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Bipolar Disorder – Types, Signs, and Management

Bipolar Disorder – Types, Signs, and Management

Bipolar disorder is a mental health condition that can cause severe symptoms like hypomanic episodes (emotional highs) or depressive episodes (lows). When affected by depressive episodes, one may feel gloomy, hopeless, and uninterested in most activities. When the mood shifts to mania or hypomania, they can feel incredibly joyful, energized, or irritable. Such intense feelings can affect focus, judgment, behavior, and sleep. Here is a look at the causes, signs, and management of the disorder: 

Types
Here are the four primary kinds of bipolar disorder that doctors use for a precise diagnosis:

Bipolar I disorder: People with this condition experience one or more manic episodes that last for seven days or require hospitalization. Although a depressive episode is not required for diagnosis, the majority of those who have this condition experience both manic and depressive episodes at various points in their lives. The depressive episode can last at least two weeks. People with bipolar I can experience symptoms of both episodes simultaneously.

Bipolar II disorder: Here, one experiences depressive and hypomanic episodes that can last a few days. One does not experience a complete manic episode, which makes it different from bipolar I. Here, one usually experiences hypomania, a less severe form of mania.

Cyclothymic disorder or cyclothymia: Those with this disorder experience persistent mood instability. They experience periods of hypomania and mild depression for at least two years. One can go through brief euthymic phases (i.e., without mood disturbances), but these intervals usually only last eight weeks or less.

Other types: If a person exhibits clinically significant abnormal mood elevation but does not meet the diagnostic criteria for bipolar I, II, or cyclothymia, they are diagnosed with bipolar disorder not otherwise specified (NOS).

Signs
Manic episodes lasting at least a week are indicative of bipolar I disorder, whereas hypomanic episodes are indicative of bipolar II disorder. These fluctuating moods and emotions are unalike and do not follow any pattern. A person may experience the same mood repeatedly, with periods of euthymia in between, before feeling the opposite emotion. Those with bipolar disorder may go through mood swings for weeks, months, or even years. Depression can last for several weeks or months, whereas mania can last for several days or weeks. Manic and depressive phases can vary in intensity from person to person, and over time, from episode to episode. Here are indications of a manic episode:

  1. Abrupt and extreme mood swings, say, going from being happy to furious and belligerent
  2. Anxiousness
  3. Rapid speaking and thinking
  4. Energy boost and unwillingness to sleep
  5. Excessive joy, optimism, and excitement
  6. Increased impulsiveness and poor decision making
  7. Making ambitious yet impossible plans
  8. Recklessness and risk-taking behavior
  9. Feeling isolated and most powerful
  10. Hallucinations and delusions—symptoms of psychosis, which are experienced in the most severe manic episodes

The following are indications of depressive episodes:

  1. Feelings of worthlessness or despair
  2. Loss of pleasure in formerly enjoyable activities
  3. Poor decision-making and focus
  4. Hysterical sobbing
  5. Overwhelming sadness
  6. Low energy and tiredness
  7. Inadequate motivation
  8. A change in appetite
  9. Suicidal or homicidal thoughts (suicidal ideation)
  10. Irritability
  11. Increased sleep requirement
  12. Excessive sleeping or insomnia

Causes
The precise causes of bipolar disorder are not yet known. However, it is one of the most inherited psychiatric illnesses. Although a parent may not necessarily pass the condition to their child, family history is a strong risk factor. Additionally, according to researchers, the following factors can lead to bipolar disorder:

Changes in the brain: In patients with bipolar disorder, there is a slight variation in the average size or activation of brain structures. However, this cannot be confirmed solely with a brain scan.

Other factors like stress and trauma: A stressful incident, such as the death of a loved one, a serious illness, a divorce, or financial difficulties, can increase the risk of a manic or depressive episode. Such emotional factors may contribute to the development of this illness. Numerous studies have been conducted to determine the origins of bipolar disorder, which can help with therapy and efforts to make managing the disorder easier.

Management options
Doctors can recommend various treatment options depending on the patient’s condition and the preferred course of therapy by the healthcare provider. The following options are typically recommended and combined to develop a treatment plan:

  1. Self-management techniques like educating oneself and recognizing the early signs of an episode or potential triggers of attacks
  2. Psychotherapy
  3. Prescription treatment options
  4. Beneficial lifestyle practices, like yoga, meditation, and exercise, that supplement treatment but cannot substitute it
  5. If a treatment option is ineffective or quick symptom management is required to avoid injury, doctors may recommend electroconvulsive therapy (ECT).

The illness requires lifelong therapy as it is a chronic condition. Occasionally, it may take some time to identify the best course of action for various patients before selecting the one that best addresses most symptoms. It is critical to be patient and hopeful when undergoing treatment, as results and understanding how to manage the condition can take time. Manic and depressive episodes can recur. Many people with bipolar disorder experience no mood changes in between episodes. On the other hand, some people might still experience fluctuations in mood. These symptoms can be managed with long-term, persistent treatment.

