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Encyclopedia > Polar behaviour
Bipolar affective disorder
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ICD-10 F31
ICD-O: {{{ICDO}}}
ICD-9 296
OMIM

{{{OMIM}}} The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ...

MedlinePlus {{{MedlinePlus}}}
eMedicine {{{eMedicineSubj}}}/{{{eMedicineTopic}}}
DiseasesDB {{{DiseasesDB}}}

Bipolar disorder, still often referred to colloquially as manic-depression, is a mood disorder marked by episodes of clinically significant impairment due to mania or depression. MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... A mood disorder is a condition where the prevailing emotional mood is distorted or inappropriate to the circumstances. ... This article is about the medical condition. ... Look up depression in Wiktionary, the free dictionary. ...


Emil Kraepelin, who first described the illness and coined the term "manic depression", noted in his original delineation of the disease that intervals of acute illness, manic or depressive, were generally punctuated by relatively symptom-free intervals in which a patient was able to function normally. Emil Kraepelin (February 15, 1856- October 7, 1926) was a German Psychiatrist who attempted to create a synthesis of the hundreds of mental disorders classified by the 19th century, grouping diseases together based on classification of common patterns of symptoms, rather than by simple similarity of major symptoms in the...


To that point, there are currently three types of Bipolar disorder outlined by the DSM-IV-TR generally accepted within the medical community; Bipolar I, Bipolar II, and Cyclothymia. Like many disorders involving brain chemistry, Bipolar disorder is still under investigation, and the range of symptoms may differ dramatically from person to person. Typically, symptoms of Bipolar disorder include periods of euphoria, which alternate with periods of profound depression. Very often, periods of mood stability complement these periods of instability. Individuals experiencing symptoms that do not fit within the criteria of these three disorders would be diagnosed Bipolar, Not Otherwise Specified (NOS). The abbreviation DSM can mean several things: General Defense Suppression Missile Deputy Stage Manager Design Structure Matrix Demand Side Management of energy the IATA airport code for Des Moines International Airport in Des Moines, Iowa, USA (and sometimes used as a written abbreviation for the city of Des Moines itself...

  • Symptoms of Bipolar I - one or more episodes of mania or depression every day for at least one week punctuated by periods of mixed episodes (where mania and depression may occur simultaneously).
  • Symptoms of Bipolar II - one or more episodes of depression accompanied by at least one episode of Hypomania.
  • Symptoms of Cyclothymia - fluctuating moods and periods of depression and hypomania. These episodes are usually shorter and do not occur with the same day to day regularity of Bipolar I or Bipolar II. The episodes are often less severe than in the type I or type II categorizations.

Contents

Hypomania is a state involving combinations of: elevated mood, irritability, racing thoughts, people-seeking, hypersexuality, grandiose thinking, religiosity, and pressured speech. ...


Diagnostic criteria

The DSM-IV-TR details two general profiles of bipolar disorder, Bipolar I and Bipolar II. Bipolar I is characterized by alternating episodes of full-blown mania and depression, while Bipolar II, the less severe and more common type of the disorder, is characterized by episodes of hypomania and depression. The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and internationally. ...


Criteria for a MANIC EPISODE (DSM-IV-TR):


A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).


B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:


(1) inflated self-esteem or grandiosity (2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) (6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) Sex, in the scope of this article and category, refers to the male and female duality of biology and reproduction. ...


C. The symptoms do not meet criteria for a Mixed Episode.


D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.


E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).



Criteria for a MAJOR DEPRESSIVE EPISODE (DSM-IV-TR):


A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) or (2).


(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others) (3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. (4) Insomnia or Hypersomnia nearly every day (5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) (6) fatigue or loss of energy nearly every day (7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) (8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) (9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide Guilt is a word describing many concepts related to an emotion or condition caused by actions which are, or are believed to be, morally wrong. ...


B. The symptoms do not meet criteria for a Mixed Episode.


C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.


D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).


E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.



Criteria for a MIXED EPISODE:


A. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.


B. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.


C. The symptoms are not due to the direct physiological effects of a substance (e.g., a illicit drugs, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).



Criteria for a HYPOMANIC EPISODE:


A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non depressed mood.


B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:


(1) inflated self-esteem or grandiosity (2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) (6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)


C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.


D. The disturbance in mood and the change in functioning are observable by others.


E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.


F. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).



According to the DSM-IV-TR, a diagnosis of bipolar I disorder requires at least one manic or mixed episode, but may also include hypomanic or depressive episodes. A depressive episode is not required for a diagnosis of bipolar I disorder.


A diagnosis of bipolar II disorder requires neither a manic nor mixed episode, but requires at least one hypomanic episode AND one major depressive episode.


A diagnosis of cyclothymic disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do NOT meet the criteria for major depressive episodes.


If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the exact criteria for one of the conditions laid out above, he or she receives a diagnosis of bipolar disorder NOS (not otherwise specified).


Other types of mood disorders include major depressive disorder and dysthymic disorder. Bipolar and other mood disorders may have no identifiable medical, traumatic or other external cause (exogenous) or may be due to a medical condition (endogenous). Environment also comes into play, as with Seasonal Affective Disorder. Current psychiatric view no longer labels mood episodes as endogenous or exogenous. The exceptions being a substance induced mood disorder or a mood disorder due to a general medical condition. Clinical depression is state of sadness or melancholia that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... Dysthymia or dysthymic disorder is a form of the mood disorder of depression characterised by a lack of enjoyment/pleasure in life that continues for at least two years. ... Seasonal affective disorder, or SAD, is an affective, or mood disorder. ...


Epidemiology

The lifetime prevalence rate of Bipolar Disorder I and II is between .6 and 2% of the population. (Goodwin & Jamison, p.163) Bipolar I disorder is gender-neutral, affecting both women and men equally, according to the DSM. Bipolar II is found more frequently in women (Goodwin & Jamison, p166ff). No publication to date has suggested that there is a difference between races in the prevalence of bipolar disorder.


Most frequently, the disorder starts with a depressive interval, and mania or hypomania follows. In the vast majority of cases, the symptoms begin in early adulthood, and continue over the course of the lifespan. There are some occurrences of a single manic episode followed by full recovery with no recurrence; however, these cases are rare enough to suggest some other confounding factors. This article is about the medical condition. ... Hypomania is a state involving combinations of: elevated mood, irritability, racing thoughts, people-seeking, hypersexuality, grandiose thinking, religiosity, and pressured speech. ...


