Friday, May 24, 2024

Bipolar Disorder And Manic Depression

How Is Bipolar Disorder Diagnosed

Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology

As with most mood disorders, there is no laboratory test or brain imaging method to diagnose bipolar disorder. After performing a physical exam, your doctor will evaluate your signs and symptoms. Your doctor will also ask you about your personal medical history and family history. Lab tests may be done to rule out other medical illnesses that can affect mood.

In addition, your doctor may want to talk with family members to see if they can identify times when you were elated and over-energized. Because elation may feel good or even normal when compared to depression, it’s often hard for a person with bipolar disorder to know if the mood was too high. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, unwise business or financial decisions may be made when an individual is in a manic phase. So early diagnosis and effective treatment is very important with bipolar disorder.

What If Im Not Happy With My Treatment

If you arent happy with your treatment you can:

  • talk to your doctor about your treatment options,
  • ask for a second opinion,
  • get an advocate to help you speak to your doctor,
  • contact Patient Advice and Liaison Service , or
  • make a complaint.

There is more information about these options below.

How can I speak to my doctor about my treatment options?

You can speak to your doctor about your treatment. Explain why you arent happy with it. You could ask what other treatments you could try.

Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you arent given this treatment, ask your doctor to explain why it isnt suitable for you.

Whats a second opinion?

A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.

You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.

What is advocacy?

An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.

There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. NHS complaints advocates can help you if you want to complain about the NHS.

Duration Of Episodes In Bipolar Disorder

Kraepelin noted that states of manic excitation can vary greatly in duration from weeks to several months, and that more severe forms of mania with severe excitement and psychotic features tend toward relatively long episodes. He also noted that melancholic states are generally longer than manic attacks, can sometimes persist for years, and tend to become more prominent than mania at older ages .

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Patterns Of Depression And Mania

If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.

Between episodes of depression and mania, you may sometimes have periods where you have a “normal” mood.

The patterns are not always the same and some people may experience:

  • rapid cycling where a person with bipolar disorder repeatedly swings from a high to a low phase quickly without having a “normal” period in between
  • mixed state where a person with bipolar disorder experiences symptoms of depression and mania together for example, overactivity with a depressed mood

If your mood swings last a long time but are not severe enough to be classed as bipolar disorder, you may be diagnosed with a mild form of bipolar disorder called cyclothymia.

What Is The Treatment For Mania Hypomania And Depression

Manic depression

You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.

NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:

The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.

What medications are recommended?

Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.

The mood stabilisers we talk about in this factsheet are:

  • Lithium
  • Certain benzodiazepine medication

Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.

If you are taking antidepressants your doctor may advise you to withdraw from taking them.

You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:

  • Haloperidol
  • Quetiapine
  • Risperidone

If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.

If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.

Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.

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What Are The Treatments For Bipolar Disorder

Bipolar disorder is a long-term illness that requires management throughout a person’s life. People who have numerous episodes of mood changes in a year can be much more difficult to treat. Medication is the primary form of treatment, but the additional use of psychotherapy or “talk” therapy is sometimes recommended to help prevent future episodes.

There are many drugs available to treat bipolar disorder. Proposed guidelines for treatment options are based on the three main phases of bipolar disorder, which include the acutemanic/mixed mood states, acute major depressive episodes, and finally the continuation/maintenance phase. As a general rule, avoiding antidepressants and taking two mood stabilizers has proven to be an effective strategy for most patients.

Mood-stabilizing drugs

Lithium is a mood-stabilizing drug. It has proven helpful in controlling mania and depression and preventing depression and manic episodes. Lithium will reduce symptoms of mania within two weeks of starting therapy, but it may take weeks to months before the condition is completely controlled. Thus other drugs like antipsychotic drugs or antidepressant drugs may also be used to help control symptoms.

Common side effects of lithium include:

  • Frequent need to urinate
  • Nausea

The following are signs of a lithium overdose. Call your doctor immediately or go to the nearest emergency room if you experience:

  • Blurred vision
  • Weight gain
  • Slight trembling of hands

Atypical neuroleptics

Can I Take Medicine For Bipolar Disorder While Breastfeeding

Yes. Certain medicines to treat bipolar disorder are safe to take while breastfeeding.7 Talk to your doctor about what medicines you can take after giving birth.

Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter your medicine into the LactMed® database to find out whether your medicine passes through your breastmilk and, if so, any possible side effects for your nursing baby.

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What Can You Do To Cope With Your Illness

People with manic depression may need to make some changes in their lifestyle in order to cope better with their illness, changes are such as:

  • Keep regularity of daily activities e.g. sleeping pattern, exercise
  • Avoid any alcohol and street drugs
  • Keep working
  • Maintain social contact with family members, friends or church members etc.
  • Compliance with treatments
  • Risk Factors For Developing Bipolar Disorder

    Bipolar Manic Depressive 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.

    Family Tendencies

    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.

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    What Are The Symptoms Of Bipolar Disorder

    The changing mood states do not always follow a set pattern, and depression does not always follow manic phases. A person may also experience the same mood state several times before experiencing the opposite mood. Mood changes can happen over a period of weeks, months, and sometimes even years.

    An important aspect of the mood changes are that they are a departure from the persons regular self and that the mood change is sustained for a long period of time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression. Shorter periods of mania or depression may be an indicator of more severe episodes in the future but are usually not enough to diagnose a person with bipolar disorder.

    The severity of the depressive and manic phases can differ from person to person and in the same person at different times. Symptoms of mania include:

    • Excessive happiness, hopefulness, and excitement
    • Sudden changes from being joyful to being irritable, angry, and hostile
    • Restlessness
    • Rapid speech and poor concentration
    • Increased energy and less need for sleep
    • High sex drive

    Patients with depression can also become psychotic and hear things or have delusions.

    Does Bipolar Disorder Look Different In Men Vs Women

    Both men and women are affected equally and have similar symptoms. However, men usually experience mania first while women typically start with depressive episodes. Women and people with bipolar II disorder are significantly more likely to experience periods of rapid cycling than men with the same condition. Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness.

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    Depression And Bipolar Disorder

    What Is Bipolar Disorder?

    Bipolar disorder is a complex disorder that likely stems from a combination of genetic and non-genetic factors. The mood episodes associated with it involve clinical depression or mania with periods of normal mood and energy in between episodes. The severity of mood episodes can range from very mild to extreme, and they can happen gradually or suddenly within a timeframe of days to weeks. When discrete mood episodes happen four or more times per year, the process is called rapid cycling. Rapid cycling should not be confused with very frequent moment-to-moment changes in mood, which can sometimes occur in people with bipolar disorder or other conditions such as borderline personality disorder.

    Along with manic or depressive episodes, patients with bipolar disorder may have disturbances in thinking. They may also have distortions of perception and impairment in social functioning.

    What is Therapy?

    Our therapy services are carefully designed to provide you with a welcoming, supportive and productive environment in which you can address and overcome your mental health concerns. Sometimes, being at home and in a familiar surrounding can put you at ease and help you embrace therapy, which is often the first obstacle clients face. We can deliver high-quality, effective assessments and treatments wherever you are in the UK.

    What can Therapy help me with?

    What are the benefits of Therapy?

    Our unique approach to private mental health treatment

    Bipolar Disorder And Other Conditions

    ALL FOR NURSING: Psychiatric Nursing: Bipolar Disorder

    Some bipolar disorder symptoms are similar to those of other illnesses, which can make it challenging for a health care provider to make a diagnosis. In addition, many people may have bipolar disorder along with another mental disorder or condition, such as an anxiety disorder, substance use disorder, or an eating disorder. People with bipolar disorder have an increased chance of having thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.

    Psychosis: Sometimes, a person with severe episodes of mania or depression may experience psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the persons extreme mood. For example:

    • People having psychotic symptoms during a manic episode may have the unrealistic belief that they are famous, have a lot of money, or have special powers.
    • People having psychotic symptoms during a depressive episode may falsely believe they are financially ruined and penniless, have committed a crime, or have an unrecognized serious illness.

