If you have bipolar disorder with depression , symptoms you may experience include: Fatigue Sadness Decreased energy Overeating or loss of appetite Suicidal thoughts Our team at Boston MindCare take a detailed history to decipher your symptoms and give you a definitive diagnosis. Types of bipolar disorder Bipolar disorder is a condition that affects your brain and your mental health. Bipolar 1 This type of bipolar disorder is characterized by manic episodes, with or without depression symptoms.
Bipolar 2 Bipolar 2 disorder is characterized by having both manic and depressive episodes. Cyclothymic disorder In cyclothymic disorder, you experience both manic and depressive episodes for two years or longer. What are your treatment options? Close Font Resize. Keyboard navigation. Readable Font. Choose color black white green blue red orange yellow navi. Underline links. A study on elderly unipolar and bipolar manic patients, however, found that elderly UM patients had an earlier onset [ 27 ].
Another recent study [ 11 ] reported earlier age of onset in unipolar mania 23 years when compared to bipolar mania 28 years which was almost similar to the findings of Yazici et al. Regarding gender, the results have been mixed with some early studies reporting a slight male preponderance [ 14 , 28 ] and others finding no difference between both sexes [ 11 , 15 , 18 , 20 , 26 , 29 ].
Furthermore, in other studies, UM was found to be more common in females than males [ 22 , 23 , 30 ]. Marital status [ 22 , 23 , 29 ], educational status [ 23 , 26 , 29 ], and occupational status [ 22 , 29 ] do not differ in unipolar and bipolar mania. But, due to lack of cross-cultural studies, this cannot be regarded as conclusive. However, a recent cross-cultural study reported that UM was three times more common in Tunisia than in France [ 32 ].
Two studies have been reported from USA. In these studies, the majority of the UM patients came from Iowa [ 15 , 30 ] which was described as being a more rural setting than the other regions studied [ 30 ]. This, according to the authors, was the reason for the different prevalence of UM among various sites. The only study comparing the prevalence of UM among different ethnic groups, carried out in Fiji, found no significant differences in this regard [ 22 ].
This probably refutes the possibility of difference in ethnicities being the reason for difference in prevalence of UM in different cultures. It would, however, be premature to propose an explanation based on the results of single study. Studies on clinical features have revealed some significant differences between UM and bipolar manias Table 2. Studies have also reported no differences in phenomenology and other clinical features between UM and bipolar disorders [ 19 ], number of episodes [ 22 , 23 , 29 ], duration of episodes [ 23 ], risk of psychiatric illness in first-degree relatives [ 11 , 15 , 18 , 19 , 22 , 23 , 27 ], and chronotype [ 29 ].
However, an Indian study by Avasthi et al. Dakhlaoui et al. With regard to family history, only Abrams et al. Other factors that may have a role in clinical presentation such as psychosocial variables, exposure to viruses, diet, and prenatal environment also should be taken into consideration in future studies [ 15 ].
Among the studies, the duration of follow-up varies between 6 and 28 years. Perris observed that change in polarity from mania to depression mainly occurred by the third episode and rarely after the eighth episode [ 10 ]. In their Table 3 a summarizes the studies based on retrospective chart reviews which assessed the course of UM.
To date, there are three prospective studies which assessed the diagnostic stability of UM Table 3 b. Neuroimaging revealed that UM patients had smaller third-ventricular width [ 33 ]. After brain injury, they had higher minimental scores and smaller subcortical, but larger cortical, lesions primarily in right orbitofrontal and right basotemporal regions than classical bipolar patients [ 34 ]. However, Cakir et al. UM patients had less thyroid autoimmunity during chronic lithium treatment [ 36 ].
Pfohl et al. One of the most important findings in support of the view that UM is an entity distinct from BD is the difference in treatment response. Although no such difference has been reported with respect to the acute treatment of manic episode, different response characteristics to prophylactic treatment have been reported. The predominance of depression in BD patients has been associated with a better response to lithium maintenance therapy.
Husain et al. On the other hand, Angst et al. Recently, Yazici and Cakir [ 39 ] found that the response rate to lithium prophylaxis was significantly less in the UM group than that in the BD group, whereas the response rate to valproate prophylaxis was similar in both groups. These data suggest that valproate may be a better choice for prophylactic treatment in UM patients.
These findings indicate that being less responsive to lithium prophylaxis was associated more closely with UM than with manic preponderance in bipolarity.
The above review of literature clearly indicates that only a handful of studies pertaining to UM are available at present. The available literature shows that there has been no consensus regarding the definitions and diagnostic criteria of UM which has resulted in its prevalence ranging widely from 1.
The differences in study design retrospective versus prospective could be another factor which might have contributed to this. No differences have been found between UM and bipolar manias in most of the studies on sociodemographic variables like gender, age of onset of illness, marital status, educational status, and occupational status.
However, it is a clinically stable diagnosis over a period of time. It has also been reported that UM produces less social and work disability than BD. Regarding neuroimaging findings, UM shows significantly less third-ventricular size than bipolar mania but this awaits replication.
As far as treatment is concerned, UM has poor response to lithium prophylaxis and valproate could be a better choice in these patients. The evidence has thus accumulated in favor of UM over the time which indicates that this entity merits further study. There are certain issues which need to be explored and addressed in future. Firstly, there is a need to adopt stricter diagnostic criteria for UM. This would allow for a better interpretation of the data.
There are no markers for bipolar disorder in the blood, but a blood test and a comprehensive physical exam may help rule out other possible causes for your behavior.
Doctors usually treat bipolar disorder with a combination of medications and psychotherapy. Mood stabilizers are often the first drugs used in treatment. You may take these for a long time.
Lithium has been a widely used mood stabilizer for many years. It does have several potential side effects. These include low thyroid function, joint pain , and indigestion. It also requires blood tests to monitor therapeutic levels of the drug as well as kidney function. Antipsychotics can be used to treat manic episodes. Your doctor may start you on a low dose of whichever medication you both decide to use in order to see how you respond. You may need a stronger dose than what they initially prescribe.
You may also need a combination of medications or even different medications to control your symptoms. All medications have potential side effects and interactions with other drugs. Writing in a diary can be an especially helpful part of your treatment. Keeping track of your moods, sleeping and eating patterns, and significant life events can help you and your doctor understand how therapy and medications are working.
But with proper treatment and support from family and friends, you can manage your symptoms and maintain your quality of life. This includes:. The more you know about the condition, the more in control you may feel as you adjust to life after diagnosis. You may be able to repair strained relationships. Educating others about bipolar disorder may make them more understanding of hurtful events from the past.
Support groups, both online and in person, can be helpful for people with bipolar disorder. They can also be beneficial for your friends and relatives.
The Depression and Bipolar Support Alliance maintains a website that provides:. Back to Bipolar Disorders. Bipolar Disorders. It depends. Mood shift frequency varies from person to person. A small number of patients may have many episodes within one day, shifting from mania an episode where a person is very high-spirited or irritable to depression. Does having one manic episode necessarily mean you will have more and will have depressive episodes? Not necessarily. Studies have shown that approximately 10 percent of patients have a single episode only.
However, the majority of patients have more than one.
0コメント