For many years it was believed that the Bipolar profile emerged in late adolescence and/or young adulthood. Recent research by the National Institute for Mental Health suggests that even young children can suffer from Bipolar symptoms or precursors.NIMH Roundtable These precursors can include acute anxiety or panic attacks. Although there is no specific official diagnostic category for this pre-adolescent patient profile, it is often called "pediatric bipolar disorder". NIMH or NiMH may refer to: National Institute of Mental Health, a part of the United States National Institutes of Health. ... Anxiety is a complex combination of negative emotion that includes fear, apprehension and worry, and is often accompanied by physical sensations such as palpitations, chest pain and/or shortness of breath. ... A panic attack is a period of intense fear or discomfort, typically with an abrupt onset and usually lasting no more than thirty minutes. ...


Etiology

There are many theories regarding the development of Bipolar disorder. Multiple factors may be involved, such as stressful events or major life transitions, conditions in the womb, past or present drug use (may complicate diagnoses if present and may lead to misdiagnoses), sleep deprivation, drug use, both legal and illegal, or a family history of bipolar disorder, clinical depression, or schizophrenia. This type of family history creates a genetic vulnerability which can significantly increase the likelihood of developing the disorder Genetic Likelihood. Clinical depression is state of sadness or melancholia that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ...


The "kindling" theory [1] asserts that people who are genetically predisposed toward bipolar disorder experience a series of stressful events, each of which lowers the threshold at which mood changes occur. Eventually, the mood episode itself is sufficient to trigger recurring difficulties.


As with nearly all psychiatric or psychological phenomena, the etiology of bipolar disorder is thought to include a complex interply between environmental stimuli (stressful life events, drug use, etc.) and genetic vulnerability. While bipolar disorder has a strong genetic component, the concordance rate between MZ (identical) twins, who share 100% of their DNA, is not 100%. Therefore, environmental and genetic factors must be at play.


Many drugs, legal and illegal, may intiate a manic episode. The mania induced by such drugs, including antidepressant medications and stimulants (e.g. Adderall or methamphetamines), may or may not resolve when the medication is discontinued.


Comorbid conditions

Several disorders may occur simultaneously with bipolar I and II disorders. As these disorders are not all episodic, they may present themselves during the course of both mood dysregulation or mood stability. Further, the medications used to manage the symptoms of bipolar disorders may be ineffective against the symptoms of comorbid disorders, and, in some cases, are contraindicated because they aggravate other conditions.


Anxiety disorders or obsessive-compulsive disorder (mild or severe) may occur in conjunction with bipolar disorder. Other co-occurring symptomologies may include panic disorder, social phobia, suicidal ideation, substance dependence, and somatization disorders. Another comorbid condition that often confuses the diagnosis in the juvenile population is ADHD. ADHD and bipolar disorder co-occur frequently, perhaps due to their overlapping symptom profiles or to the prescription of stimulant medications to juveniles with ADHD [2]. Anxiety disorder is a blanket term covering several different forms of fear, phobia and nervous condition, that come on suddenly and prevent pursuing normal daily routines including: general anxiety disorder social anxiety, sometimes known as social phobia or social anxiety disorder (SAD) specific phobias agoraphobia claustrophobia panic disorder separation anxiety... It has been suggested that Suicide and culture be merged into this article or section. ... Drug addiction, or substance dependence is the compulsive use of drugs, to the point where the user has no effective choice but to continue use. ...


Cycles in bipolar disorder

The cycles of bipolar disorder may be long or short, and the ups and downs may be of different magnitudes: for instance, a person suffering from bipolar disorder may suffer a protracted mild depression followed by a shorter and intense mania. The depressed periods may seem much worse following a manic period from the point of view of the patient.


Severe depression or mania may be accompanied by symptoms of psychosis. These symptoms include hallucinations (hearing, seeing, or otherwise sensing the presence of stimuli that are not there) and delusions (false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's cultural concepts). Psychotic symptoms typically reflect the extreme mood state at the time. This article is about the mental state. ... A hallucination is a sensory perception experienced in the absence of an external stimulus, as distinct from an illusion, which is a misperception of an external stimulus. ... A delusion is commonly defined as a fixed false belief and is used in everyday language to describe a belief that is either false, fanciful or derived from deception. ...


Domains of bipolar disorder

Mania

Researchers at Duke University have refined Kraepelin’s four classes of mania to include hypomania (featuring mainly euphoria), severe mania (including euphoria, grandiosity, high levels of sexual drive, irritability, volatility, psychosis, paranoia, and aggression), extreme mania (most of the displeasures, hardly any of the pleasures) a.k.a. dysphoric mania, and two forms of mixed mania (where depressive and manic symptoms collide)[3]. Duke Chapel Duke University is a private, coeducational, research university located in Durham, North Carolina, USA. Although founded in 1924, Duke traces its roots back to 1838. ... Euphoria may refer to: A psychological state of intense good feeling, see happiness Euphoria, a pop/dance music act from the 1990s Euphoria, a psychedelic music group Euphoria, an album by Leftover Salmon Euphoria, an album by Def Leppard Euphoria programming language Euphoria, a movie directed by Brad Armstrong (Euphoria... Libido in its common usage means sexual desire, however more technical definitions, such as found in the work of Carl Jung, sex is when the mans penis (normally very big) goes in to the womans vagina opening. ... Irritability is an irregularly updated web comic by Mike E. Woodson. ... Volatility is the standard deviation of the change in value of a financial instrument with a specific time horizon. ... This article is about the mental state. ... In popular culture, the term paranoia is usually used to describe excessive concern about ones own well-being, sometimes suggesting a person holds persecutory beliefs concerning a threat to themselves or their property and is often linked to a belief in conspiracy theories. ... Aggression is sometimes used for beneficial purposes, for instance, by inducing intimidation and coercion during extremely rigorous physical training. ...


Hypomania

Hypomania is a less severe form of mania without progression to psychosis. Many of the symptoms of mania are present, but to a lesser degree than in overt mania. People with hypomania are generally perceived as being energetic, euphoric and overflowing with new ideas, yet they are sufficiently capable of coherent thought and action to participate in everyday life. Hypomania is a state involving combinations of: elevated mood, irritability, racing thoughts, people-seeking, hypersexuality, grandiose thinking, religiosity, and pressured speech. ... This article is about the medical condition. ... This article is about the mental state. ...


It is questionable whether hypomania occurs without being part of a cycle of mania or depression. Patients rarely, if ever, seek out a psychiatrist complaining of hypomania. Johns Hopkins psychologist John Gartner in The Hypomanic Edge contends that many famous people – including Christopher Columbus, Alexander Hamilton, Andrew Carnegie, Louis B Mayer, and Craig Venter (who mapped the human genome) owed their ideas and drive (and eccentricities) to their hypomanic temperaments. The creativity and risky behavior associated with hypomania (and bipolar disorder in general) may suggest why it has survived evolutionary pressures. Christopher Columbus (1451 – 20 May 1506) was an Italian explorer and trader who crossed the Atlantic Ocean and reached the Americas on October 12, 1492 under the flag of Castile. ... A portrait of Alexander Hamilton by John Trumbull, 1792. ... Andrew Carnegie (November 25, 1835 – August 11, 1919) was a Scottish-American businessman, a major philanthropist, and the founder of the Carnegie Steel Company which later became U.S. Steel. ... Louis Burt Mayer (July 4, 1882 – October 29, 1957) was an early film producer. ... Dr. Venter (right) with Michael Janich on his visit in Hong Kong in December 2004 John Craig Venter (born October 14, 1946, Salt Lake City) is an American biologist and businessman. ... In biology the genome of an organism is the whole hereditary information of an organism that is encoded in the DNA (or, for some viruses, RNA). ...


