Seven Classes And The Key Findings That Shaped Them
The seven phenoclasses, as the U-M team has dubbed them, include standard measures doctors already use to diagnose and track the progress of bipolar disorder.
Changes in cognition, which includes thinking, reasoning and emotion processing
Psychological dimensions such as personality and temperament
Measures of behaviors related to substance use or abuse called motivated behaviors
Aspects of the persons life involving family, intimate relationships and traumas
Patterns of sleep and circadian rhythms
Measures of how patients symptoms change over time and respond to treatment
Some of the key findings the U-M team made in the Prechter cohort include:
Although bipolar disorder tends to run in families, the long-term study revealed no one gene explains it, says McInnis, who is the Woodworth Professor of Bipolar Disorder and Depression in the U-M Medical Schools Department of Psychiatry.
If there was a gene with a strong effect like what we see in breast cancer, for instance, we would have found it, he explains. We hope this new framework will provide a new approach to understand this disorder, and other complex diseases, by developing models that can guide a management strategy for clinicians and patients and give researchers consistent variables to measure and assess.
It Took Over A Month For Me To Return To My Stable Self
This is a month AFTER the two week depressive episode. As my dear friend Jay Carter, the author of always says, it takes a very long time for our brains to get back on track chemically when we have an episode. This is especially true for longer episodes. The longer the episode- the longer the recovery time. This makes sense when we read it, but when were going through it, we often expect life to magically get back to normal once the mood swing ends.
If it took me 30 days to recover from two weeks of depression, what does it take to recover from a massive manic and psychotic episode? It can take a year for some people. No one wants to hear this, but I believe we need to be honest with ourselves in order to survive bipolar disorder.
If we know that recovery takes time, we can go easier on ourselves.
I want to be nice to myself when I get sick. I want to and need to give myself time to recover.
Patience doesnt come naturally for me. I tend to put myself down for not being able to work much, but wow, this is a pretty darn serious illness. I need to respect what my body experiences when I get sick and give it time to heal.
We have to be ready for recovery time after an episode. We dont just bounce back.
We can come back. We can flourish- we can get better and back to our stable selves, but its a process and it always takes longer than we
Alcohol Abuse And Drug Intoxication And The Aftereffects
Abusing drugs and alcohol doesnt cause bipolar disorder, but it can cause an episode to suddenly occur, or it can worsen the underlying illness. Whats more, about one in five people with bipolar disorder have a substance abuse disorder, according to an analysis of data on young adults with mental illness from an article published in February 2015 in the journal Social Psychiatry and Psychiatric Epidemiology.
Intoxication with drugs such as cocaine and amphetamines can cause or worsen manic symptoms, while the aftereffects of cocaine or use of alcohol are associated with worsening of depressive symptoms.
Recommended Reading: Where Can I Get Ketamine Treatment For Depression
Consequences Of Forgoing Bipolar Disorder Treatment
The National Alliance of Mental Health has reported that there are serious risks in deciding not to treat diagnosed bipolar disorder. Some of the consequences that can occur with untreated bipolar disorder include:
- Having more severe episodes of mania and/or depression
- Displaying risky behaviors, taking dangerous chances
- Extreme changes in energy, activity level, sleep
- Partaking in excessive drinking, drug abuse
- Greater risk of suicidal ideation
- Experience long lasting periods of unstable moods
- Suffer from higher death rates from cancer, heart disease or stroke
- Symptoms become more pronounced and debilitating
- Increased involvement in illegal substances
- Periods of irrational behaviors
About one-half of all people who have bipolar disorder or manic-depressive illness do not receive treatment. While bipolar disorder is a chronic lifelong condition, treatment is effective and frees those from harsh unrelenting episodes of mania and/or depression. Untreated bipolar disorder will display symptoms and behaviors that worsen, becoming more pronounced over time.
