Monday, December 17, 2012

My Bipolar Disorder Page and Links VIA @Peta_de_Aztlan

Note ~
First Posted Oct 15, 2012 ~To be updated ~ PSLopez

This is a simple blogpost about a complex condition AKA disorder. I will probably add to it from time to time. If you happen to know other websites and stuff let me know if you can marshal the fundamentals.

Be aware of dope pushers via Big Pharma. Do not take medication if it is not mandatory and especially if you have not even bothered to explore alternative methods of treatment. If possible try to wean yourself off medication that is not absoluely necessary. I am a recovered dope fiend and dope slinger, so I am communicating this from my own personal direct experience. Keep it simple. ~Love, Peter S. Lopez AKA @Peta_de_Aztlan
++++ Definition By Mayo Clinic staff

Bipolar disorder — sometimes called manic-depressive disorder — is associated with mood swings that range from the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time.

Although bipolar disorder is a disruptive, long-term condition, you can keep your moods in check by following a treatment plan. In most cases, bipolar disorder can be controlled with medications and psychological counseling (psychotherapy). ~

Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. The "mood swings" between mania and depression can be very quick.

Bipolar Disorder

What is bipolar disorder?

Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic and typically vary greatly over the course of a person’s life as well as among individuals. Over 10 million people in America have bipolar disorder, and the illness affects men and women equally. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in children. Most people generally require some sort of lifelong treatment. While medication is one key element in successful treatment of bipolar disorder, psychotherapy, support, and education about the illness are also essential components of the treatment process.

What are the symptoms of mania?

Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include:

~either an elated, happy mood or an irritable, angry, unpleasant mood
~increased physical and mental activity and energy
~racing thoughts and flight of ideas
~increased talking, more rapid speech than normal
~ambitious, often grandiose plans
~risk taking
~impulsive activity such as spending sprees, sexual indiscretion, and alcohol abuse
~decreased sleep without experiencing fatigue

What are the symptoms of depression?

Depression is the other phase of bipolar disorder. The symptoms of depression may include:

~loss of energy
~prolonged sadness
~decreased activity and energy
~restlessness and irritability
~inability to concentrate or make decisions
~increased feelings of worry and anxiety
~less interest or participation in, and less enjoyment of activities normally enjoyed
~feelings of guilt and hopelessness
~thoughts of suicide
~change in appetite (either eating more or eating less)
~change in sleep patterns (either sleeping more or sleeping less)

What is a "mixed" state?
A mixed state is when symptoms of mania and depression occur at the same time. During a mixed state depressed mood accompanies manic activation.

What is rapid cycling?
Sometimes individuals may experience an increased frequency of episodes. When four or more episodes of illness occur within a 12-month period, the individual is said to have bipolar disorder with rapid cycling. Rapid cycling is more common in women.
What are the causes of bipolar disorder?

While the exact cause of bipolar disorder is not known, most scientists believe that bipolar disorder is likely caused by multiple factors that interact with each other to produce a chemical imbalance affecting certain parts of the brain. Bipolar disorder often runs in families, and studies suggest a genetic component to the illness. A stressful environment or negative life events may interact with an underlying genetic or biological vulnerability to produce the disorder. There are other possible "triggers" of bipolar episodes: the treatment of depression with an antidepressant medication may trigger a switch into mania, sleep deprivation may trigger mania, or hypothyroidism may produce depression or mood instability. It is important to note that bipolar episodes can and often do occur without any obvious trigger.

How is bipolar disorder treated?
While there is no cure for bipolar disorder, it is a treatable and manageable illness. After an accurate diagnosis, most people can achieve an optimal level of wellness. Medication is an essential element of successful treatment for people with bipolar disorder. In addition, psychosocial therapies including cognitive-behavioral therapy, interpersonal therapy, family therapy, and psychoeducation are important to help people understand the illness and to internalize skills to cope with the stresses that can trigger episodes. Changes in medications or doses may be necessary, as well as changes in treatment plans during different stages of the illness.

It is useful to know whether the "mood stabilizing medication" prescribed has been approved by the FDA for use in bipolar disorder:

Medications for Mania:
Currently FDA approved: lithium (Eskalith or Lithobid), divalproex sodium (Depakote), carbamazepine (Tegretol), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify)

At least one adequate well controlled study with positive data: haloperidol (Haldol)
Medications for bipolar depression:

Currently FDA approved: combination of olanzapine and fluoxetine (Symbyax)

Also at least one adequate well controlled study with positive data: quetiapine (Seroquel) and lamotrigine (Lamictal)
Medications for preventing (or delaying) recurrence:

Currently FDA approved: lithium (Eskalith or Lithobid), lamotrigine (Lamictal), olanzapine (Zyprexa), and aripiprazole (Abilify)

Frequently a combination of two or more medications is used, especially during severe episodes of acute mania or depression.
Medication specifics and possible side effects:

Lithium has long been used as a first line treatment for acute mania in people with bipolar disorder for more than 50 years. It generally has more positive impact when used earlier, rather than later, in the course of bipolar disorder. Research shows it is most effective in those individuals with a family history of the illness, and in those experiencing the bipolar I sequence of swings between mania and depression with return to normal function between episodes.