Although hypomania sounds in many ways like a desirable condition, it does have significant downsides. Many of the negative symptoms of mania can be present; the primary differentiating factor is the absence of psychosis. Many hypomanic patients have symptoms of disrupted sleep patterns, irritability, racing thoughts, obsessional traits, and display poor judgment. Hypomania, like mania, can be associated with recklessness, excessive spending, risky hypersexual activity, general lack of judgment and out-of-character behaviour that the patient may later regret and may cause significant social, interpersonal and financial problems. This article is about the mental state. ...


Hypomania can also signal the beginning of a more severe manic episode, and in people who know that they suffer from bipolar disorder, can be used as a warning sign that a manic episode is on the way, allowing them to seek medical treatment while they are still sufficiently self-aware before descent into psychosis corresponding with full-blown mania occurs. This article is about the mental state. ...


Bipolar depression

People with bipolar disorder are depressed far more often than they are manic. According to the Stanley Foundation Bipolar Network, bipolar patients spend three times more days in depression than they do in mania[citation needed], however, there are cases of Bipolar I in which patients are primarily manic. For bipolar II patients, a study by Hagop Akiskal of the University of California, San Diego revealed this population was depressed 37 times more than they were hypomanic[citation needed]. The University of California, San Diego (popularly known as UCSD) is a public, coeducational university located in La Jolla, California. ...


A 2003 study by Robert Hirschfeld of the University of Texas, Galveston found bipolar patients fared worse in their depressions than unipolar patients. (See Bipolar Depression.) The University of Texas Medical Branch at Galveston (UTMB) is a component of the University of Texas System located in Galveston, Texas. ...


Cognition

Numerous studies show that bipolar disorder affects a patient's ability to think and perform mental tasks, even in states of remission[4]. Deborah Yurgelun-Todd of McLean Hospital in Belmont, Massachusetts has argued these deficits should be included as a core feature of bipolar disorder. By the same token, research by Kay Jamison of Johns Hopkins University and others have attributed high rates of creativity and productivity to individuals with bipolar disorder. (See Brain Damage.) However, there is no conflict here: cognitive dysfunction does not necessarily bar creativity. However, cognitive dysfunction does not always entail intellectual impairment either. McLean Hospital is a psychiatric hospital in Belmont, Massachusetts. ... Belmont is a town located in Middlesex County, Massachusetts, a suburb of Boston. ... Official language(s) English Capital Boston Largest city Boston Area  - Total  - Width  - Length  - % water  - Latitude  - Longitude Ranked 44th 27,360 km² 305 km 80 km 25. ... Kay Redfield Jamison (born October 14, 1946) is an American psychologist and science writer who is an expert on bipolar disorder. ... The Johns Hopkins University is a private institution of higher learning located in Baltimore, Maryland, United States. ...


The Mood Spectrum Perspective

Clinical depression and bipolar disorder are classified as separate illnesses, but psychiatry is increasingly viewing them as part of an overlapping spectrum that also includes anxiety and psychosis.


In a 2003 study, Akiskal and Judd re-examined data from the landmark Epidemiological Catchment Area study from two decades before.[citation needed] The original study found that .08 percent of the population surveyed had experienced a lifetime manic episode (the diagnostic threshold for bipolar I) and .05 a hypomanic episode (the diagnostic threshold for bipolar II). But by tabulating survey responses to include criteria below the diagnostic radar, such as one or two symptoms over a short time period, the authors of the study recalculated the data to arrive at an additional 5.1 percent of the population, adding up to a total of 6.4 percent of the entire population who could conceivably be thought of as having bipolar disorder.


There is also a case that clinical depression can be bipolar disorder waiting to happen. In a 2005 study, Jules Angst and his colleagues at Zurich University tracked 406 patients with major mood disorders over a 20-year period.[citation needed] Of 309 patients presenting with depression, 121 (39.2 percent) eventually manifested as bipolar (24.3 percent to bipolar I, 14.9 percent to bipolar II). In all, more than 50 percent of the study population turned out to have bipolar disorder. This could also be attributed to the fact that most cases of bipolar disorder are first misdiagnosed as depression. Clinical depression is state of sadness or melancholia that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... The University of Zurich (in German: Universität Zürich) is the largest university of Switzerland. ...


Environmental factors affecting mood in bipolar disorder

In mid-2003, a twin study was published concerning environmental factors and bipolar disorder. The bipolar twin was found to be far more affected by changes in sunlight. Longer nights resulted in mood and sleep-length changes far greater than the healthy twin. Sunny days also did more to improve mood. In fact, natural light in general was found to have a profound positive effect upon the well-being of the bipolar twin.[5] A twin study is a kind of genetic study done to determine heritability. ...


Paradoxically, in the 2004 publication of a study using Tel Aviv's public psychiatric hospitals, it was found that "Admission rates of bipolar depressed patients increase during spring/summer and correlate with maximal environmental temperature".[6] Unipolar depressed patient admission had no such correlation. High temperature points in the month, as well as high temperature months, were found to be correlated with depressive episodes in admissions. Tel-Aviv was founded on empty dunes north of the existing city of Jaffa. ...


In contrast, it has been found that the bipolar cycle tends towards extreme mania in the mid-to-late-summer, followed by an inevitable crash into depression with the ending of the manic episode coupled with the decreasing natural light in autumn.


Treatment of bipolar disorder

There is no cure for bipolar disorder; the emphasis is on management of the symptoms. A variety of medications are used to treat bipolar disorder; many people with bipolar disorder require multiple medications. Some people with bipolar disorder add to or replace their Western medication with herbal or holistic options. Still, even with optimal medication treatment, many people with the illness have some residual symptoms. Cognitive therapy may work to lessen the severity of mood swings by recognizing and managing triggering symptoms or events. Interpersonal and Social Rhythm Therapy (ISPRT) emphasizes the regulation of sleep, diet and exercise to prevent episodes, along with teaching coping skills; it is well-documented that sleep disruptions can trigger manic episodes. A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... See drugs, medication, and pharmacology for substances that are used to treat patients. ... The term Herbalism refers to folk and traditional medicinal practice based on the use of plants and plant extracts. ... Holism (from holon, a Greek word meaning entity) is the idea that the properties of a system cannot be determined or explained by the sum of its components alone. ... Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of mental disorder. ...