A Bipolar Disorder Psychiatrist in Atlanta is a Phone Call Away
Proper diagnosis and treatment is just a phone call away. If you suffer from recurring mood swings and episodes of mania or depression and find it increasingly difficult to manage your life, friends, family or work, call for a confidential appointment and expert diagnosis. Make the call that can change your life for the better.
Antidepressants And Mood Switching
There is widespread concern that antidepressant treatment for bipolar depression risks switching into potentially dangerous agitation or mania, especially in BD-I . Such risk is more associated with the long-term BD course-pattern of depression followed by mania before a stable interval than the opposite . However, it is difficult to distinguish spontaneous from antidepressant-associated switching in BD, mean rates of which are similar . Though it is plausible to expect mood-stabilizing and antipsychotic drugs to prevent mood-switching with antidepressants, required randomized comparisons are lacking . Trials of antidepressants have found little difference in risk of new mania between antidepressants and placebo, with or without a mood-stabilizer included, although exposure times were short . However, one study found that switching in BD was 2.8-times greater within 9 months after adding an antidepressant, but not if a mood-stabilizer also was used , and switching risk was increased in the rare long-term trials with an antidepressant included in treatment .
You May Like: Can I Overcome Depression Without Medication
Does Lamotrigine Interact With Any Medications Or Other Substances
Certain other drugs can affect the way lamotrigine works in your body by decreasing its effectiveness or delaying its excretion from your body. These include hormonal birth control methods, estrogen-containing contraceptives, hormone treatments, the antibiotic rifampin, seizure medications such as phenobarbital, and valproic acid, which is also used to treat bipolar disorder.
Your doctor will carefully prescribe and monitor your dosage when lamotrigine is taken with other treatments. Avoid alcohol, cannabis, and other substances that can increase dizziness or drowsiness while taking lamotrigine. To rule out dangerous side effects, discuss all other medications or mind-altering substances you consume with your doctor before taking lamotrigine.
One recent British study found that folic acid supplements can cancel out lamotrigines benefits . No one expected that result, as folic acid usually helps depression, and other medications, like valproate , says Dr. Aiken. More research is needed before we can fully trust this result, but until then, we recommend taking lamotrigine without any folic acid supplements, including those found in multivitamins. Once youre doing well on lamotrigine, if you decided to add folic acid, watch out for a potential loss of benefits.
Lithium Treatment And Suicide
An association of reduced risk of suicides and attempts during long-term treatment with lithium in BD is supported consistently by most , but not all studies . At least 10 placebo-controlled, randomized trials not specifically designed with suicide risk as the primary outcome measure, but involving more than 110,000 person-years of risk, found five- to sixfold reductions in suicidal acts . Based on such studies, several expert reports recommend long-term lithium treatment to limit risk of suicidal behavior in BD patients .
Also Check: Free Online Help For Depression
Blowout Arguments With Partners Coworkers Or Friends
Broken relationships are too often the result of untreated bipolar disorder.
But getting into a spat with a loved one could also be a red flag: Your argument could be due to the irritability that often occurs during a manic or depressive episode, or could itself cause stress that becomes a contributing factor for a recurrent episode.
Any type of relationship conflict whether its with your partner, coworker, family member, or friend can trigger stress and send you over the edge. In a study published in May 2015 in the Journal of Affective Disorders, people with bipolar disorder said negative social experiences were among the events that triggered suicidal thinking for them.
How Do Doctors Treat It
Although there’s no cure for bipolar disorder, treatment can help stabilize moods and help the person manage and control symptoms. Like other teens with long-lasting medical conditions , teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it.
This team of medical professionals, together with the teen and family, develop what is called a treatment plan. Teens with bipolar disorder will probably receive medication, such as a mood stabilizer, from a psychiatrist or other medical doctor. A psychologist or other type of counselor will provide counseling or psychotherapy for the teen and his or her family. Doctors will watch the symptoms closely and offer additional treatment advice if necessary.
