When to Seek Treatment for Bipolar Disorder

Bipolar disorder can have a major impact on a person’s life. Associated with periods in which a person feels strong symptoms of depression, alternating with periods of excessive joy, impulsivity, and high-energy (also referred to as “mania”), it can cause havoc on one’s personal and professional lives. Considering this, it is critically important for someone who is experiencing signs of this condition to seek treatment for bipolar disorder.

The challenge with getting treatment for bipolar disorder is that sometimes symptoms are tough to acknowledge or identify. It’s easy for an individual to simply write off depression periods as “having a bad day” or “hitting a rough spot,” while the manic episodes can even come as a relief for a person because he or she no longer feels depressed. However, such extremes are usually inconsistent with functioning and can lead to long-term damage of relationships and careers, which is why treatment for bipolar disorder is often necessary.

Signs to look for in the treatment for bipolar disorder

When trying to figure out if you should seek treatment for bipolar disorder, there are a number of signs and symptoms that you should be aware of.

Importance of depression treatment for bipolar disorder

The depression symptoms of bipolar disorder are similar to regular clinical unipolar depression (though often deeper) and include an individual being withdrawn from society, showing noticeably little interest in fun activities and perhaps a significant change in weight and sleep. People who may need to seek treatment for bipolar disorder also tend to have low energy levels during their depressive periods, and may have a hard time concentrating. In its most serious forms, these periods may also result in thoughts of death or suicide, or even suicide attempts€”making depression treatment for bipolar disorder that much more important.

Importance of mania treatment of bipolar disorder

Often just as problematic to an individual who may need treatment for bipolar disorder, however, are the manic periods. These usually include racing thoughts, an inability to focus for any extended period of time and, perhaps most dangerously, an urge to engage in activities that are very high-risk. In fact, many people who need treatment for bipolar disorder have been known to gamble excessively, engage in sexual activity with multiple partners and go on shopping sprees. In addition to these symptoms, people in a manic period will often be noticeably more talkative and feel an inflated sense of self.

While these symptoms for both manic and depressive episodes are common in people with bipolar disorder, it’s important to note that these signs may not automatically translate into the condition. Generally, physicians like to see evidence of a specific period of time of an abnormally and persistently elevated or irritated mood before making a diagnosis for someone to seek treatment for bipolar disorder.  Evidence can include family or personal reports, emergency room or medical reports, or even a mood chart that graphs the fluctuations in mood.

Options for the treatment of bipolar disorder

There are a number of options that individuals who may have bipolar disorder can take when it comes to treatment. The most common is medication, which can be a very effective treatment for bipolar disorder. Some medications can have negative side effects, such as loss of appetite, weight gain, tremor, thyroid and kidney difficulties, and sexual issues.

Transcranial Magnetic Stimulation (TMS) is an FDA-approved treatment for unipolar treatment resistant clinical depression that uses MRI-strength magnetic fields to improve the function of very specific parts of the brain. One of its main benefits is its low tendency to produce negative side effects.  At this time, TMS treatment for bipolar disorder depression would be off-label (not FDA-approved).  There is promise for the use of TMS for bipolar depression, particularly if the patient has a history of more mild forms of mania, called hypomania.

If you feel that you may need treatment for depression, West Coast TMS Institute in Sherman Oaks, Los Angeles, is available to discuss appropriate treatments.  Contact us if you feel you’d like to look into treatment for bipolar disorder symptoms and would like to set up a psychiatric consultation.

If you found this post on treatment for bipolar disorder interesting and want to learn more about other behavioral health issues, please check out our next post on insomnia.

The Most Common Bipolar Disorder Symptoms

The Most Common Bipolar Disorder Symptoms

Bipolar disorder symptoms are difficult to both cope with and treat. Because bipolar disorder affects behavior across a broad spectrum of symptoms and severity”from clinical depression on one end to extreme mania at the other”care must be taken to identify the particular bipolar disorder symptoms that an individual is dealing with and to what degree he or she suffers from those symptoms.