Principles

Medications called mood stabilizers are used to prevent or mitigate manic or depressive episodes. Because mood stabilizers are generally more effective at treating mania than bipolar depression, periods of depression are sometimes also treated with antidepressants. However, antidepressants carry the risk of inducing mania, especially in bipolar patients who are not taking a mood stabilizer. A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... A mood stabilizer is a psychiatric medication used in the treatment mood disorders characterised by rapid and unstable mood shifts. ... An antidepressant is a medication designed to treat or alleviate the symptoms of clinical depression. ...


In severe cases where the mania or the depression is severe enough to cause psychosis (and recently sometimes in less severe cases as well, although this remains controversial), antipsychotic drugs may also be used. A new class of atypical antipsychotics are also popular. The FDA has only approved them for acute episodes, if at all (with the exception of olanzapine, which is approved as a mood stabilizer). Like most doctors, psychiatrists use medication for "off-label" uses, even when such uses are not supported by available research. It is becoming accepted practice to use any/all of the atypical antipsychotics as mood stabilizers at this point, and there is support in the literature for their effectiveness in mood stabilization. This article is about the mental state. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ... The atypical antipsychotics (also known as second generation antipsychotics) are a class of prescription medications used to treat psychiatric conditions. ... Acute may refer to: An acute accent is a diacritic character. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... Psychiatry is a branch of medicine that studies and treats mental and emotional disorders (see mental illness). ... The atypical antipsychotics (also known as second generation antipsychotics) are a class of prescription medications used to treat psychiatric conditions. ...


Some people have reported that antipsychotics cause mania, panic attacks, or psychosis[citation needed]. Any agitation should be reported to the doctor immediately. Antipsychotics also carry a risk of causing tardive dyskinesia, a disfiguring and sometimes irreversible movement disorder. The risk is proportionate to the length of duration of neuroleptic/antipsychotic use (roughly 5% per year in non-elderly patients) and has recently been linked to an equally high occurence in both typical and atypical antipsychotics[citation needed], in contrast to claims of lower risks when the atypicals were introduced. The only antipsychotic with no association to tardive dyskinesia is clozapine. This article is about the medical condition. ... A panic attack is a period of intense fear or discomfort, typically with an abrupt onset and usually lasting no more than 30 minutes. ... This article is about the mental state. ... Tardive dyskinesia is a serious neurological disorder caused by the long-term use of traditional or typical antipsychotic drugs. ... Clozapine (trade names Clozaril®; Leponex®; Fazaclo®), approved by the FDA in 1989, was the first of the atypical antipsychotics. ...


Medications work differently in each person, and it takes considerable time to determine in any particular case whether a given drug is effective at all, since bipolar disorder is by nature episodic, and patients may experience remissions whether or not they receive treatment. For this reason, neither patients nor their doctors should expect immediate relief, although psychosis with mania can respond quickly to antipsychotics, and bipolar depression can be alleviated quickly with ECT. Many doctors emphasize that patients should not expect full stabilization for at least 3-4 weeks (antidepressants, for example, take 4-6 weeks to take effect), and should not “give up” on a medication prematurely Hope, nor should they discontinue medication with the disappearance of symptoms as that negates maintenance/preventative effects. This article is about the mental state. ... This article is about the medical condition. ... Stabilization is a process to help prevent shock in sick or injured people. ... An antidepressant is a medication used primarily in the treatment of clinical depression. ...


Compliance with medications can be a major problem, because some people becoming manic lose the awareness of having an illness, and they therefore discontinue medications. Patients also often quit taking medication when symptoms disappear, erroneously thinking themselves "cured", and some people enjoy the effects of unmedicated hypomania.


Depression does not respond instantaneously to resumed medication, typically taking 2–6 weeks to respond. Mania may disappear slowly, or it may become depression. Other reasons cited by individuals for discontinuing medication are side effects, expense, and the stigma of having a psychiatric disorder. In a relatively small number of cases stipulated by law (varying by locality but typically, according to the law, only when a patient poses a threat to himself or others), patients who do not agree with their psychiatric diagnosis and treatment can legally be required to have treatment without their consent. Throughout North America and the United Kingdom, involuntary treatment or detention laws exist for severe cases of bipolar disorder and other mental illnesses. It has been suggested that this article or section be merged into involuntary commitment. ...


Prognosis

While bipolar disorder can be one of the most severe and devastating medical conditions, indeed the sixth highest cause of disability in the world according to the World Health Organization, fortunately many individuals with bipolar disorder can also live full and mostly happy lives with correct management of their condition. Compared to patients with schizophrenia, persons with bipolar disorder are more likely to have periods of normal functioning in the absence of medication. Although schizophrenic patients may have remissions with relatively high levels of functioning, schizophrenic patients tend to suffer some impairment during these intervals in contrast to persons with bipolar disorder who often appear completely healthy when they are between mood swings. WHO emblem The World Health Organization (WHO) is an agency of the United Nations, acting as a coordinating authority on international public health, headquartered in Geneva, Switzerland. ...


Lithium salts

The use of lithium salts as a treatment of bipolar disorder was first discovered by Dr. John Cade. Lithium salts are chemical salts of lithium used as mood stabilizing drugs (Eskalith® Lithobid® Camcolit®), primarily in the treatment of bipolar disorder, depression, and mania; but also in treating schizophrenia. ... Dr John Frederick Joseph Cade AO (1912-1980) was an Australian psychiatrist credited with discovering (in 1948) the effects of lithium carbonate as a mood stabilizer in the treatment of Bipolar Disorder (then known as Maniac Depression). ...


Lithium salts have long been used as a first-line treatment for bipolar disorder. In ancient times, doctors would send their mentally ill patients to drink from "alkali springs" as a treatment. They did not know it, but they were really prescribing lithium, which was present in high concentration in the waters. The therapeutic effect of lithium salts appears to be entirely due to the lithium ion, Li+. The two lithium salts used for bipolar therapy are lithium carbonate (mostly) and lithium citrate (sometimes). Approved for the treatment of acute mania in 1970 by the FDA, lithium has been an effective mood-stabilizing medication for many people with bipolar disorder. Lithium is also noted for reducing the risk of suicide[7]. Although lithium is among the most effective mood stabilizers, most persons taking it experience side effects similar to the effects of ingesting too much table salt, such as high blood pressure, water retention, and constipation. Regular blood testing is required when taking lithium to determine the correct lithium levels since the therapeutic dose is close to the toxic dose. General Name, Symbol, Number lithium, Li, 3 Chemical series alkali metals Group, Period, Block 1, 2, s Appearance silvery white/gray Atomic mass 6. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ...


