Bipolar disorder and how it affects everyday life Carli Davis University of Cincinnati June 8, 2013

What is bipolar disorder? Mental Illness in which common emotions become intensely and often unpredictably magnified Those with bipolar disorder can quickly swing from extremes of happiness, energy and clarity to sadness, fatigue, and confusion All individuals will have manic episodes that last at least a week and can impair functioning. Not all become depressed

Characteristics of bipolar disorder People with Bipolar Disorder can experience “mood episodes” Overly joyful or overexcited state is called a manic episode Extremely sad or hopeless state is called a depressive episode Sometimes a mood episode can include both types of symptoms, this is called a mixed state Extreme changes in energy, activity, sleep and behavior can accompany these changes

Types of bipolar disorder Bipolar I Disorder- defined by manic or mixed episodes that last at least a week and will usually also experience a depressive episode Bipolar II Disorder- a pattern of depressive episodes shifting back and forth with hypomanic episodes but without manic or mixed episodes Bipolar Disorder Not Otherwise Specified (BP-NOS)-diagnosed when a person has symptoms but does not meet diagnostic criteria for Bipolar I or II Cyclothymic Disorder- mild form of bipolar disorder, this person will have hypomania with mild depression for at least two years

Difference in Bipolar I & II Here you can see that Bipolar I experiences a more intense mania episode

Prevalence More than 5.7 million American adults have bipolar disorder Affects both men and women equally Typically develops in late adolescence or early adulthood Internationally Bipolar Disorder appears equally common among youth in the US as the rest of the world Rates may be lower in Asia than the US (could be lower rates of obesity or higher fish consumption) This means 2.6% of the population in the US have Bipolar disorder

Is Bipolar disorder on the rise? The media often presents the percentage to be increase, which exaggerates the appearance of change Some risk factors have been on the rise so we can not rule out the possibility that there is an increase in Bipolar Disorder Here you can see that there is a slight increase in the outpatient diagnosis of Bipolar disorder. The small increments on the vertical axis makes this appear to be much larger than it actually is.

Risk factors for bipolar disorder Genetics- researchers are looking for genes that may increase a persons chance of developing the illness Children with a parent or sibling who has Bipolar Disorder are four to six times more likely to develop the illness compared to those who do not have family history of the illness Traits that appeared to run in families: Psychiatric hospitalization Age at first manic episode Number and frequency of manic episodes

Bipolar Disorder Phenome Database Scientists linked visible signs of the disorder with the genes that may influence them Most people with Bipolar Disorder: Missed work because of episodes Other illness at the same time Been treated or hospitalized for bipolar disorder Scientists do not fully understand how these factors interact to cause Bipolar Disorder

How is bipolar disorder diagnosed? Cannot be physiologically detected by blood tests or brain scans Physicians must rule out other medical conditions first Can be based on by: Symptoms Illness Family History

Symptoms of elevated mood Increased energy Euphoric Mood Extreme Irritability Poor concentration Racing thoughts, jumping between ideas Sleeplessness Increased sexual behavior Abuse of drugs (alcohol, cocaine, sleeping medications) Spending sprees

Symptoms of depressed phase Sad, anxious Feelings of hopelessness Feelings of guilt and worthlessness Loss of interest in activities Decreased energy Difficulty concentrating Restlessness and irritability Change in appetite, unintended weight loss or gain Thoughts of death or suicide

Physical effects of Bipolar disorder Increased physical and mental activity Trouble breathing Social withdrawal Loss of energy, aches and pains Unexplained crying spells Poor health Weight gain, diabetes

Bipolar disorder and Suicide Depressive phase is often severe and suicide can be a major risk factor People who suffer from Bipolar Disorder and more likely to attempt suicide than those suffering from regular depression Be aware of the warning signs of suicide Talking about death or self-harm Acting recklessly Feeling worthless or like a burden to others Seeking out weapons or pills that could be used to commit suicide

