Beruflich Dokumente
Kultur Dokumente
DISORDER
DESCRIPTION
Bipolar disorder involves periods of elevated or irritable mood (mania), alternating with periods
of depression. The "mood swings" between mania and depression can be very abrupt. Bipolar
disorder is a serious mental illness. People who have it experience dramatic mood swings. They
may go from overly energetic, "high" and/or irritable, to sad and hopeless, and then back again.
They often have normal moods in between. The up feeling is called mania. The down feeling is
depression.
The elevated moods are clinically referred to as mania or, if milder, hypomania. Extreme manic
episodes can sometimes lead to such psychotic symptoms as delusions and hallucinations. The
current term "bipolar disorder" is of fairly recent origin and refers to the cycling between high
and low episodes (poles). Bipolar disorder can run in families. It usually starts in late
adolescence or early adulthood. Untreated, bipolar disorder can result in damaged relationships,
poor job or school performance, and even suicide.
Most people will start to see symptoms of Bipolar when they are around 25 years of age.
However, there have been people who developed the Bipolar disorder in their early childhoods or
some will develop it when they are as old as 40 or 50 years of age. It doesnt matter what your
age, race, ethnic group or social class because men and women can develop Bipolar.
Bipolar is a complex illness. There are many different symptoms -- and several different types -of bipolar disorder. The primary symptoms of the disorder are dramatic and unpredictable mood
swings. The various types of bipolar disorder range from mild to severe.
SYMPTOMS
Mania Symptoms
Mania symptoms may include excessive happiness, excitement, irritability, restlessness,
increased energy, less need for sleep, racing thoughts, high sex drive, and a tendency to make
grand and unattainable plans.
Depression Symptoms
Depression symptoms may include sadness, anxiety, irritability, loss of energy, uncontrollable
crying, change in appetite causing weight loss or gain, increased need for sleep, difficulty
making decisions, and thoughts of death or suicide.
TYPES
Bipolar Types
There are several types of bipolar disorder; all involve episodes of depression and mania to a
degree. They include bipolar I, bipolar II, cyclothymic disorder, mixed bipolar, and rapid-cycling
bipolar disorder.
Bipolar I
A person affected by bipolar I disorder has had at least one manic episode in his or her life. A
manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that
disrupts life.
Bipolar II
Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time.
However, in bipolar II disorder, the "up" moods never reach full-on mania.
Rapid Cycling
In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or
depression in one year. About 10% to 20% of people with bipolar disorder have rapid cycling.
Mixed Bipolar
In most forms of bipolar disorder, moods alternate between elevated and depressed over time.
But with mixed bipolar disorder, a person experiences both mania and depression simultaneously
or in rapid sequence.
Cyclothymia
Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic
disorder have milder symptoms than in full-blown bipolar disorder.
CAUSES
The cause of bipolar disorder is not entirely known. Genetic, neurochemical and environmental
factors probably interact at many levels to play a role in the onset and progression of bipolar
disorder. The current thinking is that this is a predominantly biological disorder that occurs in a
specific part of the brain and is due to a malfunction of the neurotransmitters (chemical
messengers in the brain). As a biological disorder, it may lie dormant and be activated
spontaneously or it may be triggered by stressors in life.
Although, no one is quite sure about the exact causes of bipolar disorder, researchers have found
these important clues:
Bipolar disorder tends to be familial, meaning that it runs in families. About half the
people with bipolar disorder have a family member with a mood disorder, such as
depression.
A person who has one parent with bipolar disorder has a 15 to 25 percent chance of
having the condition.
A person who has a non-identical twin with the illness has a 25 percent chance of illness,
the same risk as if both parents have bipolar disorder.
A person who has an identical twin (having exactly the same genetic material) with
bipolar disorder has an even greater risk of developing the illness about an eightfold
greater risk than a nonidentical twin.
Studies of adopted twins (where a child whose biological parent had the illness is raised
in an adoptive family untouched by the illness) has helped researchers learn more about
the genetic causes vs. environmental and life events causes.
