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Bipolar Disorder

Bipolar Disorder

Bipolar disorder is a serious mental illness that causes unusual shifts in mood. Ranging from extreme high (mania) to low depression. Bipolar disorder is disabling and severe psychiatric disorders commonly perceived as equally affecting both men and women. But rapid cycling is seen more often in women. Women also tend to experience more depressive and mixed state episode than do men.

Types of Bipolar Disorder:

The categories include:

Bipolar 1 Disorder:

Involve manic episode lasting 7 days or more or severe mania that requires hospitalization.

Person experience major depressive episode that last 2 weeks or more.

Bipolar 2 Disorders:

Both mania and depression but mania is less severe than in bipolar 1 called a (hypomania).

Cyclothymic:

Also known as cyclothymic includes symptoms of hypomania and depression that last for 2 year or more in adult or 1 year in children.

Other Type:

People with their disorder experience symptoms that do not fall into the above categories. These symptoms may stem from drug or alcohol use or some other medical condition.

Symptoms- Bipolar Disorder:

Depression:

During a period of depression, your symptoms may include:

  • Feeling sad, hopeless or irritable most of the time.
  • Lacking energy
  • Difficulty concentrating and remembering things.
  • Self-doubt
  • Difficulty in sleeping
  • Suicidal thoughts

Manic:

The manic phase of bipolar disorder may include:

  • Feeling very happy
  • Talking very quickly
  • Feeling self-important
  • Easily irritated
  • Hallucination and illogical thinking
  • Making decision or saying things that are out of character and that other see as being risky or harmful.

Pattern of depression and mania:

A person, who has bipolar disorder, may have episode of depression more regularly than episode of mania, or vice versa.

Between episode of depression and mania a person may sometimes have periods where he/she have a ‘normal’ mood.

But the pattern is not always the same for example

Rapid Cycling:

Where a person with bipolar disorder repeatedly swings from a high to low phase quickly without having a ‘normal’ period in between.

Mixed State:

Where a person with bipolar disorder experience symptoms of depression and mania together; for example, over activity with a depress mood.

Cyclothymic:

If person mood swing last a long time but are not a severe enough to be classed as bipolar disorder, a person may be diagnosed with mild form bipolar disorder called cyclothymic.

Bipolar in Pakistan:

The estimates rate of prevalence for bipolar spectrum disorder among students of Pakistan is 14.3%. No significant difference in prevalence of BSD was observed in either gender. However, the age group of 20-21 year was the most affected one. Lots of myths in country like Pakistan people think that  someone had done some sort of ‘Black magic’ on person. But in reality it’s a mental illness.

Bipolar in women:

Bipolar effective disorder in women is a challenging disorder to treat. It is unique in its presentation in women and characterized by later age of onset, seasonality, atypical presentation, and a higher degree of mixed episodes. Medical and psychiatric co-morbidity adversely affects recovery from the bipolar disorder (BD) more often in women. Co-morbidity, particularly thyroid disease, migraine, obesity, and anxiety disorders occur more frequently in women while substance use disorders are more common in men. Treatment of women during pregnancy and lactation is challenging. Pregnancy neither protects nor exacerbates BD, and many women require continuation of medication during the pregnancy. The postpartum period is a time of high risk for onset and recurrence of BD in women. Prophylaxis with mood stabilizers might be needed. Individualized risk/benefits assessments of pregnant and postpartum women with BD are required to promote the health of the women and to avoid or limit exposure of the foetus or infant to potential adverse effects of medication.

Female patients of BD are more likely to report history of sexual abuse, which is associated with a worse course of this disorder, earlier age of onset, greater co-morbidity and a higher rate of suicidal.

 Bipolar disorder different from schizophrenia and psychotic condition:

Bipolar disorder and schizophrenia are psychiatric conditions that have some common                                        traits, but also key differences. Bipolar disorder causes shifts in mood, energy levels, and    thinking. Schizophrenia causes a person to appear to lose touch with reality.