Like all medications, lithium treatment produces side effects. The most common ones are dose-related and can be effectively managed, but for about 30 percent of people who try it, lithium is not tolerable. Lithium side effects may include frequent urination, excessive thirst, weight gain, memory problems, hand tremors, gastrointestinal problems, hair loss, acne, and water retention. There are two important lithium side effects, that can be effectively monitored by a simple blood test: 1)hypothyroidism, which mimics depression and can be easily treated, and 2) less commonly, damage to kidney functions.

Anti-convulsants: The Food and Drug Administration (FDA) approved divalproex sodium (Depakote) in 1995 for treating bipolar episodes. Originally approved in 1983 as a drug to treat epilepsy, Depakote was found to be as effective as lithium for treating acute mania, and appears to be better than lithium in treating the more complex bipolar subtypes of rapid cycling and dysphoric mania, as well as co-morbid substance abuse. In addition, Depakote may be safely given in larger doses to treat acute episodes, and works faster in this situation than lithium. The generic version of this drug is valproic acid. Some people find that the generic version produces more gastrointestinal distress than Depakote.

Depakote may also produce sedation and gastrointestinal distress, but these side effects often resolve during the first six months of treatment, or with dose adjustment. Another dose-related side effect is weight gain, and rare liver and pancreatic function problems may develop while taking Depakote. However, Depakote is generally well-tolerated, and is now prescribed far more often then lithium. Recent controlled trials indicate that the combination of Depakote and lithium is more effective in preventing relapse and recurrence than treatment with lithium alone.

Lamictal (lamotrigine), another anti-convulsant, is effective in the treatment of acute depression in bipolar I and II and in promoting remissions between episodes. For most people, Lamictal has a very tolerable side effect profile. Rarely, this medication can cause a rash serious enough to cause a medical emergency. The risk of this one potentially serious side effect can be reduced by starting with a low dose and going slowly in increasing the dose.

Use of Antidepressants

Standard antidepressant medications (those approved for the treatment of unipolar depression) have not yet been proven effective for bipolar depression. Although the evidence supporting their use for bipolar depression is limited to small or less rigorous studies, these medications remain the most commonly used treatment for bipolar depression. The data from larger studies finds neither evidence of benefit nor evidence that these agents cause large numbers of depressed patients to switch into mania.
Use of Antipsychotic Medications as Mood Stabilizers

To control acute episodes, antipsychotic medications may be used alone (monotherapy), or added to anti-convulsant medications (combination therapy). Medication guidelines now recommend the combination of these two medications as most effective for acute manic episodes. Because the older typical antipsychotic medications run the risk of causing permanent movement disorder, and have been associated with depression when used over the long term, the new atypical antipsychotics are now preferred for this purpose. All the new atypicals are effective in the treatment of acute and mixed mania. Olanzapine (Zyprexa) and risperidone (Risperdal) are FDA-approved for this purpose.

Finding the right preventive/maintenance medicine is an art informed by science and your own observations. Not all medicines that work in the acute phase of mania are as strong in preventing the next episode, so this is an area to explore.

Side effects of the atypicals are different than with first-generation antipsychotics (such as Haldol), although sedation, weight gain, and risk of diabetes are problems associated with many of the new antipsychotics. Clozapine and olanzapine, both effective antipsychotics and mood stabilizers, offer the most risk in this area. Weight gain is a serious clinical concern related to all atypical antipsychotics, and to anti-convulsants as well. Not only can weight gain lead to adult onset also known as type 2 diabetes and cardiovascular diseases, but being overweight is also now the leading cause of medication non-adherence. Doctors advise weekly monitoring of weight in the early stages of taking these medications, along with regular exercise and healthy diets, and people must be willing to make lifestyle changes to maintain optimal health. The FDA has noted an association between all atypical antipsychotics and the risk of diabetes. As the science develops in this area, it will continue to inform medicine choices for the person that best reflect their risks and benefits.

Reviewed by Ken Duckworth, MD, October 2006


Rapid Cycling Bipolar Disorder

What Is Rapid Cycling Bipolar Disorder?

Rapid cycling is a pattern of symptoms in bipolar disorder. In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year.

Understanding Bipolar Disorder

Who Gets Rapid Cycling Bipolar Disorder?