The mechanism of lithium salt treatment is believed to work as follows: some symptoms of bipolar disorder appear to be caused by the enzyme inositol monophosphatase (IMPase), an enzyme that splits inositol monophosphate into free inositol and phosphate. It is involved in signal transduction and is believed to create an imbalance in neurotransmitters in bipolar patients. The lithium ion is believed to produce a mood stabilizing effect by inhibiting IMPase by substituting for one of two magnesium ions in IMPase's active site, slowing down this enzyme. Inositol is a biological molecule that plays an important role as a second messenger in a cell, in the form of inositol phosphates. ... In chemistry, a phosphate is a polyatomic ion or radical consisting of one phosphorus atom and four oxygen. ... In biology, signal transduction is any process by which a cell converts one kind of signal or stimulus into another. ... Neurotransmitters are chemicals that are used to relay, amplify and modulate electrical signals between a neuron and another cell. ...


Lithium orotate is used as an alternative treatment to lithium carbonate by some sufferers of bipolar disorder, mainly because it is available without a doctor's prescription. It is sometimes sold as "organic lithium" by nutritionists, as well as under a wide variety of brand names. There seems to be little evidence for its use in clinical treatment in preference to lithium carbonate. Self-treatment without medical monitoring is potentially dangerous. This article needs to be cleaned up to conform to a higher standard of quality. ...


Anticonvulsant mood stabilizers

Anticonvulsant medications, particularly valproate and carbamazepine, have been used as alternatives or adjuncts to lithium in many cases. Valproate (Depakote and Depakene, Epival) was FDA approved for the treatment of acute mania in 1995, and is now considered by many to be the first line of therapy for bipolar disorder. It is preferable to lithium because its side effect profile seems to be less severe, compliance with the medication is better, and fewer breakthrough manic episodes occur. However, valproate is not as effective as lithium in preventing or managing depressive episodes, so patients taking valproate may also need an antidepressant as an adjunct medicinal therapy. Some research suggests that different combinations of lithium and anticonvulsants may be helpful. Anticonvulsants are also used in combination with antipsychotics. Newer anticonvulsant medications, including lamotrigine and oxcarbemazepine, are also effective as mood stabilizers in bipolar disorder. Lamotrigine is particularly promising, as it alleviates bipolar depression and prevents recurrence at higher rates. [8] Topiramate has not done well in clinical trials, which may be because it seems to help a few patients very much but most not at all. It is useful in some treatment resistant cases. Gabapentin has failed to distinguish itself from placebo as a mood stabilizer. The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Valproic acid or 2-Propylpentanoic acid is CH3CH2CH2CH(CH2CH2CH3)COOH . ... Carbamazepine (Biston®; Calepsin®; Carbatrol®; Epitol®; Finlepsin®; Sirtal®; Stazepine®; Tegretol®; Telesmin®; Timonil®; Equetro®) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder; but also used to treat schizophrenia and trigeminal neuralgia. ... Lamotrigine (marketed as Lamictal by GlaxoSmithKline) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Lamotrigine (marketed as Lamictal by GlaxoSmithKline) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Topiramate (brand name: Topamax®) is an anticonvulsant drug produced by Ortho-McNeil, a division of Johnson & Johnson. ... Gabapentin (brand name: Neurontin®) is an anticonvulsant medication indicated in the treatment of epilepsy and neuropathic pain. ...


According to studies conducted in Finland in patients with epilepsy, valproate may increase testosterone levels in teenage girls and produce polycystic ovary syndrome in women who began taking the medication before age 20. Increased testosterone can lead to polycystic ovary syndrome with irregular or absent menses, obesity, and abnormal growth of hair. Therefore, young female patients taking valproate should be monitored carefully by a physician. It should be noted, however, that the therapeutic dose for a patient taking valproate for epilepsy is very different than the therapeutic dose of valproate for an individual with bipolar disorder. Testosterone is a steroid hormone from the androgen group. ... Polycystic Ovary by Sonography Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. ...


Other anticonvulsants effective in some cases and being studied closer include phenytoin, levitiracetam, pregabalin and valnoctimide. Clonazepam and other benzodiazepines are also antimanic agents. Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Pregabalin (brand name: Lyrica®) is a new anticonvulsant drug indicated as an add on therapy for partial onset seizures and for certain types of neuropathic pain. ... Clonazepam (marketed by Roche under the trade-name Klonopin® in the United States and Rivotril® in Canada and Europe) is an anticonvulsant sedative-hypnotic anxiolytic (anti-anxiety drug), and a member of the benzodiazepine class of drugs. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ...


Atypical antipsychotic drugs

The newer atypical antipsychotic drugs such as risperidone, quetiapine, and olanzapine are often used in acutely manic patients, because these medications have a rapid onset of psychomotor inhibition, which may be lifesaving in the case of a violent or psychotic patient. Parenteral and orally disintegrating (in particular, Zydis wafers) forms are favoured in emergency room settings. [9] These drugs can also be used as adjunctives to lithium or anticonvulsants in refractory bipolar disorder and in prevention of mania recurrence. In light of recent evidence, olanzapine (Zyprexa) has been FDA approved as an effective monotherapy for the maintenance of bipolar disorder.[10] A head-to-head randomized control trial in 2005 has also shown olanzapine monotherapy to be just as effective and safe as lithium in prophylaxis.[11] Eli Lilly also offers Symbyax, a combination of olanzapine and fluoxetine.[12] The atypical antipsychotics (also known as second generation antipsychotics) are a class of prescription medications used to treat psychiatric conditions. ... Risperidone (Belivon®, Rispen®, Risperdal® in the United States) is an atypical antipsychotic medication. ... Quetiapine (kwe-TYE-a-peen), marketed by AstraZeneca with the brand name Seroquel, is one of the atypical antipsychotics. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... Prophylaxis refers to any medical or public health procedure whose purpose is to prevent, rather than treat or cure, disease. ... One of the worlds largest corporations, Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company with headquarters in Indianapolis,Indiana, USA. A Fortune 500 corporation, the company had revenues of $12. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... To meet Wikipedias quality standards, this article or section may require cleanup. ...


Omega-3 fatty acids

Omega-3 fatty acids are also used as an alternative or additional treatment for bipolar disorder. An initial clinical trial by Stoll et. al. produced positive results [13]. However, since 1999 attempts to confirm this finding of beneficial effects of omega-3 fatty acids in several larger double-blind clinical trials have produced inconclusive results. It was hypothesized that the therapeutic ingredient in omega-3 fatty acid preparations is eicosapentaenoic acid (EPA) and that supplements should be high in this compound to be beneficial [14]. To meet Wikipedias quality standards, this article or section may require cleanup. ... Eicosapentaenoic acid (more commonly known as EPA; C20H30O2, all-cis-fatty acid 20:5 omega-3) is a polyunsaturated fatty acid that acts as a precursor for prostaglandin-3, which inhibits platelet aggregation) and thromboxane-3 groups. ...


