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Bipolar disorder is classified as a brain disorder and a mood disorder. Bipolar disorder consists of four different types, Bipolar 1 disorder, Bipolar 2 disorder, Cyclothymic disorder and other Specified and Unspecified Bipolar and related disorders (NIMH, 2016). A person with Bipolar disorder has very high highs and very low lows. According to the National Institute of Mental Health website 4.4% of adults will experience some type of Bipolar during their lifetime. Of that 4.4%, 82.9% will be serious and 17.1 % will be moderate. An estimated 2.9% of adolescents aged 13-18 had Bipolar and 2.6% of those had severe impairment (NIMH, 2001-2003).
The symptoms of bipolar disorder can be similar to other types of illnesses so it can be hard for a doctor to diagnose. People with bipolar disorder often suffer from substance abuse, anxiety disorders and even an eating disorder. Bipolar disorder suffers are at a higher risk of developing thyroid disease, heart disease and diabetes (NIMH, 2016).
Manic episodes are characterized by extreme highs that can make a person feel like they are on top of the world, with extreme energy, experience racing thought and mood swings. They can be very jumpy and get extremely agitated very quickly. They have a decreased need for sleep, do many things all at once and can end up talking fast. During a manic episode people can engage in high risk behavior including risky sex, spending money and drug use. Severe cases of mania can cause psychosis which will match a persons” mood. A less severe type of mania is called hypomania. Hypomania may manifest itself as a time where you feel good, your mood is up but it is not out of control. Some people will only ever have hypomania and never experience full mania, but for some hypomania may easily turn into mania or depression without any warning (WebMD, 2016).
Depressive episodes are characterized by feelings of being severely depressed which include feeling sad, empty, having little to no energy, anhedonia. A person may feel worried and have trouble concentrating. They may experience memory and appetite disturbances. Feelings or thoughts about suicide and death are common. A person with Bipolar disorder can experience both manic and depressive symptoms at the same time which is called a mixed episode (NIMH, 2016).
Bipolar 1 disorder is characterized by extreme highs and lows that interfere with everyday life. Manic episodes have to last at least 7 days or are so extreme that a person needs care from a hospital. While the depressive episodes have to last at least 2 weeks (NIMH, 2016). Most of the people that suffer from Bipolar 1 disorder have symptoms that first appear in their teens or early twenties but before age 50, and people with an immediate family member who suffer from Bipolar are at an increased risk of having this disorder. People who are type 1 have to have had at least one full blown manic episode in their lifetime (WebMD, 2016).
Bipolar 11 disorder is similar to Bipolar 1 except that the high moods never reach full mania. This is where the hypomanic symptoms happen. Most people with Bipolar 11 disorder experience depressive episodes most often. During a Hypomanic episode the elevated mood is either euphoric or the person is irritable. People who are hypomanic are often fun to be around because of their pleasant mood but hypomania can lead to unhealthy behavior and erratic behavior. There can be long periods of normal mood in between the hypomanic or depressive states. Hypomania usually goes unnoticed because it does not normally cause unhealthy behaviors or impair function so it is often untreated.
Cyclothymic disorder is defined by many periods of hypomanic and depressive symptoms lasting for at least 2 years but the symptoms do not meet the requirements for a depressive or hypomanic episode (NIMH, 2016). Cyclothymic disorder is considered to be a mild mood disorder where moods fluctuate from hypomania to mild depression but are less severe and take a shorter amount of time to cycle. The line between cyclothymia and normal mood swings can be extremely short. Cyclothymia usually goes untreated and undiagnosed (WebMD, 2016).
All other Bipolar symptoms that do not meet the criteria for Bipolar 1, 11 or Cyclothymic disorder are considered to be other Specified and Unspecified Bipolar and Related disorders (NIMH, 2016).
Bipolar disorder tends to be passed from generation to generation, but there are many factors that can cause bipolar disorder. The most effective treatment of bipolar disorder is a combination of medication and psychotherapy. Bipolar is a life long illness. Some people can have times that they are symptom free and others the symptoms linger. There are 3 types of medication typically used to treat bipolar disorder, mood stabilizers, atypical antipsychotics and antidepressants. Sometimes electroconvulsive therapy is used and many times a person will need medication to help them sleep.
The types of psychotherapy used most commonly are CBT, family-focused, interpersonal and psychoeducation (NIMH, 2016). With the right combination of medication and therapy a person with bipolar can live a normal, happy life.
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