Virtually anyone can develop rapid cycling bipolar disorder. About 2.5% of the U.S. population suffers from some form of bipolar disorder – nearly 6 million people. About 10% to 20% of people with bipolar disorder have rapid cycling. Women, and people with bipolar II disorder, are more likely to experience rapid cycling.

Most people are in their late teens or early 20s when symptoms first start. Nearly everyone with bipolar II disorder develops it before age 50. People with an immediate family member with bipolar disorder are at higher risk.

What Are the Markers of Bipolar Disorder?

The major markers of bipolar disorder include:
  • At least 1 episode of mania in the patient's lifetime
  • Episodes of depression (major depressive disorder), which are often recurrent
Mania is a period of abnormally elevated mood, usually accompanied by erratic behavior lasting at least seven days at a time. Hypomania is an elevated mood not reaching full-on mania. The usual duration is four to seven days.
A few people with rapid cycling bipolar disorder alternate between periods of hypomania and major depressive disorder. Far more commonly, though, depression dominates the picture. Repeated periods of depression are punctuated by infrequent, shorter periods of elevated mood.

How Is Rapid Cycling Bipolar Disorder Diagnosed?

Bipolar disorder is diagnosed after someone experiences a hypomanic or manic episode along with multiple additional episodes of either mania, hypomania, mixed episodes, or depression. Rapid cycling bipolar disorder is diagnosed after four episodes of depression, mania, or hypomania occur within one year.  "Rapid cycling" is not in itself a diagnosis, but rather, a course specifier for bipolar disorder that describes the pattern and frequency of episodes during a one year period.  Rapid cycling can occur at any time in the course of bipolar disorder and may come and go at varying points over a lifetime course of illness.

Rapid cycling bipolar disorder can be difficult to diagnose. Rapid cycling may seem to make bipolar disorder more obvious, but because most people with rapid cycling bipolar disorder spend far more time depressed than manic or hypomanic, they are often misdiagnosed with "just" depression.

For example, in one study of people with bipolar II disorder, the amount of time spent depressed was more than 35 times the amount of time spent hypomanic. Also, people often don't take note of their own hypomanic symptoms, mistaking them for a period of unusually good mood.

How Is Rapid Cycling Bipolar Disorder Treated?

Because symptoms of depression dominate in most people with rapid cycling bipolar disorder, treatment is usually aimed toward relieving depression while preventing the comings-and-goings of new episodes.
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How Is Rapid Cycling Bipolar Disorder Treated? continued...

Antidepressants such as Prozac, Paxil, and Zoloft have not been shown to treat the depression symptoms of rapid cycling bipolar disorder, and may even increase the frequency of depressive recurrences over time. Many experts therefore advise against the use of antidepressants (especially long term) in bipolar patients with rapid cycling.
Mood-stabilizing drugs -- such as lithium  Depakote, Tegretol or Lamictal -- are the core treatments of rapid cycling.  Often, a single mood stabilizer is ineffective at controlling episode recurrences, resulting in a need for combinations of mood stabilizers.  Several antipsychotic medicines such as Zyprexa or Seroquel also have been studies in rapid cycling and are used as part of a treatment regimen, regardless of the presence or absence of psychosis (delusions and hallucinations).
Treatment with mood stabilizers is usually continued even when a person is symptom-free. This helps prevent rapid cycling. Antidepressants, if and when used, are generally tapered as soon as depression is under control.

What Are the Risks of Rapid Cycling Bipolar Disorder?

The most serious risk of rapid cycling bipolar disorder is suicide. People with bipolar disorder are 10 times to 20 times more likely to commit suicide than people without bipolar disorder. Tragically, 8% to 20% of people with bipolar disorder eventually lose their lives to suicide.

People with rapid cycling bipolar disorder are probably at even higher risk for suicide than those with nonrapid cycling bipolar disorder. They are hospitalized more often, and their symptoms are usually more difficult to control long term.

Treatment reduces the likelihood of serious depression and suicide. Lithium in particular, taken long term, reduces the risk.

People with bipolar disorder are also at higher risk for substance abuse. Nearly 60% of people with bipolar disorder abuse drugs or alcohol. Substance abuse is associated with more severe or poorly controlled bipolar disorder.

Links to Further Information ~

Bipolar disorder From Wikipedia, the free encyclopedia ~ ~

Do you feel guilty about having bipolar disorder? By Marcia Purse~ ~

Facebook Group~ ~

Rapid Recycling Bipolar Disorder ~

Online Groups to check out ~

Bipolar Closed Group ~I am a member (unless I get kicked out!) >

Depression and Bipolar Groups ~ I am a member of >

Note: To Be Updated ~ Peter S. Lopez

HELP-Matrix Humane-Liberation-Party Blog ~ ~

Humane-Liberation-Party Portal ~ ~

@Peta_de_Aztlan Blog ~ ~ @Peta_de_Aztlan