    As a result, people with bipolar disorder who also have psychotic symptoms are sometimes incorrectly diagnosed with schizophrenia. When people have symptoms of bipolar disorder and also experience periods of psychosis that are separate from mood episodes, the appropriate diagnosis may be schizoaffective disorder.

    Anxiety: It is common for people with bipolar disorder to also have an anxiety disorder.

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    Bipolar Disorder And Suicide

    The depressive phase of bipolar disorder is often very severe, and suicide is a major risk factor. In fact, people suffering from bipolar disorder are more likely to attempt suicide than those suffering from regular depression. Furthermore, their suicide attempts tend to be more lethal.

    The risk of suicide is even higher in people with bipolar disorder who have frequent depressive episodes, mixed episodes, a history of alcohol or drug abuse, a family history of suicide, or an early onset of the disease.

    Suicide warning signs include:

    • Talking about death, self-harm, or suicide.
    • Feeling hopeless or helpless.

    Get more help

    Bipolar Disorder Symptoms, causes, and treatment.

    Rapid Cycling Signs, symptoms, and causes of rapid cycling in bipolar disorder.

    Bipolar Workbook and other self-help resources.

    Hotlines and support

    In the U.S.: Call the NAMI HelpLine at 1-800-950-6264 or find DBSA Chapters/Support Groups in your area.

    UK: Call the peer support line at 0333 323 3880 and leave a message for a return call or Find a Support Group near you.

    Australia: Call the Sane Helpline at 1800 187 263 or find a local Support Group.

    Canada: Visit Finding Help for links to provincial helplines and support groups.

    India: Call the Vandrevala Foundation Helpline at 1860 2662 345 or 1800 2333 330

    The HelpGuide team appreciates the support of Diamond Benefactors Jeff and Viktoria Segal.

    How Do I Get Help If I Think I Have Bipolar Disorder

    The usual first step to getting help is to speak to your GP.

    It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.

    Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:

    • depression, and
    • ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.

    They might refer you to a psychiatrist at your local NHS community mental health team .

    Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.

    Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.

    Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.

    You can find more information about:

    • NHS mental health teams by clicking here.

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    Bipolar Disorder Vs Major Depression

    You may have heard of people who were first diagnosed with depression but later diagnosed with bipolar disorder, and this can be confusing. How can you tell the difference? Keep in mind that the hallmark of bipolar disorder is the presence of episodes of mania or hypomania. These are not present in major depression.

    Another common question that’s asked is “Can depression turn into bipolar disorder?” The answer to that question is no, depression doesn’t transition into bipolar disorder later on.

    However, it is possible for someone to be diagnosed while they are in the depressive phase, which may result in a diagnosis of depression. At the time, they may not recall or be asked about symptoms of mania or hypomania that would lead to a bipolar diagnosis. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic episode, the diagnosis of bipolar may become clear.

    Other Mental Health Conditions

    Mania and Depression – Bipolar Disorder

    Bipolar depression may be more likely if a person has another mental health condition, such as obsessive-compulsive disorder or traits of borderline personality disorder .

    Bipolar disorder usually appears during adolescence or early adulthood, but it can occur at any age, including childhood.

    Some statistics show that, on average, it starts between ages . Other research suggests its more likely to occur after the age of 25. One large study found evidence that higher numbers of first episodes appear in people ages 15 to 24 and in those ages 45 to 54.

    Global statistics suggest bipolar I disorder affects around

    Hypomania involves symptoms similar to mania but less severe. The biggest difference between the two is that symptoms of hypomania have a less significant effect on your life and your ability to work, study, and carry out daily tasks.

    In addition, for a diagnosis of mania for bipolar I, the episode must last at least 7 days . For a diagnosis of bipolar II hypomania, an episode must last at least 4 days.

    Manic episodes can involve psychosis and may lead to hospitalization, but this is unlikely to happen with hypomania.

    Some people with bipolar disorder experience mixed mood states in which depressive and manic symptoms coexist. In a mixed state, a person will often have symptoms that include:

    • agitation

    diagnoses of bipolar disorder, depending on how the features and symptoms appear.

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