Read Also: How To Get Past Depression On Your Own
Duration Vs Cause Of Depression
The cause of your depression symptoms might also affect how long they last if they go untreated.
In most depression cases, seeking the support of a health professional can shorten the duration and intensity of your symptoms.
There are several causes of depression, ranging from genetic to environmental. Common causes include:
- Biology. indicate that some people with depression have a smaller hippocampus and/or less active frontal lobe. However, scientists dont yet know if this causes depression or is a result of it.
- Drug use. A history of substance use disorder may lead to depressive disorders.
- Hormone changes. Menstrual cycles, pregnancy, and giving birth can lead to depression. In some of these cases, symptoms will subside or improve when the root cause is addressed.
- Environment. Exposure to traumatic events, social isolation, prolonged stress, and poverty can make some people more vulnerable to long-term or recurrent depressive episodes.
- Family history. Depression can run in families. You might have a higher chance of developing the condition if your family members live with the condition.
- Medications. Blood pressure medication and sleeping aids may lead to symptoms of depression that will last for the duration of your treatment.
- Psychology. If you worry a lot, have low self-esteem, or are self-critical and negative, you may experience recurrent depressive symptoms.
Intensity of depression symptoms is classified as:
Healthy Living May Help Your Mood
We all know that being active and eating healthy play an important role in our physical health. However, there may be times when you just dont feel up to physical activity and making healthy choices at mealtime.
However, its important to try and be active and eat healthy as both could be beneficial.
Recommended Reading: Baclofen For Anxiety And Depression
Suicide And Treatment With Antidepressants
Suicide cannot be treated but only prevented . Research on treatments aimed at suicide prevention, not surprisingly, is very limited because of clinical and ethical problems arising if an inactive or ineffective treatment, such as placebo, were compared to an experimental intervention, with death as a potential outcome. In addition, it is virtually impossible to know when a suicide has been prevented, whereas suicidal acts or surrogate measures can be counted. Rarity of suicide, even among psychiatric patients, encourages research reliance on more prevalent measures related to suicide, including suicidal ideation, threats, self-injurious acts, or emergency interventions. However, the typically distant relationship of such measures to suicide limits their value in testing for therapeutic effects on suicide itself. Relating treatments to suicidal risks is further complicated by uncertain long-term adherence to recommended treatments . Treatments for BD considered for possible suicide-prevention include antidepressants, anticonvulsants and lithium, antipsychotics, ECT, and psychosocial interventions .
Table 3 Treatments aimed at reducing suicidal risk in bipolar disorder patients
Bipolar Disorder Causes Mood Episodes
Bipolar disorder, which was previously called manic depression, is a mood disorder that causes , lasting a couple of weeks or longer, of depression or mania, and sometimes psychosis. This is a mood disorder because it causes changes in mood that are not healthy and that can disrupt a persons life significantly. It causes abnormal patterns of thinking, behavior, and thoughts and moods that do not align with someones reality.
For instance, a person with bipolar disorder may have a great life with a loving family and a nice job, but during a depressive episode cannot shake the feeling that he or she is worthless. These abnormal moods usually shift between depression and mania, the latter being the opposite of depression but just as destructive and unhealthy. In severe instances, some people will also go through episodes of psychosis in which they lose touch with reality and may hallucinate or have disturbing delusions. These mood episodes can be very damaging, but they are fortunately manageable with appropriate treatment.
Read Also: Genetic Testing For Depression Meds
Current Status Of Bipolar Depression
Adequate understanding, timely diagnosis, and effective short- and long-term treatment of depressive episodes in BD patients are critically important but remarkably insufficiently resolved . Clinical significance of bipolar depression is underscored by strong association with overall morbidity, other co-occurring psychiatric conditions , disability, and excess mortality owing largely to suicide in young patients and intercurrent medical illness in older patients .
