Bipolar

=**Bipolar Disorder:**=

This is a mood disorder. That mean that they presence of one or more episodes of abnormally elevated energy levels, cognition, and moodwith or without one or more depressive episodes. It is also the cycling between high and low episodes.

=Signs and Symptoms:=

Bipolar disorder is a condition in which people experience intermittent abnormally elevated (manic or hypomanic) and, in many cases, abnormally depressed states for periods of time in a way that interferes with functioning. Not everyone's symptoms are the same, and there is no simple physiological test to confirm the disorder. Bipolar disorder can appear to be unipolar. Diagnosing bipolar disorder is often difficult, even for mental health professionals. What distinguishes bipolar disorder from unipolar depression is that the affected person experiences states of mania and depression. Often bipolar is inconsistent among patients because some people feel depressed more often than not and experience little mania whereas others experience predominantly manic symptoms. Additionally, the younger the age of onset bipolar disorder starts in childhood or early adulthood in most patients—the more likely the first few episodes are to be depression. Because a bipolar diagnosis requires a manic or hypomanic episode, many patients are initially diagnosed and treated as having major depression.

=Causes:=

The causes of bipolar disorder likely vary between individuals. Twin studies have been limited by relatively small sample sizes but have indicated a substantial genetic contribution, as well as environmental influence. For bipolar I, the (probandwise) concordance rates in modern studies have been consistently put at around 40% in monozygotic twins (same genes), compared to 0 to 10% in dizygotic twins. A combination of bipolar I, II and cyclothmia produced concordance rates of 42% vs 11%, with a relatively lower ratio for bipolar II that likely reflects heterogeneity. The overall hertirbility. of the bipolar specturm has been put at 0.71. There is overlap with unipolardepresion and if this is also counted in the co-twin the concordance with bipolar disorder rises to 67% in monozigotic twins and 19% in dizigotic. The relatively low concordance between dizygotic twins brought up together suggests that shared family environmental effects are limited, although the ability to detect them has been limited by small sample. It may be genetic not proven yet.

Public Perception: the normal preception is that people that have this are crazy. With all of the crazy emotions that they have everyone is sort of scared of them.

=Treatments:=

A naturalistic study from first admission for mania or mixed episode (representing the hospitalized and therefore most severe cases) found that 50% achieved syndromal recovery (no longer meeting criteria for the diagnosis) within six weeks and 98% within two years. Within two years, 72% achieved symptomatic recovery (no symptoms at all) and 43% achieved functional recovery (regaining of prior occupational and residential status). However, 40% went on to experience a new episode of mania or depression within 2 years of syndromal recovery, and 19% switched phases without recovery.

=Personal Stories:=

Some people say, "I woke up on the wrong side of bed today." I used to say, "I woke up on the wrong side of life." That's exactly how I felt for many years. I knew from a very young age that something was wrong with me. I used to go through severe suicidal lows, but never followed through with taking my life. So year after year I muddled through life, a very miserable person, just surviving. I am a Christian and very spiritual, yet no matter how much I prayed, I couldn't get relief. I read many self-help books, but still no relief. Now I'm 45 and after years of struggling, I finally have answers. I've taken my life back! No more "black cloud." I got the nickname "Queenie" because I was the oldest of seven; they said I bossed them around. I literally made the nickname stick after being crowned Homecoming Queen. To this day, I still don't believe that happened, because I was //terrified// of people. I was sweet and nice to everyone but wore this mask to hide my illnesses. I had them all fooled.

What is Crazy, Anyway?
People don't believe that I'm mentally ill because I don't look crazy! They just haven't seen me during one of my rages, looking like a raving lunatic. I've been able to hide it well by wearing a mask for many years. (I should get an Oscar for best actress.) But it's a role that became harder for me to play the older I got. I became more and more emotional. For a long time I gave an all-star performance in the Army, where at all costs you must show no sign of weakness. So I would go to work, wearing my armor, then come home and fall apart. But after 18 years in the Army, the stress became too much, and on my doctor's orders I had to go into the inactive reserve. I've lived a life of utter chaos, on a constant emotional roller coaster - or a recurring a train wreck. I've been homeless a few times. I would go through fits of rage. I came close to physically abusing my daughter. I've actually lost it to a point where I've floored my car from 0 to 60 down alleys and streets. I've put my fist through walls and doors, kicked in my car door so hard with my combat boot that it looked like my car was wrecked. I hit a filing cabinet so hard that I almost broke my hand. Once, when I was angry at my boyfriend, I drank a whole bottle of cheap liquor, then drove on the freeway to his house with my daughter in the car. I was so drunk I was swerving all over the road. Cars were honking, but I kept going. I had it out with my boyfriend, then drove back home the same way. It was by the grace of God that we made it home safe. (Who knew angels flew so low?) And when I went through my crack phase, I came close to buying it with my daughter in the car. These are good examples of how mania can impair judgment. I would go out binge drinking, black-out, and have to be dragged home. Not a pretty sight, and unfortunately my daughter saw me like that a few times. I also tried cocaine, weed, mixed pills with alcohol - you name it, and I've tried it (except intravenous drugs). I would do //anything// to kill the pain of depression and to help lessen the mania so I could sleep, because I would be so amped up for no apparent reason. I was always a high-strung, successful workaholic. At every job I felt I was Superwoman - and for many years I was. I would go through spells where I felt vibrant and vivacious with people, on top of the world. But then I'd come crashing down, going into suicidal depressions and literally hiding from people by retreating to my bedroom or home. I became agoraphobic (housebound). I wouldn't go out for anything but groceries and necessities. If I had to work, I was quiet and would race home after work. The black cloud was suffocating me. I hit rock bottom. Part of the reason things got so bad had to do with hormones. I later realized a part of those mood swings were based on my menstrual cycle, triggered by my hormones, which compounded the bipolar disorder. Trying to hide manic depression is like trying to force a beach ball under water. In the last ten years, the depression hit an all-time low. Suicide was always on my mind, but I was too chicken to follow through with it. For me, suicidal thoughts became as automatic as breathing. The fact that I have a child was the only thing that kept me grounded. When I was treated psychiatrically, it was usually for major depression. The doctors would prescribe antidepressants, which would trigger mania. And there was one time when I was given a decongestant for sinusitis and allergies. The medication had an amphetamine in it which triggered a manic episode. In a doctor's office one time I suddenly heard gangster voices and almost ran out of the office. Once when I was driving on the freeway I saw the freeway rolling up towards me, about to swallow me. Paranoia affected my judgment severely, and caused me to alienate everyone.