Healthcare professionals frequently advise patients to adopt helpful lifestyle changes and avoid engaging in actions that may exacerbate symptoms. Here are some instances of lifestyle modifications to manage the disorder:

  1. Maintaining a daily or mood journal will enable one to keep track of their thoughts, actions, and potential triggers
  2. Adopting regular sleep patterns can help one feel happier, more energized, and concentrate better throughout the day
  3. Exercising can improve one’s mood and overall mental health, aiding in symptom reduction
  4. Meditation and yoga aid in maintaining composure, preventing panic attacks, and overcoming stressful situations

Previous Read

Known Signs of Hemophilia and Anemia

Bleeding disorders refer to a group of conditions like hemophilia or anemia that interfere with normal blood functions in the body. Hemophilia affects the ability of the blood cells to clot naturally, while anemia lowers hemoglobin count in the red blood cells. These conditions exhibit a unique set of symptoms that can be identified. Early diagnosis helps doctors form a viable healthcare plan. So, it pays to know and identify the following symptoms. Hemophilia and Anemia: Understanding the difference Both conditions are common bleeding disorders. However, anemia & hemophilia signs are distinctly different from each other when it comes to the disease progression. The latter is a genetic disorder that affects the red blood cell’s ability to clot and close wounds. Certain clotting factors in the blood bind with the red blood cells to prevent uncontrolled bleeding. Anemia is a condition where the body lacks sufficient healthy red blood cells in the first place. Also, a low hemoglobin count affects the red blood cell’s ability to carry oxygen to vital organs and extremities via the circulatory system. Genetic mutation triggers most known types of hemophilia, while certain nutritional deficiencies in the body trigger common forms of anemia. Symptoms of hemophilia The absence of essential clotting factors in the blood can trigger a variety of noticeable and unusual symptoms. Uncontrolled bleeding Bleeding is one of the primary symptoms of hemophilia. It can happen under the skin or in the joints. As the red blood cells are unable to bind and clot, this pool of blood can trigger swelling, pain, and tightness in the joints. This symptom is most commonly noticeable in the knees, elbows, and ankles. Blood collecting under the skin can lead to buildups under the muscle and soft tissue to cause more painful bruising. This symptom is called hematoma in medical terminology. Frequent nosebleeds When the bleeding is triggered externally, it can result in frequent nosebleeds that can be difficult to stop. Note that external environmental factors and physical injuries generally cause nosebleeds. So, any unexplained bleeding could indicate a developing condition. Bleeding caused due to cuts, bruises, and vaccinations Lack of essential clotting factor VIII can trigger bleeding from the lightest of impacts, cuts, bruises, or even after losing a tooth. Some people experience sudden bleeding after taking a vaccination. This could be the body’s reaction to producing antibodies, but the strain could be too much to bear, resulting in bleeding from the extremities. Blood in urine or stool Excess blood in the urine or stool is a clear sign of disease progression. The urine and stools appear dark red or even blackish due to the presence of red blood cells mixed with the excreta. Immediate medical assistance is advisable for visual symptoms. Bleeding in infants Complicated pregnancies can be physically taxing for both the mother and the child leading to possible symptoms of hemophilia at birth. But in some rare cases, infants may experience internal bleeding in the head. Symptoms of anemia The most common types of anemia, including iron deficiency anemia and vitamin deficiency anemia, develop due to the lack of nutrients in the body. Therefore, anemia exhibits more physically taxing symptoms as the condition worsens. Tiredness Increased fatigue and weakness for no apparent reason is one of the main indicators of nutritional deficiencies. An unexplained decrease in overall stamina with no physical exertion or any activity during the day could mean low iron in the blood. Without iron, the body cannot produce enough red blood cells. And low hemoglobin means not enough oxygen is being circulated around vital organs in the body, thus resulting in fatigue induced by low energy levels. Respiratory symptoms Experiencing shortness of breath, chest pains, and even noticing an irregular heartbeat could indicate a possible anemic condition. An iron deficiency lowers hemoglobin count, and this means not enough oxygen is being circulated by the blood. Low hemoglobin affects the breathing rate as the body struggles to extract more oxygen resulting in shortness of breath. The heart must also put in extra efforts to pump the low hemoglobin blood forcefully, thus resulting in irregular heartbeats. Doctors refer to this condition as heart palpitations. These symptoms can also induce chest pains due to the sheer stress being put on the organ. Pale skin and damaged hair Skin and hair symptoms are visible indicators of a developing anemia condition. An iron deficiency results in low red blood cell production and indirectly affects the shade of the skin. Pale skin is noticeably visible around the face, gums, lower lips, lower eyelids, and even on the nails. This symptom is more visually obvious among people who flaunt a lighter skin tone. Also, hair thinning, hair fall, and a damaged scalp is a clear sign of iron deficiency. Treatment options Note that anemia & hemophilia signs never overlap. Once the primary indicators are confirmed, doctors quickly suggest blood tests to identify the leading causes or triggers. Knowing the differences can help with prompt diagnosis even though both the conditions are bleeding disorders. It is even possible to recover from common forms of anemia within 2 to 3 months. Hemophilia is a more serious bleeding disorder that is treated by introducing the missing clotting factors. Doctors also suggest prescriptions that help stimulate the body to release more clotting factors. However, a transfusion offers more promising results for moderate to severe progression. Effective preventive measures and home remedies can help lower the risk of bleeding. These conditions cannot be completely cured. But it is possible to improve the quality of life by incorporating healthy lifestyle habits. Prescriptions and treatments only help slow down the disease progression.