Psychotherapy

Certain types of psychotherapy or psychosocial interventions, generally used in combination with medication, often can provide tremendous additional benefit. These include cognitive-behavioral therapy, interpersonal and social rhythm therapy, interpersonal group therapy, family systems therapy, and psychoeducation. Psychotherapy is a set of techniques intended to improve mental health, emotional or behavioral issues in individuals, who are often called clients. These issues often make it hard for people to manage their lives and achieve their goals. ... Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ... Family therapy (or family systems therapy) is a branch of psychotherapy that treats family problems. ...


Electroconvulsive therapy

Main articles: Electroconvulsive therapy, and [[]], and [[]], and [[]], and [[]]

Electroconvulsive therapy (ECT) is sometimes used to treat severe bipolar depression in cases where other treatments have failed. Although it has proved to be a highly effective treatment, doctors are reluctant to use it except as a treatment of last resort because of the side-effects and possible complications of ECT, particularly when repeated treatments ("maintenance ECT") are needed. Electroconvulsive therapy, also known as electroshock or ECT, is a type of psychiatric shock therapy involving the induction of an artificial seizure in a patient by passing electricity through the brain. ...


Medical Marijuana

There are many anecdotal claims that medical marijuana can help control the mood swings associated with bipolar disorder. The euphoriant effect of THC can elevate depressive phases, while the tranquilizing effects of THC are effective at controlling manic phases. This is only a theory. It should be noted that THC has different effects on different brains, and some studies suggest that marijuana can actually increase anxiety and depression. While most anti-depressants take several weeks to work at full strength, smoked marijuana is effective in minutes, and eaten marijuana is effective within an hour or two. Also, negative side effects associated with pharmaceutical anti-depressants such as nausea, sleep disruption, and loss of libido are usually non-existant with medical marijuana. Of course, marijuana legality issues makes this treatment medically unavailable and/or difficult to obtain for those looking for an alternative. Cannabis sativa extract. ...


In contrast to these beliefs, controlled medical studies have concluded that data suggests adults do not increase their risk for depression by using marijuana.[15]


One opinion popular among proponents of medical marijuana suggests that since plants cannot be patented, and because marijuana is easily grown, there has been a concerted effort by the pharmaceutical industry to suppress the use of medical marijuana as a treatment for many disorders and illnesses, including bipolar disorder. In contrast, a UK company, GW Pharmaceuticals, has recently begun marketing Sativex, which is a whole-plant Cannabis extract, and is also pursuing studies of its use for various illnesses, such as cancer and depression. Sativex is an oromucosal (mouth) spray developed by the UK company GW Pharmaceuticals for multiple sclerosis patients, who can use it to alleviate neuropathic pain and spasticity. ... Species Cannabis indica Cannabis ruderalis Cannabis sativa Cannabis is a genus of flowering plant that includes one or more species. ...


Alternative treatments

Further information: Complementary treatments for bipolar disorder

Complementary non-Western treatments, such as acupuncture and orthomolecular therapy, are used by people with bipolar disorder, and some research shows that some of them may have some scientific merit. Acupuncture chart from the Ming dynasty. ... Orthomolecular medicine or optimum nutrition, emphasizes the use of natural substances found in a healthy diet such as vitamins, dietary minerals, enzymes, amino acids, glyconutrients, and essential fatty acids in the prevention and treatment of diseases. ...


Treatment issues

Nearly all bipolar treatment studies have involved treating patients in the acute (initial) mania stage, where overmedication is often justified in removing a patient from danger. Less is known, however, about long-term treatment, where relapse prevention and full remission are the main treatment goals.


Until recently, depression was largely overlooked in bipolar disorder. The anticonvulsant medication, lamotrigine is often used for treating bipolar depression, particularly where other drugs have failed and the patient's disorder has a strong depressive component. New clinical trials are finding that certain new-generation antipsychotics such as olanzapine and quetiapine show some beneficial effect in treating bipolar depression. Lithium also has a mild antidepressant effect. Lamotrigine (marketed as Lamictal by GlaxoSmithKline) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Olanzapine (Zyprexa®, Zydis®, or in a combination with fluoxetine as Symbyax®) was the second atypical antipsychotic to gain FDA approval and has become one of the most commonly used atypical antipsychotics. ... Quetiapine (kwe-TYE-a-peen), marketed by AstraZeneca with the brand name Seroquel, is one of the atypical antipsychotics. ...


Because there is a danger of antidepressant medications such as SSRIs switching bipolar patients into mania, these medications are used with caution, nearly always with a mood stabilizer.[16].


Research findings

Heritability

Bipolar disorder appears to run in families. The rate of suicide is higher in people who have bipolar disorder than in the general population. In fact, people with bipolar disorder are about twice as likely to commit suicide as those suffering from major depression (12% to 6%).


More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a heritable component. Studies seeking to identify the genetic basis of bipolar disorder indicate that susceptibility stems from multiple genes. Scientists are continuing their search for these genes using advanced genetic analytic methods and large samples of families affected by the illness. The researchers are hopeful that identification of susceptibility genes for bipolar disorder, and the brain proteins they code for, will make it possible to develop better treatments and preventive interventions targeted at the underlying illness process.


Recent genetic research

Bipolar disorder is considered to be a result of complex interactions between genes and environment. The monozygotic concordance rate for the disorder is 70%. This means that if a person has the disorder, an identical twin has a 70% likelihood of having the disorder as well. Dizygotic twins have a 23% concordance rate. Children of a bipolar parent have a 50% chance of developing schizophrenia, schizoaffective or bipolar disorder. First degree relatives are seven times more likely to develop the condition than the general population. Bipolar can refer to: Bipolar (biology) Bipolar disorder Bipolar junction transistor (electronics) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ...


In 2003, a group of American and Canadian researchers published a paper that used gene linkage techniques to identify a mutation in the GRK3 gene as a possible cause of up to 10% of cases of bipolar disorder. This gene is associated with a kinase enzyme called G protein receptor kinase 3, which appears to be involved in dopamine metabolism, and may provide a possible target for new drugs for bipolar disorder.[17] Genetic linkage occurs when particular alleles are inherited together. ... In 2003, a group of American and Canadian researchers published a paper that used gene linkage techniques to identify a mutation in the GRK3 gene as a possible cause of up to 10% of cases of bipolar disorder. ... Dopamine is a chemical naturally produced in the body. ...


