http___hr.265health.com_mental-health_bipolar-disorder_1016095027.html_1.xml
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causes A variety of physical, genetic, environmental, and emotional factors seem to be involved in causing bipolar disorder. Genetic Factors: As stated in risk factors, a gene has been linked with developing bipolar illness. Neurotransmitters: Some studies suggest that a low or high level of neurotransmitters such as serotonin, norepinephrine, or dopamine may cause bipolar disorder. Studies have found evidence that a change in the sensitivity of the receptors on nerve cells to these neurotransmitters may be one issue, along with an imbalance in the amounts of neurotransmitters. Head trauma may cause chemical imbalances and result in bipolar disorder. Balancing neurotransmitters with drug therapy is the current focus for treatment of bipolar disorder. Medications: High levels of digoxin, a common heart medication used for congestive heart failure (CHF), can also give rise to mania due to a toxic buildup of the drug in the body. Medications that have been reported to cause symptoms of bipolar include amphetamines, baclofen, bromocriptine, captopril, cimetidine, cocaine, corticosteroids (including adrenocorticotropic hormone or ACTHa), cyclosporine, disulfiram, hallucinogens, hydralazine, isoniazid, levodopa, methylphenidate, opiates and opioids such as phencyclidine (PCP), procarbazine, procyclidine and yohimbine. Other causes: Stress (both physical and emotional), drug abuse (such as cocaine and methamphetamine), and mood changes that happen with the seasons (seasonal affective disorder or SAD), may trigger bipolar symptoms. Stress causes increases in the hormone cortisol, which may lead to neurochemical imbalances. diagnosis No specific tests are available to definitively diagnose bipolar disorder. The diagnosis is made on the basis of all the signs and symptoms. Bipolar disorder is diagnosed on the basis of symptoms that occur during a manic episode, a history of previous episodes, and family history. A diagnosis may be made solely by the presence of a manic episode - depression need not have occurred, or a patient with depression may be misdiagnosed for just having depression. In addition to the mood abnormality, other symptoms must also be present before a diagnosis can be made, including inflated self-esteem, decreased need for sleep, rapid speech, racing thoughts, loss of attention span, increase or decrease in activities (whether social or work-related) and increase in activities that may lead to problems (for example, buying sprees or sexual indiscretions). A clinician will need to rule out the possibility that the patient's symptoms are a result of an underlying medical or drug-related condition. An initial episode that occurs after the age of 40 is particularly suggestive of mania secondary to another cause. A drug screen should be part of the workup, as amphetamines or cocaine can precipitate manic symptoms. Prescription drugs may also cause manic symptoms, so they must be ruled out. If an individual experiences at least four symptoms of mania and depression for a period of at least two weeks, that person may have bipolar disorder or another form of mood disorder. Tests may be ordered to rule out other causes, such as blood or urine tests to determine the balance of salts and sugar in the blood, hormone function, blood cell counts, and drug and alcohol levels. Computerized tomography (CT) scan, positron emission tomography (PET), or magnetic resonance imagining (MRI) of the head may be ordered to check for blood clots, bleeding, or tumors. An electroencephalogram (EEG) to test brain waves for abnormalities, may be ordered if the person is thought to have a seizure disorder. A spinal tap (lumbar puncture) may be ordered to get a sample of spinal fluid to determine if a brain infection, such as meningitis or encephalitis (both forms of brain inflammation), exists. These test may not only rule out other conditions that may be present (such as brain tumor or other disease), they may also determine if imbalances in neurochemistry are present. Treatment is based on the results of these tests. If test results are all normal, the diagnosis is most likely a psychiatric disorder, such as bipolar disorder. Diagnosis also involves ruling out other mental health conditions that may produce symptoms similar to bipolar disorder. These may include other mood disorders, such as schizophrenia, attention-deficit/hyperactivity disorder, and borderline personality disorder. After determining if the individual has a bipolar illness, then the type of bipolar disorder will be determined based on criteria from the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR). The categories are Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder NOS (Not Otherwise Specified). Bipolar I Disorder: Bipolar I disorder involves one or more manic or mixed episodes, and often one or more major depressive episodes. A depressive episode may last for several weeks or months. Between episodes of bipolar I disorder, there may be periods of normal functioning. Symptoms may also be related to seasonal changes. Bipolar II Disorder: Bipolar II disorder involves one or more major depressive episodes along with at least one hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes but are less severe. There may be periods of normal functioning between episodes of bipolar II disorder. Symptoms may also be related to seasonal changes. Seasonal affective disorder (or SAD) is a common cause of depression, particularly during the winter season. Bipolar disorder may also respond to these seasonal changes, with symptoms of depression being more prominent during the winter months. Cyclothymic Disorder: Cyclothymic disorder is a long-term fluctuating mood disturbance with periods of hypomania and periods of depression. It is a milder form of bipolar disorder. That's because the periods of both depression and hypomania are shorter, less severe, and do not occur with regularity. Bipolar Disorder Not Otherwise Specified: This type of bipolar disorder is when the individual does not fit into other categories of bipolar disorders. Types of episodes: According to the American Psychiatric Association, bipolar disorder includes four types of mood episodes or disturbances, including depression, mania, hypomania, and a mixture of them. Depression: People with bipolar disorder can feel depressed, sometimes for long periods of time. Some may not even want to get out of bed or eat. They isolate from friends and family and most don't enjoy doing things they used to enjoy. Mania: Mania is the extreme opposite of depression. Mania may start with a good feeling, almost like a "high." Or it may make a person feel very irritable and angry. People with mania may do very risky things due to a loss of inhibition. Hypomania: Hypomania is a milder, less dramatic form of mania. A person may feel good and may think that he or she is getting more things done. However, the good feeling can change into full-blown mania or depression at any time. Mixed mood: Feelings of mania and depression can also alternate in the same day, meaning someone may feel manic upon rising and depressed by the evening. This is called a mixed episode. Other: Children with bipolar disorder do not often meet the strict DSM-IV definition. In pediatric cases, the cycling can occur very quickly. Rapid cycling occurs when the cycles between depression and mania occur quickly, sometimes within the same day or the same hour. When the symptoms of both mania and depression occur simultaneously, mixed cycling occurs. Often other psychiatric disorders are diagnosed in bipolar children. Problems that may be misdiagnosed as bipolar disorder include depression, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), schizophrenia, and Tourette syndrome (a neurological disorder characterized by nervous "tick", both physical and verbal). Misdiagnosis may lead to incorrect medications, which can trigger mania and/or suicidal ideation and attempts. The energy, impulse control difficulties, and lack of maturity in bipolar children can make suicide risk a serious concern, even with children younger than 8 years old. signs and symptoms Bipolar disorder is characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of the associated signs and symptoms varies. Bipolar disorder can range from a mild condition to a severe condition, and there may be periods of normal behavior. Many patients may need therapy and hospitalization. Manic phase: Signs and symptoms in the manic phase may include increased energy level, feelings of euphoria, extreme optimism and inflated self-esteem, rapid speech, racing thoughts, agitation and increased physical activity, poor judgment, risky or unusual activities to the extreme, even if it is likely that bad things will happen, difficulty sleeping or less sleep needed, tendency to be easily distracted, inability to concentrate, and aggressive behavior. Depressive phase: Neurochemical imbalances during depression cause a wide range of symptoms, including persistent feelings of sadness, anxiety, guilt or hopelessness, loss of interest in things the person previously enjoyed including sex, disturbances in sleep, an increased need for sleep, changes in weight or appetite, fatigue, problems concentrating or making decisions, irritability, chronic pain without a known cause, and recurring thoughts of suicide or death. A depressive episode is diagnosed if five or more of these symptoms last for most of the day, nearly every day, for a period of two weeks or longer. Hypomania: A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus, even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania may become severe mania in some people or can switch into depression. Psychosis: Often severe episodes of mania or depression include symptoms of psychosis, or psychotic symptoms. Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. The various mood states in bipolar disorder are thought of as a spectrum or continuous range. At one end is severe depression, then moving into moderate depression and then mild low mood, which many people call "the blues" when it is short-lived. Then there is normal or balanced mood, then hypomania (mild to moderate mania), and finally severe mania. Mixed bipolar state: Some patients experience symptoms of mania and depression together that alternate back and forth (called a mixed bipolar state). Symptoms of a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thoughts. A person may have a very sad, hopeless mood and at the same time feel extremely energized. Bipolar disorder may appear on the surface as other unrelated mental problems. For instance, alcohol or drug abuse, poor school or work performance, or stressed and strained interpersonal relationships may actually be caused by bipolar disorder. Bipolar disorder in children and adolescents can be difficult to distinguish from other problems that may occur in these age groups. For example, while irritability and aggressiveness may indicate bipolar disorder, they can also be symptoms of attention deficit hyperactivity disorder (ADHD), conduct disorder, oppositional defiant disorder, or other types of mental disorders more common among adults such as major depression or schizophrenia. Drug abuse also may lead to such symptoms. Suicidal thoughts: Suicidal thoughts may accompany bipolar disorder, normally in the depressive phase. Anyone who has suicidal feelings, talks about suicide, or attempts suicide should be taken seriously and should receive immediate help from a mental health specialist. complications Alcohol and drug abuse are very common among people with bipolar disorder. Research findings suggest that many factors may contribute to substance abuse problems and bipolar disorder, including self-medication of symptoms. Anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, may also be common in people with bipolar disorder. Anxiety disorders can be diagnosed by a psychiatrist. Studies suggest up to 42% of individuals with bipolar disorder also suffer from anxiety. Bipolar disorder can have devastating effects on relationships as well as finances stemming from spending sprees during a manic episode or nearly complete isolation and withdrawal during a depressive phase. Suicide may be a complication of untreated, mistreated, or misdiagnosed bipolar disorder. risk factors Bipolar disorder tends to run in families. A family history of depression appears to exist in 80 to 90% of cases of bipolar disorder. More than two-thirds of people with the disorder have a close relative with it or with depression. Recent research has identified a gene (DISC1) that is linked with developing bipolar disorder. This same gene may also influence the chances of getting schizophrenia and major depression. Having certain coexisting medical conditions, or taking certain medications, may increase the risk for a manic syndrome. Conditions that have been linked with causing symptoms of bipolar disorder include attention deficit hyperactivity disorder (ADHD), acquired immunodeficiency syndrome (AIDS), extrapyramidal diseases or diseases of the nerves dealing with movement (Huntington's Disease, Parkinson's Disease), central nervous system infections (general paresis, viral encephalitis), cerebral neoplasms, cerebral trauma, cerebrovascular accidents, dialysis dementia, kidney problems, Kleine-Levin syndrome (the need for excessive sleep), Klinefelter's syndrome (genetic abnormality which increases risk of diseases), multiple sclerosis (MS, an inflammatory disease of the muscular system), pellagra (a vitamin B3 or niacin deficiency), Pick's disease (rare brain disease leading to dementia), postpartum mania (mania after having a baby), stroke, temporal lobe epilepsy, thyroid diseases, Wilson's disease (accumulation of copper), and Vitamin B12 deficiency.
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psihijatri i klinički psiholozi imaju specifičnu izobrazbu za dijagnosticiranje duševnih bolesti , uključujući i bipolarni poremećaj . Dijagnoza bipolarnog poremećaja je napravio, ako su ispunjeni uvjeti navedeni u DSM -IV za bipolarni poremećaj . Vrste bipolarnog poremećaja uključuje razdoblja manije i depresije , dok je bipolarnog poremećaja II uključuje razdoblja hypomania i depresije . Hypomania je kraći u trajanju i manje težak od manije Značajke Srpski Srpski hipomanijačkih i manične epizode su barem tri od sljedećih simptoma : . Povišenog raspoloženja , razdražljivost , napuhan samopoštovanje , smanjenu potrebu za snom , povećana Pričljivost , utrke misli, slabu koncentraciju , povećanje golom usmjerena aktivnost i prekomjerno uključenost u ugodnim aktivnostima s visokim potencijalom za negativne posljedice . Depresivne epizode uključuju barem pet od sljedećih simptoma : depresivno raspoloženje , nedostatak interesa i zadovoljstva u aktivnostima nekad uživali , značajne promjene težine, nesanicu ili prekomjerno spavanje , psihomotornu uznemirenost ili usporenost , umor, osjećaj bezvrijednosti ili pretjerane krivnje , slabu koncentraciju i ponavljajuća razmišljanja o smrti ili samoubojstvu . Povijest Procjena bipolarnog poremećaja zahtijeva ispitivanje povijest promjena raspoloženja . Dijagnoza bipolarnog poremećaja zahtijeva najmanje jednu sadašnjeg ili bivšeg epizodu hypomania ili manije i jednog sadašnjeg ili bivšeg epizoda depresije . Vremenskog okvira Epizode su navedeni rokovi vremena u kojem su određene simptome raspoloženja prisutne . Maničnih epizoda traje najmanje tjedan dana , depresivnih epizoda traju najmanje dva tjedna i hipomanijačkih epizoda trajati najmanje četiri dana. Razmatranja Bipolarni poremećaj je često dijagnosticirao kao velike depresije , jer pojedinci obično samo potražiti pomoć kada se osjećaju depresivno . Mnogi antidepresivni lijekovi mogu izazvati manično epizode kod osoba s bipolarnim poremećajem . From:http://hr.265health.com/mental-health/bipolar-disorder/1016095027.html