This week our topic focused around bipolar disorder. Bipolar disorder is characterized by continual changes in mood that last over a long period of time. These moods cycle between depression and mania and can last in one part of the cycle for weeks at a time. The symptoms for mania include being easily distracted, little need for sleep, poor judgment, poor temper control, reckless behavior, elevated mood, extreme involvement in activities. There are also two types of bipolar disorder, 1 and 2, bipolar 1 is characterized with the mania symptoms, while bipolar 2 still has mania symptoms, but not as intense. Some of the other symptoms and possible treatments can be found on this link: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001924/
It is often difficult to characterize and quantify the extent of the depression or mania symptoms so it is often challenging to diagnose true bipolar disorder. It often takes many sessions over a long period of time to diagnose. Often times doctors will ask about family history and ask about your recent behavior and mood swings to try to diagnose, but this is very difficult. The official psychologist diagnostic manual called the DSM even states at the end that these episodes of depression/mania could be bipolar if they can’t be explained better through schizophrenia disorders, delusion disorders or other unspecified disorders. Here is the link that include the descriptions from the DSM: http://www.fortunecity.com/campus/psychology/781/dsm.htm This is extremely frustrating because there is no clear test or set of symptoms to declare that an individual definitively has bipolar disorder. Simply put, it seems as though this disorder is diagnosed through the process of elimination.
Treatment is just as difficult if not more challenging to pinpoint. Our article this week focused on three major medications for the treatment disorder, they include lithium, valproic acid and carbamazepine. These medications are classified as “mood stabilizers” because they try to level out the mania and depressive symptoms however they work better on the mania symptoms and no one is sure why. The different medications work differently on different individuals and the different types of bipolar disorder and since it is so hard to diagnose often times individuals are on these drugs on a “trial and error” method. They will be prescribed one treatment and if that doesn’t work they move on to the next and the next and the next. Along with these mood stabilizers, doctors may also prescribe antiseizure medication, antipsychotics and antidepressants. Some patients may even be on all of the drugs at once with many harmful side effects and when the treatment starts working and the symptoms lessen, doctors may be unable to pinpoint which drugs is the effective drug. Treatments for bipolar disorder other than drugs include electroconvulsive therapy (small shocks to the brain), transcranial magnetic stimulation (sends pulses to a specific area of the brain) or even talk therapies and support groups. For more information about the drugs, side effects and other treatments please follow this link: http://mentalhealth.gov/health/publications/bipolar-disorder/complete-index.shtml
Over Medicated and Undiagnosed
