Bipolar Affective Disorder
- What is Bipolar Affective Disorder?
Bipolar disorder is a treatable medical illness like diabetes and blood pressure disease. Bipolar disorder is a disorder that affects one of every 40-50 people worldwide, which is called by names such as bipolar disorder, manic-depressive illness, bipolar disorder, bipolar affective disorder. It is seen with equal frequency in men and women throughout the society, and the incidence does not differ due to race, education, occupation or income level.
Among these periods of illness, there is exuberance (mania) on one side, and depression (depression) on the other. These periods progress with remission and exacerbations, and the patient returns to normal completely outside these periods.
- What Are the Symptoms of Bipolar Affective Disorder?
In bipolar disorder, individuals experience fluctuations in mood, ranging from extremes (mania) to lows (depression) and again, with periods of normal mood at intervals. Don’t be too energetic, get angry easily, sleep less, think you’re more important than everyone else, be more talkative
There are also periods when spending money excessively, not behaving according to one’s personality, and on the contrary, taking on a de4pressive mood. During this period, his depression is more severe than the sadness experienced in a normal way, lasts longer and interferes with daily activities. In this process, symptoms such as decreased appetite, excessive desire to sleep and low energy are experienced, and feelings of hopelessness and helplessness accompany this state.
- What Causes Bipolar Affective Disorder?
Among the reasons for the emergence of the disease, genetic factors are at a considerable rate, and genetic causes are held responsible for 2/3, another reason is the changes in the transport or levels of chemical substances that provide intercellular transmission in the brain. In addition, stressful or traumatic events may also cause the first illness period of bipolar disorder to occur.
Bipolar disorder arises due to different biological, genetic and environmental effects and affects the centers of the person that control emotions, thoughts and behaviors.
When mood disorders are examined, presynaptic (the region where the stimulus is transferred to the other cell part) and postsynaptic (the region where the stimulus is received) receptors and neurotransmitters are indicated. The most prominent of these neurotransmitters are serotonin, noradrenaline, dopamine and acetylcholine.
- How Is Bipolar Affective Disorder Diagnosed?
The diagnosis of bipolar disorder is made by a psychiatrist as a result of a psychiatric examination. A clear diagnosis may not be made at the first interview, although there is no analysis to diagnose the disease on its own, observation may be required for a while. When a person’s first-degree close relatives have bipolar disorder, the probability of occurrence may increase approximately 3-4 times, but heredity alone does not determine the occurrence of the disease. Although some genes thought to be responsible for the disease have been identified, they have not yet reached the level to be used for diagnosis.
Periods:
- mania:
Manic symptoms are usually excessive joy, sometimes anger, enthusiasm, thoughts, speech, acceleration in movements, increased self-confidence, feeling very good, increase in physical-mental productivity, often needing very little sleep. Distraction, increased spending, receiving gifts, increased sexual activity, driving fast, taking risks can be seen. During periods of increase, skepticism, hallucinatory visions of disconnection from reality, and symptoms of hearing voices that are not in reality attract attention.
2. Depression:
Decreased or excessive sleepiness, malaise, loss or increase in appetite, unhappiness, lack of energy, self-confidence, feelings of worthlessness and remorse, fatigue, decreased self-care, and suicidal thoughts may occur in later cases.
- Bipolar Affective Disorder Treatment
The treatment is basically done with drugs. Three groups of drugs can be used: mood stabilizers, antidepressants and antipsychotics. In the case of bipolar disorder, pharmacological treatment is provided with mood stabilizers (lithium, valproate, carbamazepine, lamotrigine, etc.) and dopamine hormone (antipsychotic-based) drugs. Even if the symptoms of the disease do not recur for a long time with drug treatment, preventive treatment with drugs
it is necessary to continue. Because current information shows that the risk of recurrence of the disease increases when preventive drugs are stopped.
In general, in order to control both manic and depressive symptoms, one drug may not be enough, so more than one drug may be required depending on the current period of the disease and the severity of the symptoms. The most common mistake in the treatment of bipolar disorder is to stop following the medication and physician follow-up when you start to feel better. Stopping the drugs on their own can cause the disease to recur more quickly. Along with the treatment, it is necessary to avoid alcohol use and salt consumption. In addition to pharmacological support, psychotherapies enable both the person and the family to adapt to the process and to acquire coping mechanisms.
Although the mainstay of bipolar therapy is drug therapy, psychoeducation, when added to drug therapy, is a very effective technique that has proven to reduce relapses and hospitalizations in all bipolar types. The aim is to understand the disease and process of the patient and the family, to increase the compliance with the treatment and to improve the quality of life. Because, studies show that poor prognosis and relapses in bipolar disorder increase in parallel with the rate of people’s susceptibility to stress. In addition, knowing the harms of alcohol or substance use and maintaining a more balanced social life are important steps in terms of support. Adapted versions of evidence-based modalities such as cognitive behavioral therapy (CBT), family-focused therapy are helpful.
In general, the drugs used in the acute period are continued during the preventive treatment. Since bipolar disorder is a lifelong chronic mental disorder with recurrent attacks, the recurrent character of the disorder, leading to disability, high morbidity (number of people who have the disease) and suicide risk, frequency of concomitant alcohol and substance use, and increase in the number of periods are associated with it. Due to the worsening of the prognosis (the course of the disease), it is recommended to continue with the doctor consultations and psychotherapy with preventive treatment, in addition to the treatment of crisis periods.
Goals of Conservation Therapy
- Preventing new manic, depressive and mixed symptoms,
- Reducing the number and severity of periods,
- Shortening the duration of the disease crisis,
- Prolonging the duration of healthy processes,
- Prevention of suicide attempts,
- Reducing hospitalizations,
- Increasing people’s life functionality.
- What is Seasonal Affective Disorder?
Seasonal affective disorder, called seasonally recurrent depression, is a type of depression that tends to occur (and recurs) when the autumn and winter days get shorter. The incidence of seasonal affective disorder increases in people who live further from the equator. One of the most important features in the course of bipolar disorder is that it shows seasonality, while patients experience mania and euphoria in the spring and summer months, they may feel depressed and depressed in the autumn and winter months. During the transition from spring to summer, impulsive and reactive behaviors, increased aggression, outbursts of anger, excessive spending can be observed.
- Recommendations for Bipolar Affective Disorder
- Get detailed information about disease symptoms and periods, treatment process, drug use, therapy support.
- Involve your family in the process and ensure that they are informed.
- Monitor early herald signs (unhappiness, agitation, increased spending, sleep disturbances, thoughts of death, sudden decisions and risk taking, etc.) in order to track the transitions of illness.
- Disrupting your sleep patterns, drinking alcohol, excessive stress, etc. Avoid situations that trigger the disease.
- Do breathing exercises.
- Eat regularly.
- Have your medical examinations and mood stabilizer blood level follow-ups done regularly.