People with bipolar disorder may experience episodes of mania and depression, often separated by periods of relative stability.

Individuals with schizophrenia experience symptoms of psychosis, such as hallucinations or delusions. Some people with bipolar disorder also experience psychotic symptoms. Because of some overlap in symptoms, getting the right diagnosis can be challenging. Also, a person can have both Trusted Source schizophrenia and bipolar disorder, which can complicate diagnosis.

Some people have schizoaffective disorder, which involves a combination of schizophrenia symptoms and those of a mood disorder.

Bipolar disorder and relationships:

Particularly with a partner who has been diagnosed with bipolar disorder: Feeling that you’re a caretaker in the relationship

Experiencing burnout

Sacrificing your life goals, values, and needs to be with your partner

Your partner stopping their treatments or medication could also be a cautionary sign for the future of the relationship. Also, as with any relationship, you should never feel that your partner is putting either you or themselves in danger.

Unhealthy signs go both ways. A person diagnosed with bipolar disorder may see red flags from their partner, too.

“A partner who is stigmatizing and very negative about mental health issues, which is unfortunately fairly common

Bipolar and drug addiction:

Compared to the general population, people with bipolar disorder are more likely to be addicted to drugs and alcohol. In some studies, about 60% of participants with bipolar disorder had some history of substance abuse. Unfortunately, it’s not known why bipolar disorder makes people more likely to abuse drugs.

Frequent drug and alcohol use can cause physical changes in the brain. The most apparent change happens to the brain’s reward system, making using drugs more pleasurable and triggering drug-seeking behaviour. People with bipolar disorder may experience manic or depressive episodes. When they are in a manic phase, they may abuse stimulants like cocaine to extend this high-energy state. Or, when they’re in a depressive state, they may reach for sedatives or depressants to calm feelings of hopelessness.

In some cases, it could be said that substance abuse caused bipolar disorder. However, substance abuse can trigger various mental health disorders, including anxiety, depression, and schizophrenia. Nonetheless, when talking about drug-induced bipolar disorder, it’s referring to someone who was previously healthy and developed a mental illness after abusing drugs.

World bipolar disorder day 30 march each year.

Treatment at New Hope:

In new hope rehab centre healthcare providers will suggest a treatment plan based on the person’s symptoms. The new hope team carefully plan a treatment. A psychiatrist and physician plan a medication and a skillful psychologist provide psychotherapy.

Psychotherapy can be important treatment component for people with bipolar disorder. It can enable them to recognize changes in thoughts and mood and respond accordingly. Lifestyle modification is also important key in the treatment of bipolar.

Our New Hope team aim is to provide awareness regarding mental health general and specifically bipolar and other mental health disorders.

About the author:

Aleena Safdar : Clinical Psychologist at New Hope Rehab and caring centre.