Medical imaging

Researchers are using advanced brain imaging techniques to examine brain function and structure in people with bipolar disorder, particularly using the functional MRI and positron emission topography. An important area of neuroimaging research focuses on identifying and characterizing networks of interconnected nerve cells in the brain, interactions among which form the basis for normal and abnormal behaviors. Researchers hypothesize that abnormalities in the structure and/or function of certain brain circuits could underlie bipolar and other mood disorders and studies have found anatomical differences in areas such as the subgenual prefrontal cortex[18] and hippocampus. Better understanding of the neural circuits involved in regulating mood states, and genetic factors such as the FAT-0 chromosome linked to bipolar disorder[19], may influence the development of new and better treatments and may ultimately aid in early diagnosis and even a cure. Functional Magnetic Resonance Imaging (or fMRI) describes the use of MRI to measure hemodynamic signals related to neural activity in the brain or spinal cord of humans or other animals. ... The location of the hippocampus in the human brain. ...


Personality types

An evolving literature exists concerning the nature of personality and temperament in bipolar disorder patients, compared to major depressive disorder (unipolar) patients and non-sufferers. Such differences may be diagnostically relevant. Using MBTI continuum scores, bipolar patients were significantly more extroverted, intuitive and perceiving, and less introverted, sensing, and judging than were unipolar patients. This suggests that there might be a correlation between the Jungian extraverted intuiting process and bipolar disorder. The Center for Applications of Psychological Type is a non-profit organization co-founded by Isabel Myers in 1975 for MBTI development, research and training. ... Jungian psychology is a theory developed by Carl Gustav Jung, and is central to the Neopsychoanalytic school of psychology. ...


Research into new treatments

In late 2003, researchers at McLean Hospital found tentative evidence of improvements in mood during EP-MRSI imaging, and attempts are being made to develop this into a form which can be evaluated as a possible treatment.


NIMH has initiated a large-scale study at twenty sites across the U.S. to determine the most effective treatment strategies for people with bipolar disorder. This study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), will follow patients and document their treatment outcome for 5 to 8 years. For more information, visit the Clinical Trials page of the NIMH Web site.


Magnetic cranial stimulation is another fairly new technique being studied.


Pharmaceutical research is extensive and ongoing, as seen at clinicaltrials.gov[20]


Gene therapy and nanotechnology are two more areas of future development. Gene therapy using an Adenovirus vector. ... A mite next to a gear set produced using MEMS, the precursor to nanotechnology. ...


Bipolar disorder and creativity

Starry Night painted by Vincent van Gogh in 1889 in the hospital for mentally disturbed people in St. Rémy de Provence. Van Gogh is considered to have been affected by bipolar disorder and this painting has high contrasts analagous to extreme bipolar highs and lows, and captures the vibrancy associated with mania.
Enlarge
Starry Night painted by Vincent van Gogh in 1889 in the hospital for mentally disturbed people in St. Rémy de Provence. Van Gogh is considered to have been affected by bipolar disorder and this painting has high contrasts analagous to extreme bipolar highs and lows, and captures the vibrancy associated with mania.

Many artists, musicians, and writers have experienced its mood swings, and some credit the condition with their creativity. However, this disease ruins many lives, and it is associated with a greatly increased risk of suicide. Psychiatrist Kay Jamison, who herself has bipolar disorder and is considered a leading expert on the disease, has written several books that explore this idea, including "Touched with Fire". Research indicates that while mania may contribute to creativity (see Andreasen, 1988), hypomanic phases, such as those experienced in Bipolar II and cyclothymia, actually contribute more (see Richards, 1988). This is perhaps due to the distress and impairment associated with full-blown mania, which may begin with symptoms of hypomania (i.e. increased energy, confidence, activity) but soon spirals into full-blown mania, a state much too debilitating to allow much creative endeavor. Image File history File links Download high resolution version (1879x1500, 761 KB) Description: Starry Night by Vincent van Gogh painted 1889. ... Image File history File links Download high resolution version (1879x1500, 761 KB) Description: Starry Night by Vincent van Gogh painted 1889. ... Vincent Willem van Gogh (March 30, 1853 – July 29, 1890) was a Dutch painter, generally considered one of the greatest painters in European art history. ... 1889 was a common year starting on Tuesday (see link for calendar). ... It has been suggested that Suicide and culture be merged into this article or section. ... Kay Redfield Jamison (born October 14, 1946) is an American psychologist and science writer who is an expert on bipolar disorder. ... by Kay Redfield Jamison: We of the craft are all crazy, remarked Lord Byron about himself and his fellow poets. ... For the classical mythological figures named Mania, see Mania (mythology). ... Manic depression, with its two principal sub-types, bipolar disorder and major depression, was first clinically described near the end of the 19th century by psychiatrist Emil Kraepelin, who published his account of the disease in his Textbook of Psychiatry. ... Cyclothymia means vagina. External links Cyclothymia Symptoms Cyclothymia Cyclothymia What Is Cyclothymia? Mental Health Matters: Cyclothymia Psych Forums: Cyclothymia Forum Cyclothymia Collective Categories: ‪Mood disorders‬ | ‪Psychology stubs‬ ...


Many famous people are believed to have been affected by bipolar disorder, based on evidence in their own writings and contemporaneous accounts by those who knew them. Bipolar disorder is found in disproportionate numbers in people with creative talent such as artists, musicians, authors, poets, and scientists, and it has been speculated that the mechanisms which cause the disorder may be related to those responsible for creativity in these persons. Many of the historical creative talents commonly cited as bipolar were "diagnosed" retrospectively after their deaths and thus the diagnoses are unverifiable; however, in cases diagnosed in recent decades there does seem to be at least some correlation between bipolar disorder and creativity. The possible explanation for this is that hypomanic phases of the illness allow for heightened concentration on activities and the manic phases allow for around-the-clock work with minimal need for sleep. Another theory is that the rapid thinking associated with mania generates a higher volume of ideas, and as well associations are drawn between a wider range of information. The increased energy also allows for greater volume of production. See list of people believed to have been affected by bipolar disorder. This is a list of people accompanied by verifiable source citations associating them with bipolar disorder. ...