It is not known exactly what causes bipolar disorder symptoms, but it is clear that genes that code for various brain cell receptors and proteins are likely involved in causing abnormal neurotransmission and neuro-circuitry between various mood centers of the brain.  Thus, as one starts to consider some of the common bipolar symptoms, it is important to keep in mind that these symptoms are the manifestations of something that is happening electrochemically in the person’s brain.

As bipolar disorder is characterized by two very extreme types of behavior, there are two sets of bipolar disorder symptoms to consider”one when the individual is experiencing a manic episode and one when he or she is experiencing a major depressive episode.  During both episodes there is significant interpersonal or occupational dysfunction.

Bipolar disorder symptoms — manic episodes

The following are the most common bipolar disorder symptoms for individuals experiencing a “manic” period:

• Inflated sense of self or grandiosity
• Decreased need for sleep, with boundless energy
• More talkative than usual or the experience of an internal pressure to keep talking
• Racing thoughts or flight of ideas
• Distractibility and inability to focus
• Increased psychomotor agitation (unintentional and purposeless motions such as pacing around a room, wringing one’s hands and pulling off clothing and putting it back on),
• Impulsivity — Becoming excessively involved in pleasurable activities with high potential for painful consequences (for example, gambling, sexual indiscretion, and buying sprees)

Psychosis, which can include delusions and hallucinations, can sometimes be present during a manic episode.

It’s important to note that clinical diagnosis of a manic episode related to bipolar disorder symptoms requires at least hospitalization or one week of abnormally and persistently elevated or irritable mood.

Bipolar disorder symptoms – depressive episodes

When a person is experiencing bipolar disorder symptoms of depression, that individual will likely display some or all of the following:

• Depressed mood (generally seen as an irritable mood in children and adolescents) most of day
• Significantly decreased interest or pleasure in almost all activities
• Significant weight change (5 percent in one month while not dieting) or change in appetite
• Difficulties falling or staying asleep; or excessive sleeping.
• Fatigue or loss of energy
• Feelings of worthlessness or excessive and inappropriate guilt
• Decreased ability to think or concentrate
• Preoccupation with death; suicidal thoughts, plans or attempts

Like with manic situations, the diagnosis of a depressive episode related to bipolar disorder symptoms requires at least five of the above signs present most days during the same two-week period.

Bipolar Disorder Symptoms — Hypomania

In addition to these two primary types of episodes, there are other types that are associated with bipolar disorder symptoms. These are hypomania and what are referred to as œmixed episodes. Hypomania is a less intense level of mania characterized by optimism, periods of unusually high activity and decreased need for sleep. Hypomania by definition never involves psychotic symptoms or is severe enough to require hospitalization.  By itself, hypomania may not be particularly alarming, but it can be off-putting, appear odd to others, and may result in alienation and negative consequences as well.  The erratic oscillation between hypomania and a depressed state can be unpredictable and problematic and a sign of bipolar disorder symptoms.

Bipolar Disorder Symptoms — Mixed Episodes

Mixed episodes are those in which symptoms of mania and depression occur simultaneously.  Mixed episodes are often characterized by significant irritability and frustration, and sense the others are incompetent and useless. These can be especially dangerous and are associated with an increased risk of substance abuse, episodes of panic disorder and suicide attempts.

If you feel that you may be experiencing depression connected to bipolar disorder symptoms, West Coast TMS Institute, located in Sherman Oaks, Los Angeles, is available to help you find treatment for bipolar disorder. Feel free to contact us if you feel you may be experiencing bipolar disorder symptoms or depression, and would like to set up a consultation.

If you found this post on bipolar disorder symptoms interesting and want to learn more, please check out our next post on treatment for bipolar disorder.

The Most Common Bipolar Disorder Causes

The Most Common Bipolar Disorder Causes

Bipolar disorder (also called manic-depressive disorder) and unipolar depression are the most common debilitating mood disorders. While unipolar depression is characterized by unusually extended periods of sadness or despair, bipolar disorder causes erratic fluctuations in mood ranging from depression to periods of intensely high energy levels, aggressiveness, or expansiveness.

