Manic depression - Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function.
Some mornings can start with overriding feelings of joy, elation and power. By the time the afternoon has arrived this can shift to feelings of desperation, despair and depression.
More than 2 million American adults, or about 1 percent of the population have bipolar disorder, the percentage figures are the same for the United Kingdom.
These figures are only an estimate, the true figures will probably never be accurately known, this is probably due the stigma attached to mental health issues and the signs and symptoms not being correctly spotted by friends, family, professionals and even the individual themselves. It is fair to say that manic depression is under diagnosed.
Signs and symptoms of mania (or a manic episode)
o Increased energy, activity, and restlessness
o Excessively "high," overly good, euphoric mood
o Extreme irritability
o Racing thoughts and talking quickly, jumping from one idea to another
o Distractibility, lack off concentration
o Little sleep needed
o Unrealistic beliefs in one's abilities and powers
o Poor judgment
o Spending sprees
o A lasting period of behaviour that is different from usual
o Increased sexual drive
o Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
o Provocative, intrusive, or aggressive behaviour
o Denial that anything is wrong
A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.
The above signs and symptoms of mania can be very difficult to spot in an individual who has manic depression as all of the EXACT symptoms and time frames may not be prevalent in every person as each individual is unique.
A good example of this would be a rapid cycle manic depressive who in the mornings is high and elated, followed by despair and depression in the afternoons. This rapid cycle could happen for 2 or 3 days then level off for a relative period of calm for a few days before it starts again.
Due to the stigma attached to mental health problems individuals may try and mask their symptoms to avoid any embarrassment they may feel. Thus making it even more difficult to spot and diagnose.
Some of these symptoms of mania may be the only symptoms that you see in a person who has manic depression, as they are easily passed of as having a "larger than life personality"
Signs and symptoms of depression (or a depressive episode)
o feeling sad, anxious, or empty mood
o Feelings of hopelessness or pessimism
o Feelings of guilt, worthlessness, or helplessness
o Loss of interest or pleasure in activities once enjoyed, including sex
o Decreased energy, a feeling of fatigue or of being "slowed down"
o Difficulty concentrating, remembering, making decisions
o Restlessness or irritability
o Sleeping too much, or can't sleep
o Change in appetite and/or unintended weight loss or gain
o Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
o Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.
A manic depressive will definitely have 5 of these symptoms. This is truly the worst time for a manic depressive, this is where the most support and help is needed.
Again the diagnosis is not 100% correct, as some people will have rapid cycles, i.e. High and elated in the morning then desperation and depression in the afternoon, these symptoms may only last a few days; sometimes they last a few weeks and in some very bad cases months.
In some people however, symptoms of mania and depression may occur together in what some people are calling a" mixed bipolar state."
Symptoms of a mixed state often include agitation, trouble sleeping, and significant change in appetite, psychosis, and suicidal thinking. A person may have a very sad, hopeless mood while at the same time feeling extremely energized.
So again this shows that manic depression or bipolar disorder is not as straight forward as highs and lows.
Diagnosis of manic depression - Bipolar Disorder
Like other mental illnesses, bipolar disorder cannot yet be identified physiologically--for example, through a blood test or a brain scan. Therefore, a diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and, when available, family history.
Treatment of Bipolar Depression
It is absolutely vital that the correct medication is administered once the diagnosis has taken place, as recent research has indicated that people with bipolar disorder are at risk of switching into mania or hypomania, or developing rapid cycling, during treatment with incorrect antidepressant medication.
Therefore, correct "mood-stabilizing" medications are generally required, alone or in combination with the correct antidepressants, to protect people with bipolar disorder from this switch.
Lithium and valproate are the most commonly used mood-stabilizing drugs today.
Side effects
As any person who is open about their Bipolar will tell you, all of these medications have side effects these can include:
o Weight gain
o Dependence on the medication
o Nausea
o Tremors
o Reduced sex drive or performance
o Anxiety
o Hair loss
o Movement problems
o Dry mouth
o Disturbed sleep
Alternative treatments
Herbal or natural supplements, such as St. John's wort (Hypericum perforatum), have not been well studied, and little is known about their effects on bipolar disorder. Before trying herbal or natural supplements, it is important to discuss them with your doctor.
There is evidence that St. John's wort can reduce the effectiveness of certain medications. In addition, like prescription antidepressants, St. John's wort may cause a switch into mania in some individuals with bipolar disorder, especially if no mood stabilizer is being taken.
Omega-3 fatty acids found in fish oil are being studied to determine their usefulness, alone and when added to conventional medications, for long-term treatment of bipolar disorder.
One such study was carried out by Dr Andrew Stoll over a four month period. The study was performed to examine whether omega 3 fatty acids also have mood stabilizing effects with people who have bipolar disorder.
He found that the omega 3 fatty acid patient group had a significantly longer period of remission than the placebo group.
In addition, for nearly every other outcome measure, the omega3 fatty acid group performed better than the placebo group.
With almost no adverse side effects apart from a slight gastric upset. This was thought to be due to the large doses of fish oil administered.
The study was published in the archives of general psychiatry in May 1999. Since then far stronger Pharmaceutical grades of omega 3 fish oil have been developed and brought on to the world market so such large doses need not be taken.
Conclusion
Manic depression - bipolar disorder is a condition that is often under diagnosed and in some cases very difficult to spot and treat correctly. A lot of people with this condition will try and mask either their true feelings and or symptoms due to the unfortunate stigma that is attached to mental health. Receiving the correct diagnosis, treatment and medication is vital if they are to stand any chance of trying to live a normal life. It is also crucial for friends and family to also try and understand this condition as it can help them come to terms with certain types of behaviour that are being displayed. As far as alternative remedies go, to date our best bet is very strong omega 3 fish oil as there are no side effects and it is the only remedy that's had any kind of scientific study performed using people with our condition . It is also safe to run along side any form of medication apart from blood thinning medication.
Copyright 2005 David McEvoy
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