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Bipolar Disorder



Bipolar Disorder Definition


Bipolar disorder is not just a single disorder, but a group of mood disorders defined by the presence of one or more episodes of abnormally elevated mood, clinically referred to as mania. People who experience manic episodes also commonly experience depressive episodes or symptoms, or combined episodes which present with features of both mania and depression. These episodes are normally separated by periods of normal mood, but in some patients, depression and mania may rapidly alternate with eachother, known as rapid cycling. The disorder has been subdivided into bipolar I, bipolar II and cyclothymia and is based on the type and severity of mood episodes experienced.


Bipolar Disorder Diagnosis


Diagnosis is based on the experiences of the patient as reported as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a clinician in a clinical assessment. These depend on both the presence and duration of certain signs and symptoms the patient is displaying. An initial assessment may include a comprehensive history and physical examination by a physician. Although no biological tests can confirm bipolar disorder, tests are carried out to exclude medical illnesses which may rarely present with psychiatric symptoms. These include blood tests measuring TSH for basic electrolytes and serum calcium to rule out a metabolic disturbance, to exclude hypo- or hyperthyroidism, full blood count including ESR to rule out a systemic infection or chronic disease, and serology to exclude syphilis or HIV infection. Two commonly ordered investigations are EEG so as not to include epilepsy, and a CT scan of the head to exclude brain lesions. There are several psychiatric illnesses which may present with similar symptoms, including schizophrenia, brief drug-induced psychosis, drug intoxication, schizophreniform disorder and borderline personality disorder.


Bipolar Disorder Epidemiology


Clinical depression and bipolar disorder are classified as separate and distinct illnesses. Some researchers increasingly see them as part of an overlapping range that also includes anxiety and psychosis. According to Hagop Akiskal, M.D., at the one end of the spectrum is bipolar type schizoaffective disorder, and at the other end is unipolar depression, whether it is recurrent or not. Also included in this view is postpartum depression, premenstrual dysphoric disorder, and postpartum psychosis. This view helps explain why many people who have the illness do not have first-degree relatives with clear-cut "bipolar disorder", but who have family members with a history of any of these other disorders.


Bipolar Disorder Treatment


Bipolar disorder cannot be cured, but instead, the emphasis of treatment is on effective management of acute episodes and prevention of episodes to further develop by use of pharmacological and psychotherapeutic techniques.


Drugs used for treatment of Bipolar Disorder


Abilify
Depakote
Geodon
Lamictal
Lithium
Risperdal
Seroquel
Solian
Trileptal
Zyprexa

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