Bipolar disorder is primarily a biological disorder that occurs in a specific area of the brain and is
due to the dysfunction of certain neurotransmitters, or chemical messengers, in the brain. These
chemicals may involve neurotransmitters like norepinephrine, serotonin and probably many
others. As a biological disorder, it may lie dormant and be activated on its own or it may be
triggered by external factors such as psychological stress and social circumstances.
A life event may trigger a mood episode in a person with a genetic disposition for bipolar
disorder.
Even without clear genetic factors, altered health habits, alcohol or drug abuse, or
hormonal problems can trigger an episode.
Among those at risk for the illness, bipolar disorder is appearing at increasingly early
ages. This apparent increase in earlier occurrences may be due to under diagnosis of the
disorder in the past. This change in the age of onset may be a result of social and
environmental factors that are not yet understood.
Although substance abuse is not considered a cause of bipolar disorder, it can worsen the
illness by interfering with recovery. Use of alcohol or tranquilizers may induce a more
severe depressive phase.
PHYSCHOLOGICAL EFFECT ON
INDIVIDUAL,
FAMILY
AND
SOCIETY:
EFFECT ON INDIVIDUAL:
It can effect an individual like the individual cant get along with others or have good
relationship with people. It makes harder for an individual to keep responsibilities, achieve their
goals and make decisions. They may feel guilty about events occurred years ago or about issues
that didnt cause. They sometimes hear a voice that they are hopeless. Bipolar disorder patients
may loss self-esteem during their depressive stage and have anxiety with low mood and
sometimes become hyperactive, they can drink too much alcohol or abuse drugs and get into a
risky situation, like a risk of suicide. Suicidal thoughts can become worse when patients use
alcohol or drugs.
EFFECTS ON FAMILY:
Siblings may experience jealousy if too much attention is devoted to the ill member and not
enough to themselves. To deal with feelings of resentment and guilt, siblings spend more time
away from the family. When the ill member is a parent who cannot meet the emotional needs of
his or her spouse, a child may assume the role of confidante with the well parent and may
sacrifice some of his or her own personal development as an independent individual.
In severe cases of manic-depressive illness, families typically find that their social network starts
shrinking in size for several reasons. The family is often embarrassed by the varied symptoms of
an ill relative whether these symptoms have to do with poor self-care skills or belligerent
behaviour. Visitors may feel awkward about what to say or how to help the family. Usually they
say nothing at all and soon both family and friends find themselves participating in a conspiracy
of silence. Eventually, it becomes easier to avoid each other.
Families go through a range of emotions in response to the unpredictability of the bipolar mood
phases. They will sometimes be loving, patient and understanding. They will also be angry that
their lives are so severely disrupted. Most families put a lot of energy into keeping the secret--maintaining a positive public face---so no one else knows about the constant turmoil and
conflict. This just adds to the mounting pressure. They will struggle with their own bouts of
depression and anxiety as a result of the unrelenting stress. Their time is filled with worry about
what's going to happen next.. They sometimes feel guilty that they aren't able to help. They are
forced to face behaviors and situations that are unfathomable.
EFFECT ON SOCIETY:
impairment in daily living activities, affect familial relationship and job performance and even
impair the bipolar sufferer to such an extent that physical health is affected. However, in some
cases of bipolar order, the outcome may be positive and lead to such an extent that physical
health is affected. However, in some cases of bipolar disorder, the outcome may be positive and
lead to such a degree of creativity so as to allow the individual to make a significant impact on
the world around them. Bipolar disorder crosses all genders , races , creeds and colors with
examples of individuals whom made an impact on society through the exhibition of their bipolar
symptoms. These symptoms often lead to absenteeism from work, loss of employment
It may be very hard to take that first step to help yourself. It may take time, but you can get better
with treatment.
