bipolar disorders
Bipolar disorders are a class of Axis I mood disorders with severe physical, social, and psychological consequences to the patient, the patient's friends and family, and society as a whole. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., the lifetime prevalence for the three main types of bipolar disorders (bipolar type I, bipolar type II, and cyclothymic disorder) combined is approximately 1-2% percent, and unlike major depressive disorders, bipolar disorder is equally common among both men and women. The disorder appears to be mostly genetic, with a concordance rate of 40% among monozygotic twins and 15-20% among first degree relatives. As the name implies, patients who suffer from bipolar disorder constantly shift between the two poles of the affective spectrum, that is, from depression to mania (or hypomania). There is no specific pattern that allows clinicians to predict what affective state the patient will present next, nor when he or she will cycle into a manic or depressive state. The fact that many patients can often last in a state of affective normalcy for years and then suddenly lapse into depression or mania makes this disorder horrendously difficult for the patient, clinician,
This insomnia is associated with a sense of euphoria or irritability. Hypomanic patients often require little sleep for days on end, take on tremendous, creative projects that they normally would not, and often experience a self-described fluidity of thought. Lithium poisoning is a very real threat for those taking lithium carbonate. and anyone involved in the patient's life. Lithium carbonate has been the drug of choice used to treat bipolar disorder for several decades. About 20 years ago, researchers found that several anticonvulsant drugs used to treat epilepsy, including Depakote, Tegretol, and Neurontin, were very effective in treating bipolar disorders, especially for rapid cyclers and in the manic and hypomanic phases of bipolar types I and II. A new category of bipolar disorder, bipolar type III, is being considered for the DSM-V and that category would include patients who were first diagnosed as depressive and given an antidepressant that precipitated their first manic or hypomanic attack. Treatments continue to be improved, and we can only hope that someday gene therapy and modern medicine will unravel the underlying causes of bipolar disorder and be able to eradicate them. It is because of this fact that medication compliance among bipolar patients is only about 30%, despite the high efficacy rate of mood stabilizing medications. Bipolar type II disorder is when the patient alternates between depression and hypomania. the differentiating criteria between bipolar and unipolar depression), some time should be spent analyzing the features of a manic episode. The category of bipolar disorder is comprised of three distinct disorders, the first and most common of which is bipolar type I disorder. In this disorder, patients experience episodes of both depression and full-blown mania, normally in a somewhat slow cycle. Hypomanic episodes are distinguished from manic episodes by both their intensity and their duration.
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