BIPOLAR DISORDER

Bipolar disorder is a psychiatric condition that was formerly known as manic depressive disorder. The main symptom of bipolar disorder involves mood swings between mania or hyperactivity and depression.

During the manic or high stage, you may feel very happy, have a lot of energy, need much less sleep than usual, talk very fast, and have the sensation that your thoughts are running through your head very quickly. You may be unable to turn off your thoughts at night to fall asleep. Often, individuals who are in the high period may get by on only 1 or 2 hours of sleep, and still be able to function the next day. In addition, during the high period, patients often make very bad decisions and use poor judgment; for example, they may gamble, spend money they do not have, make very risky investments, and write bad checks. Many individuals feel that they are more productive during the high or manic episode. However, the manic episode can also involve psychosis; that is, hearing voices, seeing things that aren't there, feeling that one has special powers, and getting overly involved in religion. Frequently when individuals are manic, family members and friends will tell them to slow down and stop talking so fast. Some manic individuals will do things like cleaning the house in the early morning hours to burn off excess energy.

The down period of bipolar disorder is called depression. During this time, the individual will feel very tired all the time, may be sad, may have crying episodes occasionally for no apparent reason, will have difficulty falling asleep, but will feel that they need sleep, may lose their appetite, or less commonly, may eat more. In extreme forms of depression, the individual may be suicidal.

Bipolar disorder often occurs in cycles; you may have an episode once a month, once a week, once a year, once a season, or less commonly once a day. It is difficult to tell how often an individual may go through a mood swing because this depends on the individual. Bipolar disorder is fairly common. It also runs in families, so you are more likely to have it if your parents or grandparents had the condition. In addition, bipolar disorder is more common if your parents or grandparents abused alcohol or had depression. There is no specific laboratory test or x-ray to diagnose bipolar disorder. It is diagnosed by the presence of some of the symptoms mentioned above.

The condition is manageable with medications, but bipolar disorder is not curable. The treatment of bipolar disorder involves the use of medications designed to make the mood more stable and to decrease the highs and lows associated with mood swings. The most commonly used drug is lithium, which is very similar to table salt. Some of the side effects from lithium therapy include diarrhea, shaking of your hands, blurred vision, weight gain, and feeling tired. If you have other medical conditions, such as high blood pressure or severe heart disease, you may not be able to take lithium. If your doctor prescribes lithium, it is important to remember that you must not change your intake of salt, nor should you take any salt tablets. However, you should inform your doctor if you are increasing your activity level, especially if done in warm weather where sweating is involved, or if you notice prolonged diarrhea. Anytime you are dehydrated, your lithium level can increase. Patients receiving lithium will have to have blood drawn for a lithium level at different times during their treatment. Your doctor will let you know whether your level is high or low, and will adjust your lithium dose depending on what the blood work shows. If you cannot take lithium, you may have been prescribed valproate (Depakote) or carbamazepine (Tegretol) to treat your bipolar disorder. You may also notice that you urinate more frequently while taking the lithium. This is a common effect and generally does not cause problems.

• Inform your doctor about all prescription and over-the-counter medications you are taking while you are receiving medication for bipolar conditions. Drugs such as antihistamines or drugs that contain high amounts of caffeine should be avoided because they may cause a manic episode.
• Avoid drugs of abuse, especially stimulants such as cocaine, amphetamines, or PCP because they also may produce a manic episode.

• Don't change your diet or your intake of salt while you are taking lithium.

• If you feel you are getting more energetic or are unable to relax, or your family members or associates have described you as "hyper."
• If you notice any side effects related to the medication you are taking.
• If you intend to change your activity level significantly.
• If you notice a decreased need for sleep or if you have trouble sleeping.

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