To help yourself:
Keep a regular routine, such as eating meals at the same time every day and going to
sleep at the same time every night
ROLE OF FAMILY:
A family that has a member who may have bipolar disorder should try their best to get that
person the help that they need. Consult an counselor who would be more than happy to answer
any questions and give any suggestions or advice. If it is believed that this person really is
suffering from bipolar disorder, than the best thing for the family to do is to get that person into
counseling. Many individuals will not go in to see a counselor because they are embarrassed or
they dont want to appear weak to others. Improve the overall atmosphere in the household and
keep the happiness and joy in life around.
People with bipolar disorder do better when they have support from family members.
Open and honest communication is essential to coping with bipolar disorder in the family. Share
your concerns in a loving way, ask the person how he or she is feeling, and make an effort to
truly listeneven if you disagree with your loved one or dont relate to whats being said.: Stress
makes bipolar disorder worse, so try to find ways to reduce stress in your family members life.
Ask how you can help and volunteer to take over some of the persons responsibilities if needed.
Establishing and enforcing a daily routine with regular times for getting up, having meals, and
going to bedcan also reduce family stress. Things you can do to support a loved ones bipolar
disorder treatment:
ROLE OF FRIEND:
To help a friend or relative, you can:
Learn about bipolar disorder so you can understand what your friend or relative is
experiencing
Listen to feelings your friend be understanding about situations that may trigger bipolar
symptoms
Invite your friend out for positive distractions, such as walks, outings, and other activities
Remind your friend, with time and treatment, he or she can get better.
Never ignore comments about your friend or harming himself or herself. Always report such
comments to his or her therapist or doctor. In this way u can help your friend and remove a
bipolar disorder.
ROLE OF GOVERNMENT:
Government should develop health centres to give treatment to bipolar patient. They should start
some vocational centres to enhance their skills and give employment and job security to them. In
this way they can remove bipolar disorder among people.
ROLE OF SOCIETY:
Role of society is that they should not neglect the acts of the patients, they must appreciate their
work, give positive response to what they are saying, understand them and their problem. In this
way society can remove the bipolar disorder among people.
PREVENTION
There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of
a mental health disorder can help prevent bipolar disorder or other mental health conditions from
worsening.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor episodes
from becoming full-blown episodes of mania or depression:
Pay attention to warning signs. Addressing symptoms early on can prevent episodes from
getting worse. You and your caregivers may have identified a pattern to your bipolar episodes
and what triggers them. Call your doctor if you feel you're falling into an episode of depression
or mania. Involve family members or friends in watching for warning signs.
Avoid drugs and alcohol. Even though you may feel better, using alcohol or street drugs makes
your symptoms more likely to come back.
Take your medications exactly as directed. Medications can have unwanted side effects, and
you may feel unhappy about having a mental health condition that requires lifelong treatment.
During periods when you feel better, you may be tempted to stop treatment. This can have
immediate consequences you may become very depressed, feel suicidal, or go into a manic or
hypomanic episode. If you think you need to make a change, call your doctor.
Check first before taking other medications. Call the doctor who's treating you for bipolar
disorder before you take medications prescribed by another doctor. Sometimes other medications
trigger episodes of bipolar disorder or may interfere with medications you're already taking to
treat bipolar disorder.
TREATMENT:
If your doctor determines that you have bipolar disorder, he or she will explain your treatment
options and possibly prescribe medication for you to take. You may also be referred to another
mental health professional, such as a psychologist, counselor, or a bipolar disorder specialist.
Together, you will work with your healthcare providers to develop a personalized treatment plan.
Psychotherapy Therapy is essential for dealing with bipolar disorder and the problems
it has caused in your life. Working with a therapist, you can learn how to cope with
difficult or uncomfortable feelings, repair your relationships, manage stress, and regulate
your mood.
Lifestyle management By carefully regulating your lifestyle, you can keep symptoms
and mood episodes to a minimum. This involves maintaining a regular sleep schedule,
avoiding alcohol and drugs, following a consistent exercise program, minimizing stress,
and keeping your sunlight exposure stable year round.
