bipolar diagnosis

The diagnosis of bipolar disorder is based on the patient’s signs and symptoms, the cause of illness, and family history when available. The mental health care provider may use a standardized rating scale such as the mood disorder questionnaire to aid diagnosis. Classic bipolar disorder with recurrent episodes of full-blown mania and depression is called bipolar 1 disorder.
Four or more episodes of illness within a year are called rapid-cycling bipolar disorder. Multiple episodes can occur within a week or even in one day. A severe episode of mania or depression can trigger psychosis and lead to an incorrect diagnosis of schizophrenia. During extreme mania, the patient may have delusions of great wealth or power resulting to terrible thing such as murdering someone.

Risky behavior of bipolar disorder patients

A person with bipolar disorder has a high risk of destructive behaviors, including suicide, addition, and violence. According to the National Institute of Mental Health (NIMH), suicide risk appears higher now than few years ago. The risk of bipolar may be higher when the patient is emerging from depression-before the mood but when better able to make and act on decisions. A suicide attempt may be overt, such as taking a drugs overdose, or covert, such as entering situations with a high risk of death. The American psychiatric Association (APA) cites a probable suicide completion rate of 10% to 15% in people with bipolar 1 disorder.
The APA cites the use of drugs or alcohol as a risk factor for suicide, and substance abuse is very common among people with bipolar disorder. They may turn to these substances in an attempt to manage symptoms, but this kind of self medication can lead to addition, which complicates treatment.
A patient in the manic phase may have extreme of anger and aggressiveness. Someone having delusions may believe that someone or everyone is against them and act to protect themselves, posting a risk of harm to themselves or others.

Methods to manage mood

In 2005, the APA updated its guardlines for treating someone with bipolar disorder. They detailed a “substantially expanded set of options” for treatment based on results of recent scientific studies. Lithium (Eskalith), divalproex (Depakote), and carbamazepine (tagretol) are commonly used as first-line mood stabilizers, and anticonvulsants, antipsychotics, and antidepressants may be prescribed as well. Psychotherapy and electroconvulsive therapy (ECT) also may play a role in therapy.
Lithium is a simple alkali metal that’s similar to sodium, has been used over 50 years to treat bipolar disorder. Often very effective at controlling mood, it has a narrow therapeutic range and can cause various adverse reactions. Safe, effective therapy depends on maintaining the patient’s plasma lithium level within the therapeutic range, so frequent monitoring initiation and periodic checks during long-term therapy are essential.

How to intervene

Because bipolar disorder is a chronic illness, one may encounter a patient with this diagnosis in any setting. Interventions include assessing and protecting the patient, administering medications and monitoring their effects, and teaching the patient and his or her family, if appropriate, about the disorder and treatment. To foster a positive response, try to establish a supportive relationship and provide a safe, structured environment.
Suicide and homicide are the most dangerous potential consequences of bipolar disorder. If the patient mentions killing his or herself or others, take it seriously.