1. BIPOLAR DISORDER WHAT IT IS, FACTS, AND TREATMENT.

2. WHAT IT IS Bipolar disorder is a mental condition that causes cycles of mood in a person, first feeling great and high energy levels (mania) and then feeling extremely sad, sometimes to the limit to commit suicide.

3. There are different types: Bipolar Disorder I: the main symptom is one or more manic or mixed symptoms (depression) that can’t be explained by other medical conditions, drugs or other substances. Bipolar disorder II: the main symptoms are major depressive episodes with at least one hypomanic episode. Cyclothymic Disorder: are mood swings less severe that those in Bipolar I or Bipolar II. Rapid-Cycling Bipolar Disorder: it is diagnosed when four or more episodes of major depression, mania and hypomania are given within a year.

7. TREATMENT Goals of the Bipolar disorder treatment: Reduce symptoms of depressive episodes. Reduce symptoms of manic episodes. Reduce the probability of future episodes. Reduce the severity of the disease. Provide assistance and support to patients and family.

8. MEDICATIONS Benzodiazepines: they are useful for treating insomnia and anxiety, which people with bipolar disorder often experience. They are highly addictive, and their uses are normally limited to the short-term and carefully restricted. Some of them include: Xanax (alprazolam) Librium (chlordiazepoxide) Valium (diazepam) Ativan (lorazepam)

9. ANTIDEPRESSANTS These drugs help dealing with the depressive phase of bipolar disorder, but antidepressants are not usually prescribed to people with bipolar disease. Sometimes antidepressants are prescribed in conjunction with mood stabilizers when used to treat bipolar disorder. The mood stabilizers are more effective dealing with the manic phase and can also help reduce the possibility of a certain side effect bipolar people risk by using antidepressants. There are different group of antidepressants and each work in a different way.

10. ANTIDEPRESSANT GROUPS SSRI (Selective serotonin reuptake inhibitors): A group of antidepressants and they are considered a first choice for treating bipolar disorder because they tend to have less side effects. They prevent serotonin from being reabsorbed by the brain, which is a neurotransmitter that helps transmit information through the nervous system and it’s associated with emotion. Two other groups of antidepressants that work similarly to SSRIs norepinephrine and dopamine reuptake inhibitors (NDRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) but they work on other neurotransmitters. Tricyclic antidepressants: The name comes from the drugs' three-ring chemical structure. Their work is similar to the uptake inhibitors, but they have more side effects. They have been around since the 1950s. Monoamine oxidase inhibitors: They prevent an enzyme that cancels serotonin and dopamine out of the nervous system from doing it’s job.

11. SIDE EFFECTS They can cause: Risk of suicidal thoughts in young people (18 to 24 years old). Serotonin syndrome. People with this syndrome have an excess of serotonin in their system and can cause chills, sweating, anxiety, diarrhea, headache and confusion. A manic or rapid-cycle phase in the patient when prescribed along with a mood stabilizer. loss of sex drive or function. Nausea nervousness tremors. changes in blood pressure. dry mouth. insomnia

12. ANTIPSYCHOTICS Antipsychotics can control manic episodes and can treat hallucinations or delusions that can occur in patients with bipolar disorder. Antipsychotics are also prescribed when mood stabilizers (like lithium) do not work. They can have different side effects that can vary depending on whether they are part of the older family or the newer family. Some of the older family are: Compazine (prochlorperazine), Haldol (haloperidol), Loxitane (loxapine), Mellaril (thioridazine) and Moban (molindone). Some of the newer family are: aripiprazole (Abilify), asenapine Maleate (Saphris), clozapine (Clozaril), iloperidone (Fanapt), lurasidone (Latuda).

13. SIDE EFFECTS The older antipsychotics can cause ESP (extrapyramidal side effect), also called movement disorder side effects, while the newer antipsychotics are less likely to cause these side effects. A rare but real dangerous form of EPS is NMS (neuroleptic malignant syndrome) and requires stopping the antipsychotic treatment and getting other medical treatment as soon as possible. NMS can cause unstable breathing, heart rate and blood pressure and can also cause an elevated white blood cell count, fever, confusion, stiff of the muscles and confusion. In other cases, EPS imitates the symptoms of Parkinson's disease: tremors, stiffness, and slowed speech and movement. This is called Parkinsonian EPS.