Typically, these two extremes occur in distinct periods called œmood episodes. These mood episodes occur along a wide spectrum, ranging from severe or mild depression to mild or severe mania.

For some people, bipolar disorder causes more deep depression periods, while they have less severe or frequent manic episodes. For others the opposite is true.  A mixed episode is when bipolar disorder causes symptoms of depression and mania at the same time, and usually involves significant symptoms of irritability and agitation.

Bipolar disorder causes symptoms that often first present themselves during the late teen or early adult years. It is a serious disorder that can lead to strained personal relationships, difficulty at work and school, and even suicide in those with extreme mood symptoms.  Usually the first episode is one of depression, so it is important not to automatically assume that a first or second episode of depression is unipolar, as frequently bipolar disorder causes depression that can suddenly switch to a manic episode with the use of certain medications, sleep deprivation, or bright light therapy.

Biological and Genetic bipolar disorder causes:

There is clearly a genetic component to bipolar disorder causes. The disorder appears to run in families. Perhaps the most convincing data comes from studies of twins, which indicate that if one twin has a mood disorder, an identical twin is about three times more likely than a fraternal twin to have a mood disorder as well  (McGuffin P, et al Arch Gen Psychiatry 2003 May;60(5):497).  If someone has one parent with bipolar disorder, they have a 13% risk of developing bipolar disorder at some point in their life; and an even higher risk if both parents have bipolar disorder (Birmaher B, et al. Arch Gen Psychiatry 2009 Mar;66(3):287).  Interestingly, advanced paternal age has been associated with an increased risk of bipolar disorder of offspring, which may point towards a potential genetic mutation contribution (Frans Em, et al. Arch Gen Psychiatry 2008 Sep;65(9):1034).

Research emanating from the Genome Wide Association Study (GWAS) suggests that there is a polygenetic (multiple gene) contribution to an increased risk of bipolar disorder (Offord J. Pharmacology & Therapeutics 2011).  In other words, there are likely several genes that increase the risk for developing bipolar disorder, with no one gene strong enough to cause bipolarity alone.  Research shows that some genes associated with bipolar disorder code for ion channel proteins located on brain cells, and impact how various neurons communicate with one another via tiny electrical currents.  This, in turn, probably effects the release or balance of chemical messengers, or neurotransmitters, in various parts of the brain.  It is no surprise, then, that calcium channel blocker medications have been shown to relieve depression in patients with bipolar disorder.

The genetic risks of bipolar disorder increase the likelihood of  various brain cells to interact abnormally, which likely results in malfunctioning neuro-circuitry and altered brain anatomy.  Studies support this hypothesis; it appears that people with bipolar disorder, compared to those without, indeed tend to have problems with the connections and size of  brain structures involved in mood regulation.  For example, bipolar disorder has been associated with:

• A loss of gray matter  (interestingly, treatment with Lithium can reverse this process)
• Alterations of white brain matter (axons)
• Aberrant connections between the cortex of the brain and the hippocampus
• Aberrant activity of the amygdala and the hippocampus when challenged with various memory and cognitive tests

Environmental Bipolar disorder causes:

Stressful life events, such as a death in the family or the loss of a job, are believed to be key triggers in some of the main bipolar disorder causes. Since every individual deals with stress differently, there is a not a specific definition of what life events lead to certain symptoms, but it is clear that stress is often related bipolar disorder causes.

Chaotic homes where people exhibit wide and unpredictable mood swings can trigger the onset of bipolar disorder causes in children who are presumably genetically vulnerable to bipolar disorder.  Some studies have shown that people with bipolar disorder have a genetic predisposition to sleep cycle variances that may be responsible for the symptoms of depression and mania (Plante DT & Winkelman JW.  Am J Psychiatry 2008;165:830-843). These studies indicate that many  with bipolar disorder experience at least one sleep cycle disruption prior to a major mood episode.

