Monday, November 30, 2009

Bi-Polar Disorder

Bipolar disorder

Bipolar Disorder was once called manic-depression. This is a mood disorder that is chiefly identified by mood swings between the two “polar” states of mania and depression.

Manic episodes are periods of persistently elevated, expansive, or irritable mood. While in an elevated mood people typically experience periods of greatly increased self-esteem, decreased need for sleep, rapid speech, floods of ideas, increased activity levels to the point of hyperactivity, with possible hyper sexuality, and risk taking. People in manic states can be euphoric or highly irritable if their goals are blocked or interfered with. The combination of blind optimism, feelings of grandiosity, increased sex drive, and poor impulse control often lead to damaged personal, family, social and vocational relations.

These manic states alternate with periods of depression in ways unique to the individual.

Milder, yet still disruptive, mood swings are symptomatic of a more moderate mood swing problem named cyclothymia.

Case Study

One bipolar disordered grandmother remained rather isolated during depressed periods only to emerge from her depressed states and go on "rampages" that struck fear into the hearts of her adult children and their families. Her behavior was unpredictable and highly problematic. She was arrested by the police for swimming at a small town public beach in her underclothes. One Thanksgiving she pulled unannounced into the driveway of her daughter’s family and let several adult turkeys out of the back of a beat-up station wagon (she had been in numerous accidents) to run through the neighborhood. After all, it was Thanksgiving, and She had “brought the dinner”!

Perhaps this sounds amusing, but her adult daughter was mortified with fear of what was coming next. She was also known to pick-up well-to-do elderly men and spend their money before moving on to other relationships. As is often the case, this individual refused to take the medication, which could have helped to controlled her mood swings. My dear grandmother remained actively bipolar until she contracted a terminal illness in her late 70's.

As a young child I could not understand my mother's mortification at her arrival at my house. To me, she was just an exciting and fun grandma. I loved her dearly and still do.

Community samples suggest a life-time prevalence of .4% to 1.6%. However, the frequency of this diagnosis appears to be increasing in children and adults

Possible Causes

Bipolar disorder is thought to be caused by biological factors. One theory suggests that a combination of low levels of serotonin and high levels of norepinephrine combine to produce bipolar symptoms. Another theory suggest that the improper transport of sodium ions involved in neuronal transmission (or perhaps an abnormality in the neuronal membrane) increases the rate of neuronal impulses and leads to mania. There is also consistent evidence that bipolar disorder may be an inherited condition. Close relatives of those who suffer from bipolar disorder also show higher rates of this problem.

If you or your loved one shows indications of Bi-Polar Disorder see your family physician for a physical. If all is well with your physical check-up, I strongly recommend a psychiatric consultation. A psychiatrist is an MD who specializes in treating serious mental disorders, of which Bi-Polar Disorder is one.

If Bi-Polar Disorder is the problem, it cannot be regulated without medication management. In addition, education and counseling with an experienced therapist is very important for long-term management of this disorder. Bi-Polar Disorder cannot be cured, but it can be managed effectively.

God Bless,

Dr. Tom

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