Risk Factors For Developing Bipolar Disorder
The exact cause of bipolar disorder remains unknown among mental health professionals. Scientists believe that there is a genetic component that may cause the disorder to run in some families. However, while people are genetically predisposed to be at risk of developing bipolar disorder, not everyone who has a family member with the disorder will experience it. Environmental factors such as gender, stress, and alcohol or substance abuse are also thought to be contributing factors to the development of bipolar disorder.
If you have a first-degree relative with bipolar disorder, such as a parent or sibling, you may be at higher risk for developing the disorder. For many people, the first symptoms tend to There is not appear during teenage years or early adulthood. Although bipolar disorder can be diagnosed at any age, the typical age of onset is 25.
While men and women are equally affected by bipolar disorder, there are some symptoms that are more specific to each gender. For example, women are more likely to experience rapid cycling mood episodes. Additionally, they are more likely to experience mixed and depressive episodes compared to men with the disorder. Men, on the other hand, may exhibit bipolar disorder symptoms such as anger, hostility, or aggression.
Alcohol or Substance Abuse
Although alcohol and other substances do not cause bipolar disorder, their use can hasten the onset of symptoms and make the associated mood episodes worse.
Recommended Reading: Can Depression Be Cured Permanently
What Are The Types Of Bipolar Disorder
There are three main types of bipolar disorder:
- Bipolar I disorder involves manic episodes that last at least 7 days or manic symptoms so severe that you need immediate hospital care. Depressive episodes are also common. Those often last at least two weeks. This type of bipolar disorder can also involve mixed episodes.
- Bipolar II disorder involves depressive episodes. But instead of full-blown manic episodes, there are episodes of hypomania. Hypomania is a less severe version of mania.
- Cyclothymic disorder, or cyclothymia, also involves hypomanic and depressive symptoms. But they are not as intense or as long-lasting as hypomanic or depressive episodes. The symptoms usually last for at least two years in adults and for one year in children and teenagers.
With any of these types, having four or more episodes of mania or depression in a year is called “rapid cycling.”
What Can Trigger Bipolar Mood Episodes
It’s well known that as a condition, bipolar disorder is highly genetic, meaning you’re more likely to be diagnosed with it if you have an immediate family member who also has the disorder. But experts aren’t quite sure why mood cycling happens in bipolar disorder, or what exactly causes people’s mood to change so drastically, James Bennett Potash, MD, MPH, a professor of psychiatry at The Johns Hopkins University School of Medicine and a psychiatrist with Hopkins Medicine, tells Health.
There are, however, some common triggers for bipolar mood episodes. Stress, in general, can trigger a change in mood, says Dr. Elmashat. For example, a job loss, death in the family, financial stress, can all trigger bipolar episodes. Drug and alcohol use, he says, are also known to trigger bipolar disorder.
Antidepressant medications may also play a role in mood cycling, says Dr. Potash. While some bipolar patients may take antidepressants to help with their depressive episodes, he says doctors are very careful about how they use them, so as not to trigger manic episodes. That’s why, when antidepressants are necessary, health care providers may monitor patients more closely, or pair the drugs with other mood-stabilizing medications.
Also Check: How To Overcome Grief And Depression
Included Publications Regarding Bipolar Disorder
As several as two-thirds of individuals dealing with depression literally attempt to grin as well as bear it they dont seek or obtain the aid they require to deal and also those who do typically allow months go by before bringing it up with their physician. Depression can stick around for many years if left unattended and also can lead to physical symptoms and even thoughts of suicide. Table 1 reports the demographic and analysis attributes of the study effects of depression on short term memory example 54% of individuals fulfilled requirements for frequent major depression, 30% for persistent major depression, and also 16% for dysthymia. The ordinary age of the sample was 48 years, and also 75% were women. A better percentage of those with dysthymia were wed or cohabiting contrasted to those with persistent major depression or frequent depression . Over fifty percent of those with recurrent depression remained in paid employment , contrasted to simply 35% of those with persistent major depression and 39% of those with dysthymia.