Due to the multifactorial nature of bipolar disorder, ambiguity exists about exact bipolar disorder causes. Because those with a genetic risk of bipolar disorder are more vulnerable to also developing the condition, especially when triggered by a series of life stressors, it is important to get treatment as soon a possible in order to reduce negative effects on interpersonal and occupational functioning.

If you feel that you may be experiencing depression related to bipolar disorder causes, West Coast TMS Institute in Sherman Oaks, California is available to help you. Contact us if you feel you may be experiencing symptoms of depression or mania and would like to set up a psychiatric consultation.

If you found this post on the most common bipolar disorder causes interesting then you may be interested in our blog post on the most common bipolar disorder symptoms.

Signs of a Mood Disorder

“Mood disorder” is a very broad term describing a situation in which a person’s main presenting symptom is a change in the way they feel about themselves and their lives (i.e., their “mood”). A variety of common disorders are considered to be mood disorders, including depression and bipolar disorder. The exact cause of mood disorders is not completely known, but an imbalance in brain chemicals known as neurotransmitters is likely to play a role. A mood disorder is often related to or confounded by medical issues, problems with substance abuse and other adverse life events.

There are two primary classifications of a mood disorder—depressive disorder and bipolar disorder. Depressive disorders are sometimes called unipolar disorders because the mood tends to stay at one negative state. Some of the more common depressive disorders are major depression, seasonal affective disorder and dysthymia.

Major depression is the most well known and most researched of the depressive disorders, while the others aren’t as well understood. Seasonal affective disorder (SAD) is a mood disorder that occurs when episodes of depression tend to happen in the fall and winter and are generally resolved by spring. Dysthymia is a more chronic mood disorder in which a person reports a low mood almost daily over the span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are more susceptible to secondary episodes of more severe major depression.

Bipolar disorder – Type I, is a mood disorder commonly referred to as “manic depression” and is characterized by alternating periods of excessively elevated mood and depression. The individual may experience manic episodes, characterized by boundless energy, a decreased need for sleep, racing thoughts, impulsivity, a sense of self-importance with euphoria and/or irritability.  This mood state is often followed by periods of sustained depression.  During manic or depressive episodes, there is significant functional impairment.

Some people have a mood disorder called Type II Bipolar Disorder, which is characterized by hypomanic episodes instead of full manic episodes.  Hypomania is simply a toned -down, less intense, more functional manic episode.

Cyclothymic disorder is a related mood disorder that is characterized by at least 2 years of several episodes of hypomania and mild depression.

Signs and symptoms of a depressive episode of a mood disorder

Symptoms of a depressive episode of mood disorder may occur regularly or sporadically. They can also vary in severity. Some of these symptoms include:

• Body aches
• Changes in appetite
• Difficulty concentrating
• Difficulty sleeping
• Fatigue
• Feelings of sadness, hopelessness, helplessness or inadequacy
• Unusual aggression or irritability
• Problems interacting with loved ones
• Sudden, unexplained weight gain or loss
• Preoccupation with death or suicidal thoughts

The role of alcohol/substance abuse in a mood disorder

High rates of mood disorders, including depression, occur in heavy drinkers and illegal substance abusers. A dual diagnosis of substance abuse and a mood disorder is becoming increasingly more common. Whether drug abuse causes depression, depression leads to drug abuse, or both have a common cause, a vicious spiral ensues when addicts use the drugs to relieve symptoms that the drugs have caused. In addition, the individual may experience depression as a symptom of withdrawal from drugs. People with a serious mood disorder also have twice the average rate of nicotine addiction, and many become depressed when they try to stop smoking.

West Coast TMS Institute in Sherman Oaks, Los Angeles (818-855-1694) can provide an evaluation and recommendations on how to manage a potential mood disorder.

If you found our Bipolar Disorder post informative, click on our post on bipolar disorder causes.