Sources

  • Material from public domain text copied from http://www.nimh.nih.gov/publicat/manic.cfm which states: "All material in this fact sheet is in the public domain and may be copied or reproduced without permission from the Institute. Citation of the source is appreciated."
  • 1, 2, 3 and 4 Links and references showing that gabapentin (Neurontin) is an inappropriate and ineffective medication for bipolar disorder.
  • Suicide rate of persons with bipolar disorder[21]

References

  1. ^ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
  2. ^  Prevalance Rates
  3. ^ Baldassano, C. F., et al. (2005). Gender differences in bipolar disorder: Retrospective data from the first 500 STEP-BD participants. Bipolar Disorders, 7(5), 465-470.
  4. ^  NIMH Roundtable on Pediatric Bipolar
  5. ^  Genetic Liklihood
  6. ^  Link and reference involving kindling theory
  7. ^ Krishnan, K.R.R. (2005). Psychiatric and Medical Comorbidities of Bipolar Disorder. Psychosomatic Medicine, 67(1), 1-8.
  8. ^ [22] A Sticky Interhemispheric Switch In Bipolar Disorder?] by John Pettigrew, Steven Miller.
  9. ^  Hakkarainen R, et al. (2003). Seasonal changes, sleep length and circadian preference among twins with bipolar disorder. BMC Psychiatry 3 (1), 6.
  10. ^  Shapira A, et al. (2004). Admission rates of bipolar depressed patients increase during spring/summer and correlate with maximal environmental temperature. Bipolar Disorder Feb;6 (1), 90–3.
  11. ^ Fawcett, J., Golden, B., & Rosenfeld, N. (2000). New Hope for People with Bipolar Disorder. Roseville, CA: Prima Health.
  12. ^  Baldessarini RJ, et al. (2003). Lithium treatment and suicide risk in major affective disorders: update and new findings. J Clin Psychiatry 64 (Suppl 5), 44–52.
  13. ^  1 and 2 Links and references showing the promise of lamotrigine (Lamictal) in the treatment of bipolar depression.
  14. ^  Osher Y, Bersudsky Y, Belmaker RH. Omega-3 eicosapentaenoic acid in bipolar depression: report of a small open-label study. J Clin Psychiatry. 2005;66(6):726–9. PMID 15960565
  15. ^  Stoll AL, Severus WE, Freeman MP et al. (1999), Omega 3 fatty acids in bipolar disorder. A preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry 56(5):407-412.
  16. ^  Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. PMID 15939837
  17. ^  Barrett TB, Hauger RL, Kennedy JL, Sadovnick AD, Remick RA, Keck PE, McElroy SL, Alexander M, Shaw SH, Kelsoe JR. Evidence that a single nucleotide polymorphism in the promoter of the G protein receptor kinase 3 gene is associated with bipolar disorder. Mol Psychiatry. 2003 May;8(5):546–57.

Further reading

Classic works on this subject include

  • Manic-depressive insanity and paranoia by Emil Kraepelin., 1921. ISBN 0405074417 (English translation of the original German from the earlier Eighth Edition of Kraepelin's textbook - now outdated, but a work of major historical importance).
  • Manic-Depressive Illness by Frederick K. Goodwin and Kay Redfield Jamison. ISBN 0195039343 (The standard, very lengthy, medical reference on bipolar disorder.)
  • Touched With Fire: Manic-Depressive Illness and the Artistic Temperament by Kay Redfield Jamison (The Free Press: Macmillian, Inc., New York, 1993) 1996 reprint: ISBN 068483183X
  • An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison (Knopf, New York, 1995) (An excellent autobiographical work about what it's like to have bipolar disorder, by the woman who is also one of the medical world's experts on it.) ISBN 0330346512
  • Mind Over Mood: Cognitive Treatment Therapy Manual for Clients by Christine Padesky, Dennis Greenberger. ISBN 0898621283
  • Bipolar Disorder: A guide for patients and families by Francis Mondimore M.D., 1999. ISBN 0801861179 (A detailed in-depth book covering all aspects of bipolar disorder: history, causes, treatments, etc.)
  • The Bipolar Disorder Survival Guide: What You and Your Family Need to Know by David J. Miklowitz Ph.D., 2002. ISBN 1572305258 (An excellent practical guide on managing bipolar disorder)

Emil Kraepelin (February 15, 1856- October 7, 1926) was a German Psychiatrist who attempted to create a synthesis of the hundreds of mental disorders classified by the 19th century, grouping diseases together based on classification of common patterns of symptoms, rather than by simple similarity of major symptoms in the...

See also

This is a list of people accompanied by verifiable source citations associating them with bipolar disorder. ... This is a list of songs that are about, or appear to be about, bipolar disorder. ... The bipolar spectrum is the continuous range of depressive diseases, ranging from bipolar disorder to unipolar depression. ... It has been suggested that this article or section be merged with Bipolar disorder. ...

External links

Bipolar Disorder and Medical Marijuana

  • The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research
  • [http://www.drugpolicy.org/marijuana/medical/challenges/litigators/medical/conditions/psychological.cfm

Medicinal Uses of Marijuana: Psychological Disorders]

  • New Study: Marijuana Users Less Depressed
  • Medical Cannabis Resource Center-Bipolar Information Pages
  • Cannabis and Depression by Jay R. Cavanaugh, Ph.D.
  • GW Pharmaceuticals
  • 'Assessment Worksheet for Evaluating Petitions to Expand the List of "Debilitating Medical Conditions" Under the Oregon Medical Marijuana Act'

Research

  • NAMI index of research studies
  • Juvenile Bipolar Research
  • Bipolar Disorder in Children - Reviews of recent findings and research
  • Mood Disorder Research Group (UK)
  • Bipolar Twin Study, Institute of Psychiatry, London - Seeking further volunteers
  • Omega-3 Fatty Acids Evaluated for Bipolar Disorder. Psychiatric Times December 1999 Vol. XVI Issue 12
  • Anticonvulsants and antipsychotics in the treatment of bipolar disorder - 2004, a literature review.
  • Psychosocial Approaches in the Management of Bipolar Disorder - another review article.
  • New Research in Bipolar Disorder - a website by a scientist who researches bipolar disorder.

Evidence-based medicine

  • Evidence-based guidelines for treating bipolar disorder: recommendations from the British Association for Psychopharmacology
  • Affective disorders - Cochrane systematic reviews
  • Cochrane Collaboration Depression, Anxiety and Neurosis Group

Other resources

  • Facts about Bipolar Disorder
  • NIMH information
  • Bipolar disorder and manic depression information - MayoClinic.com
  • Helpguide: Bipolar Disorder: Signs, Symptoms and Treatment
  • Mental Health: A Report of the Surgeon General - Chapter 4 section 3 - Mood Disorders
  • Bipolar Happens Resource written by a person suffering with bipolar disorder for over 20 years. Focuses on how a person can manage bipolar disorder.
  • Coping With Bipolar Proven techniques to help co-manage and cope with bipolar disorder in a loved one. Compiled by a NAMI faculty member from thousands of bipolar victims and co-victims.
  • Alternative Depression Therapy Alternative and Holistic approaches to the treatment of Bipolar Disorder and Depression. Written by a licensed psychotherapist specializing in mood disorders.

News stories

  • UCSD Researchers Identify Gene Involved In Bipolar Disorder
  • Unique Type Of MRI Scan Shows Promise In Treating Bipolar Disorder
  • Two mental diseases appear to be linked: reports on apparent link of protein kinase C to both bipolar disorder and schizophrenia
  • A list of famous people (including Canadians) can be found at http://www.mooddisorderscanada.ca/depression/print/p_famous.htm

 
 

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