Support Living with bipolar disorder can be challenging, and having a solid support
system in place can make all the difference in your outlook and motivation. Participating
in a bipolar disorder support group gives you the opportunity to share your experiences
and learn from others who know what youre going through. The support of friends and
family is also invaluable.
There are many things you can do to stabilize your mood and stay well. The way you live your
life is just as important, if not more so, than the medication you take. Making healthy choices for
yourself can make a huge difference in how you feel.
Check in frequently with your doctor. Its important to have regular blood tests to make
sure that your medication levels are in the therapeutic range. Getting the dose right is a
delicate balancing act. Close monitoring by your doctor will help keep you safe and
symptom-free.
Continue taking your medication, even if your mood is stable. Dont stop taking your
medication as soon as you start to feel better. Most people need to take medication longterm in order to avoid relapse.
Dont expect medication to fix all your problems. Bipolar disorder medication can help
reduce the symptoms of mania and depression, but in order to feel your best, its
important to lead a lifestyle that supports wellness. This includes surrounding yourself
with supportive people, getting therapy, and getting plenty of rest.
Mood stabilizers, antidepressants, and antipsychotics are the main types of medication used to
treat bipolar disorder. Learn how to find the right drug or drug combination for you, work with
your doctor, and manage side effects.
Cognitive-behavioral therapy
Family-focused therapy
Cognitive-behavioral therapy
In cognitive-behavioral therapy, you examine how your thoughts affect your emotions. You also
learn how to change negative thinking patterns and behaviors into more positive ways of
responding. For bipolar disorder, the focus is on managing symptoms, avoiding triggers for
relapse, and problem-solving.
Interpersonal and social rhythm therapy
Interpersonal therapy focuses on current relationship issues and helps you improve the way you
relate to the important people in your life. By addressing and solving interpersonal problems, this
type of therapy reduces stress in your life. Since stress is a trigger for bipolar disorder, this
relationship-oriented approach can help reduce mood cycling.
For bipolar disorder, interpersonal therapy is often combined with social rhythm therapy. People
with bipolar disorder are believed to have overly sensitive biological clocks, the internal
timekeepers that regulate circadian rhythms. This clock is easily thrown off by disruptions in
your daily pattern of activity, also known as your social rhythms. Social rhythm therapy
focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these
rhythms are stable, the biological rhythms that regulate mood remain stable too.
Family-focused therapy
Living with a person who has bipolar disorder can be difficult, causing strain in family and
marital relationships. Family-focused therapy addresses these issues and works to restore a
healthy and supportive home environment. Educating family members about the disease and how
to cope with its symptoms is a major component of treatment. Working through problems in the
home and improving communication is also a focus of treatment.
Light and dark therapy Like social rhythm therapy, light and dark therapy focuses on
the sensitive biological clock in people with bipolar disorder. This easily disrupted clock
throws off sleep-wake cycles, a disturbance that can trigger symptoms of mania and
depression. Light and dark therapy for bipolar disorder regulates these biological rhythms
and thus reduces mood cycling by carefully managing your exposure to light. The
major component of this therapy involves creating an environment of regular darkness by
restricting artificial light for ten hours every night.
CASE STUDY:
Female, Age 48 years, Bipolar Disorder
This 48-year-old female suffered from bipolar disorder for 30 years prior to seeking help from
upper cervical chiropractic care. The episodes of depression and mania started during her teenage
years and she had tried a number of different medications over the years.
During her upper cervical chiropractic evaluation, an upper neck injury was discovered. She
recalled experiencing a horse back riding accident during her junior high years in which she
sustained a concussion. She concluded her neck injury could have occurred then. After receiving
treatment for her neck injury, she reported a marked improvement in her health, specifically the
bipolar problem was reduced tremendously. She reported that she received more results from
upper cervical care versus any other treatment or medication she had tried over the years.