How it affects everyday life May suddenly feel guilt and shame Unexplained crying spells Cancel social engagements due to Bipolar Disorder Some say that it affect their ability to do housework and run errands

How it affects relationships Will face ups and downs in school, family, work and friends Must take medications and continue treatment to manage Bipolar Disorder Feelings of distress during episodes Disruption in regular routines Difficulty maintaining relationships

How can you help a friend or relative who has bipolar disorder Offer support, understanding and patience Learn about Bipolar Disorder so you can understand what they may be experiencing Listen to feelings carefully-be understanding about situations that may trigger symptoms Invite individuals for “positive distractions” like taking a walk or other activities Remind that they can be treated with time and correct treatment

How can I help myself if I have bipolar disorder? Talk to your doctor about treatment options Keep a regular routine Try to get a good nights rest Stay on medication Learn about what may situations may trigger episodes Be patient with treatment time

Can bipolar disorder be treated? No cure exists Treatable and manageable with psychotherapy and medications Mood stabilizing medications are first choice for medication Lithium is the most commonly prescribed medication

Psychotherapy Provides support and guidance Educates the person and families about Bipolar Disorder(s) Increase mood stability and increase overall functioning Decrease hospitalization Techniques used: Cognitive behavioral therapy Psychoeducation Family Therapy

Other treatments Electroconvulsive therapy (ECT)- formerly known as shock therapy, can provide relief for people who experience severe Bipolar Disorder Sleep medications- this helps ease the symptom of feeling sleeplessness at night Herbal supplements- St. Johns (hypericum perforatum) may help, but no evidence has been shown and study results have been mixed ECT is highly effective, but is not generally used first.

Awareness of Bipolar disorder Carol Anne’s Story- High school student who was diagnosed with Bipolar Disorder and 2 months later committed suicide International Bipolar Foundation- Raise awareness of Bipolar Disorder, become a volunteer, educate about Bipolar Disorder

References American Psychological Association (2013). Bipolar Disorder. Retrieved from http://www.apa.org/topics/bipolar/ on June 8, 2013. Brain & Behavior Research Foundation (2013). Frequently Asked Questions about Bipolar Disorder. Retrieved from http://bbrfoundation.org/frequently-asked-questions-about-bipolar-disorder on June 8, 2013. National Institute of Mental Health (2008). Bipolar Disorder, 1-26. University of Colorado, Colorado Springs. What is Bipolar Disorder? Retrieved from http://www.uccs.edu/biology/mood-disorders/bipolar-disorder.html on June 8, 2013.

References con’D Teens Health from Nemours. (2013). What is Bipolar Disorder? Retrieved from http://kidshealth.org/teen/your_mind/mental_health/bipolar.html# on June 8, 2013. Helpguide.org. (2013). Bipolar Disorder Signs and Symptoms. Retrieved from http://www.helpguide.org/mental/bipolar_disorder_symptoms_treatment.htm on June 8, 2013. Social Workers Help Starts Here. (2013). Your Options: Living With Bipolar Disorder. Retrieved from http://www.helpstartshere.org/mind-and-spirit/depression/depression-your-options-living-with-bipolar-disorder.html on June 8, 2013. American Psychological Association. (2012). Myths and Realities About Bipolar Disorder. Retrieved from http://www.apa.org/news/press/releases/2012/10/bipolar-disorder.aspx on June 8, 2013.

References Con’D National Alliance on Mental Health. (2013). Finding Your Own Way: Learning to Live with Bipolar Disorder. Retrieved from http://www.nami.org/Template.cfm?Section=Top_Story&template=/contentmanagement/contentdisplay.cfm&ContentID=144144&title=Finding%20Your%20Own%20Way%3A%20Learning%20to%20Live%20with%20Bipolar%20Disorder on June 8, 2013. Carol Anne’s Mission For Bipolar Disorder Awareness. (2010). Find Out More About Bipolar Disorder. Retrieved From http://www.bipolaraware.org/bipolarlinks.as on June 8, 2013.