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Eating Habits That Help Manage Parkinson’s Disease

Parkinson's disease is a brain disorder leading to complications, including uncontrollable movements like stiffness or shaking, which can cause balance and coordination difficulties in an individual. Symptoms of this condition take time and develop gradually but worsen with time. It may reach a point where the patient may have difficulty walking and talking, and swallowing food. As a caregiver, it is crucial to know how to make eating easier and the right foods to introduce. Patience is the key When caring for those with Parkinson's disease, it is necessary to know that patience is paramount and that taking it slow is the anthem of caregiving. Since the disease affects brain activity, it leads to movements getting slower and slower by the day, including walking, talking, and even eating. Chewing needs the use of muscles, and this activity can become frustrating with difficulty in controlling muscles. So give the patient time and be aware of their eating routine. If it helps, you can encourage smaller meals frequently rather than three big meals throughout the day. It may help them get adequate nutrition and not frustrate them with one activity for too long. Noticing the swallowing patterns Since chewing and swallowing become difficult with Parkinson's disease, it is also necessary to keep a tab on any changes in eating habits over time. If you notice your loved ones facing difficulty swallowing, then it is time to speak to a speech-language pathologist (SLP) who can assess the risk of dysphagia or aspiration, referred to when the food goes down the wrong pipe and enters the lung. The specialist will do a series of tests to understand muscle strength and suggests specific exercises that may help improve swallowing. They may also suggest some foods that are safe and unsafe during this period. Extra care with liquids As unusual as it may seem, solid foods are not as significant a threat as liquid foods. It is because the latter can quickly enter the airway and reach the lungs, leading to complications like pneumonia. It is usually advised that if any soup is given, make it thick rather than just watery. Adding thickening agents like cornstarch or potato starch can be extremely useful. Even gelatin can be added to some foods. Avoiding dry foods Those with dysphagia can have trouble swallowing very dry foods. It will include biscuits, chips, toast, and even crusty bread. Experts usually advise that these dry foods should be moistened with a liquid to make it easier for them to slide down the food pipe. Use fluids like gravy, milk, broth, or syrup to soften the food. It is also advised to always cut the vegetables as small as an inch or smaller to make them easy to slide down the food pipe, and they should always be cooked till tender. Ensure that there is no snacking while lying down to avoid choking. Handling paranoia Parkinson's psychosis can lead to hallucinations and paranoia. It is observed that many patients with this disease develop false beliefs or negative thoughts, which may also affect their eating patterns. For example, one might worry that their food is poisoned by someone and refuse to eat anything. One of the ways to handle such situations is not to argue or invalidate what they feel but to redirect the person instead. Divert them to a different activity, delay food time a little, if necessary, and then try again. Arguing with the person will only lead to more agitation and make the situation even more difficult. Another complication that arises is that of hallucinations. For example, patients may start hallucinating about deceased family members at the dinner table and insist on having dinner with them. Experts suggest that instead of brushing off this behavior, encourage them to say hello (some studies prove that this often leads to the hallucination disappearing, bringing the person back to reality) and then continue with their dinner. Adaptive kitchen tools Since muscles are not in control, a simple task like eating food without shaky hands can be frustrating and overwhelming for patients. If the tremors persist for a long time, it is often advised to invest in kitchen tools to make eating easier. It includes buying weighted utensils or utensils with a stabilizing handle. Placing plate guards or non-slip material under the utensils like plates and bowls can be helpful while spooning food. Safe food choices According to experts, a Mediterranean meal plan is recommended for those diagnosed with the disorder. This nutritional regime is based on the traditional food habits observed in Mediterranean countries. It includes adding foods like fruits, vegetables, whole grains, seeds, nuts, olive oil, and plant-based foods. However, some foods like seafood, dairy, chicken or turkey, and eggs can be moderately included in the food plan on some days. Then there are foods like red meat and sweets like cookies and candies, which should be avoided or rarely included in the meal plan. It is the basic nutrition advice for those managing Parkinson's disease. Speaking to a doctor about referring to the right nutritionist for a meal plan for those with Parkinson's disease and especially Parkinson's psychosis would be extremely helpful. Besides the tips mentioned above, consult a doctor about better caregiving tips regarding nutrition and foods that should be excluded from the meal plan. It is necessary to treat those with the disease with utmost patience and love to avoid other mental and emotional health issues along with the disorder. The caregiver and the patient can experience agitation and irritation, and it is important to have a sound support system to deal with these challenges. One can also ask the doctor about any support groups in the community that could be helpful.

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