14. The newer group are normally more used because they have less chances to cause EPS, but newer group are also known for a variety of their own side effects. The most dangerous side effect is a link to heart arrhythmia and the possibility of a drop in the number of white blood cells. The most common one is weight gain and because of that they could have an increased risk for diabetes. Other side effects are: high cholesterol and triglycerides increased appetite dizziness sleepiness prolonged and painful erection nausea lightheadedness

15. LITHIUM Lithium was the first effective drug used to treat bipolar disorder and remains one of the most effective treatments for the disorder. It can produce side effects, but the most serious are also the more rare and in most cases, the side effects can be managed. Lithium is commonly available under the names Eskalith or Lithobid. Other names include Duralith, Lithane, and Lithotabs. It can be taken in pill or liquid form. Approved in the United States in the 1970s. Lithium is a mood stabilizer. It can relief the symptoms of the manic and depressive phases of bipolar disorder and reduce the chance of a person having them recur. Lithium takes up to a few weeks to build up in the body before it can really be effective. In the case of sudden bipolar episodes, it may need to be prescribed with other drugs if it has not reached it’s optimal level in the patient's system.

16. SIDE EFFECTS Too much lithium in a person's system can be toxic and cause damage and that’s why the dosage and level of lithium in a person's system needs to be checked up regularly to make sure that the proper level is maintained in the body. A person's overall health can determine what is the right level of lithium for them. Lithium toxicity can include nausea and diarrhea, problems with coordination, mental changes such as drowsiness and disorientation and in some cases, toxicity can cause a coma. Other common side effects are frequent urination, excessive thirst, weight gain, memory problems, hand tremors, diarrhea, hair loss, acne and water retention.

17. PSYCHOTHERAPY Psychotherapy is a widely available treatment that focuses on helping people understand their thoughts, behaviors and relationships and how it impacts their mental health and overall life. It’s almost always used with other treatments like medication and lifestyle improvements such as better diet and exercise. There are different types of psychotherapy: Single: A patient and therapist in a one-on-one private setting. Group: Several people who are going through the similar conditions, such a loss of a loved one or a divorce. Couples: A patient and his or her romantic partner that helps resolve issues in a relationship or can help in a relationship where one person has bipolar disorder or another mental disorder. Family: Involves family members of someone with bipolar disorder or another condition. This type of therapy helps an entire family manage this hard experiences.

18. COGNITIVE-BEHAVIORAL THERAPY Another type of psychotherapy is the CBT and it is really helpful to treat and help people with bipolar disorder along with a lot of other mental illnesses. The treatment focuses on identifying the patient's problems and reactions to those problems and then deciding which of those reactions are unhealthy and replacing them with better and healthier alternatives. The therapy is generally short-term and usually takes four steps: Identify the problem: It can be mental or physical problem, work or relationship stress. Analyze the thoughts, behaviors and emotions related with the problems. Spot negative or wrong thoughts, behaviors and emotions. Work to change the patient's reaction to their personal problems.

19. SIDE EFFECTS There are no physical side effects to any psychotherapy, but anyone who decides to use it must be ready to talk about their issues with a therapist or even a whole group of people. Depending upon the different people’s experiences, this could be a really hard task to do.

20. ELECTROCONVULSIVE THERAPY ECT has been known for decades to be able to improve mood. It’s a safe and effective treatment in bipolar disorder especially when it’s used against the depressive phase, but it can be used during the manic phase as well. It has also been shown to be effective in preventing future episodes. It is considered more as an emergency treatment and it is used when the medications don’t work or under special situations. It works by anesthetizing the patients and then sending a small amount of electrical charge into their mind. The electrical charge causes a seizure that kind of reboots the brain helping it to more normal function.

21. SIDE EFFECTS A side effect of ECT is memory loss, usually limited to the time around the therapy session. It can also cause temporary confusion in the patient. There can be some temporary physical side effects as well such as: Nausea Vomiting Headache Jaw pain Muscle aches or spasms.