73
Back Pain
This 23-year-old male suffered a closed head injury at age 17 in which he landed on his head due
to a pole-vaulting accident at a high school track meet. Since the fall, he suffered from bipolar
disorder (rapid-cycling mood swings), seizures (2-3 per day), daily headaches, daily neck and
back pain, and sleep disorder (he would often be awake for 24-36 straight hours before finally
going to sleep and then often would sleep for 24 or more hours). He was taking tegretol for
bipolar disorder and pain medication for headaches.
During this patient's upper cervical exam, an upper neck injury was found, most likely stemming
from the pole-vaulting accident. The injury was compromising this patient's brain and spinal cord
function. After five months of upper cervical care, all mood swings, headaches, seizures, pain,
and sleep trouble were corrected, and all medications were discontinued. All family members
remarked at the enormous change in the patient's mental outlook, personality, and health.
cataplexy
impulse-control disorders
kleptomania
migraine/severe headache
narcolepsy
obsessive-compulsive disorder
panic disorder
Tourette's disorder
The following may also be a part of the spectrum accompanying affective disorders.
anxiety disorders
autism
chronic pain
pathological gambling
pyromania
personality disorders
trichotillomania
All disorders must be diagnosed and treated.
Therapy such as cognitive therapy is particularly helpful in working through one's life and group
therapy with this population is also particularly helpful. Studies has shown that this form of
therapy has reduced the number of hospitalizations and failed marriages.
A "bad childhood" has nothing to do with developing bipolar disorder. However families are
encouraged to become involved with the patient's treatment plan and become educated about the
disorder.
Recently a study revealed that out of people that were hospitalized due to mania or mixed
episodes, 50% were symptom free a year later. However 25% of that had a satisfactory job and
family life. Another study revealed that four years later one third were supporting themselves by
working.
Harvard Mental Health Letter
April 2001
May 2001
AN OVERVIEW OF RATE
BIPOLAR DISORDER:
OF
Worldwide, the rate of bipolar disorder is 2.4% - but in the United States it's 4.4%, says a newly
published study by the World Mental Health Survey Initiative that interviewed more than 61,000
people. The study also found that 75% of those with bipolar had at least one other disorder. Panic
disorder and other anxiety disorders were the most common of these, followed by behavior and
then substance abuse disorders. Bipolar disorder can cause suicidal ideation that leads to suicidal
attempts. One out of 3 people with bipolar disorder report past attempts of suicide or complete it
Across the world, fewer than half of those with BP received any kind of mental health treatment,
and the figure dips to just 25% in low-income countries. The study was conducted in 11
countries in the Americas, Europe, Asia, the Middle East and New Zealand.
In general, higher-income countries had higher rates of BP than lower-income. Some theories
about why this is so include genetics, cultural differences in the way people respond to surveys in
general, and cultural reluctance to discuss psychiatric issues.
The lowest national rate of bipolar disorder found was India, with just .1%.
Japan had a lifetime prevalence of 0.7%. Colombia, a lower-income nation, also deviated from
the trend with a relatively high prevalence of 2.6%.In Pakistan 1 out of 20000 people are
suffering from bipolar disorder.
REFERENCES:
1. Segal,Robert [lhttp://helpguide.org/mental/bipolar_disorder_symptoms_treatment.htm]
2011 April 24
2. Sannard,Lia [http://www.livestrong.com/article/155671-psychological-effects-of-bipolar- ]
2011 April 24.
3. Cadena,Christine 2006 Oct 12 [www.associatedcontent.com ]
2011 April 24
4. Croft,HarryMonday, 2010 February 22 [http://www.healthyplace.com/bipolar disorder]
2011 April 24
5. Bressert, Steve [http://psychcentral.com/lib/2007/the-causes-of-bipolar-disorder]
2011 April 24
6.Anonymous [http://www.ehow.com/about_5247117_effects-bipolar-disorder]
2011 April 24
7. Mayo Clinic Staff [http://www.mayoclinic.com]
2011 april 24
8 Aonymous [ http://bipolar.about.com]
2011 april 24
9. Elster, Erin [http://www.erinelster.com/CaseStudies.aspx?ConditionID=4]
2011 April 24
Faiza_aries91@hotmail.com