She can be reached at: aleena safdar 230@gmail.com

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Personality Disorders

Personality Disorders Personality disorders are a group of a 10 mental health conditions that involve long-la sting, disruptive patterns of thinking, behaviour, mood and relating to others. People with personality disorders often don’t realize their thoughts and behaviours are problematic. Personality disorders may cause distorted perceptions of reality, abnormal behaviours and distress across various aspects of life, including work, relationships and social functioning. Additionally, people with a personality disorder may not recognize their troubling behaviours or the negative effect they have on others. What are the types of personality disorders? The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard refere nce publication for recognized mental illnesses, organizes the 10 types of personality disorders into three main clusters (categories). Each cluster has different symptoms in common. Cluster A personality disorders: Cluster A personality disorders involve unusual and eccentric thinking or behaviours. These include: Paranoid personality disorder: The main feature of this condition is paranoia, which is a relentless mistrust and suspicion of others without adequate reason for suspicion. People with paranoid personality disorder often believe others are trying to demean, harm or threaten them. Schizoid personality disorder: This condition is marked by a consistent pattern of detachment from and general disinterest in interpersonal relationships. People with schizoid personality disorder have a limited range of emotions when interacting with others. Schizotypal personality disorder: People with this condition display a consistent pattern of intense discomfort with and limited need for close relationships. Relationships may be hindered by their distorted views of reality, superstitions and unusual behaviours. Cluster B personality disorders: Cluster B personality disorders involve dramatic and erratic behaviours. People with these types of conditions display intense, unstable emotions and impulsive behaviours. Cluster B personality disorders include: Antisocial personality disorder (ASPD): People with ASPD show a lack of respect toward others and don’t follow socially accepted norms or rules. People with ASPD may break the law or cause physical or emotional harm to others around them. They may refuse to take responsibility for their behaviours and/or display disregard for the negative consequences of their actions. Borderline personality disorder (BPD): This condition is marked by difficulty with emotional regulation, resulting in low self-esteem, mood swings, impulsive behaviours and subsequent relationship difficulties. Histrionic personality disorder: This condition is marked by intense, unstable emotions and a distorted self-image. For people with histrionic personality disorder, their self-esteem depends on the approval of others and doesn’t come from a true feeling of self-worth. They have an overwhelming desire to be noticed by others, and may display dramatic and/or inappropriate behaviours to get attention. Narcissistic personality disorder: This condition involves a consistent pattern of perceived superiority and grandiosity, an excessive need for praise and admiration and a lack of empathy for others. These thoughts and behaviours often stem from low self-esteem and a lack of self-confidence. Cluster C personality disorders: Cluster C personality disorders involve severe anxiety and fear. They include: Avoidant personality disorder: People with this condition have chronic feelings of inadequacy and are highly sensitive to being negatively judged by others. Though they would like to interact with others, they tend to avoid social interaction due to the intense fear of being rejected. Dependent personality disorder: This condition is marked by a constant and excessive need to be cared for by someone else. It also involves submissiveness, a need for constant reassurance and the inability to make decisions. People with dependent personality disorder often become very close to another person and spend great effort trying to please that person. They tend to display passive and clinging behaviour and have a fear of separation. Obsessive-compulsive personality disorder (OCPD): This condition is marked by a consistent and extreme need for orderliness, perfectionism and control (with no room for flexibility) that ultimately slows or interferes with completing a task. It can also interfere with relationships. This is a separate condition from obsessive-compulsive disorder (OCD), which is classified as an anxiety disorder. While people with OCD usually are aware that OCD is causing their behaviour and accept they need to change, people with OCPD usually have little, if any, self-awareness of their behaviours. Who do personality disorders affect? Most personality disorders begin in the teen years when your personality further develops and matures. As a result, almost all people diagnosed with personality disorders are above the age of 18. One exception to this is antisocial personality disorder — approximately 80% of people with this disorder will have started to show symptoms by the age of 11. Antisocial personality disorders are more likely to affect people assigned male at birth. Borderline, histrionic and dependent personality disorders are more likely to affect people assigned female at birth. How common are personality disorders? Approximately 9% of adults in the U.S. have some type of personality disorder, and about 6% of the global population has a personality disorder. Borderline personality disorder (BPD) and antisocial personality disorder are the most frequently diagnosed personality disorders. What causes personality disorders? Personality disorders are among the least understood mental health conditions. Scientists are still trying to figure out the cause of them. So far, they believe the following factors may contribute to the development of personality disorders: Genetics: Scientists have identified a malfunctioning gene that may be a factor in obsessive-compulsive personality disorder. Researchers are also exploring genetic links to aggression, anxiety and fear, which are traits that can play a role in personality disorders. Brain changes: Researchers have identified subtle brain differences in people with certain personality disorders. For example, findings in studies on paranoid personality disorder point to altered amygdala functioning. The amygdala is the part of your brain that’s involved with processing fearful and threatening stimuli. In a study on schizotypal personality disorder, researchers found a volumetric decrease in the frontal lobe of their brain. Childhood trauma: One study revealed a link between childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma. People with borderline and antisocial