query: What is bipolar disorder?

title: Bipolar I disorder

text: Bipolar I disorder Bipolar I disorder (BD-I; pronounced "type one bipolar disorder") is a bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most patients also, at other times, have one or more depressive episodes, and all experience a hypomanic stage before progressing to full mania. It is a type of bipolar disorder, and conforms to the classic concept of manic-depressive illness, which can include psychosis during mood episodes. The difference with bipolar II disorder is that the latter requires that the individual must never have experienced a full

title: Bipolar disorder

text: reduced response to treatment. Overall, there are likely more similarities than differences from younger adults. In the elderly, recognition and treatment of bipolar disorder may be complicated by the presence of dementia or the side effects of medications being taken for other conditions. Bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder that causes periods of depression and periods of abnormally elevated mood. The elevated mood is significant and is known as mania or hypomania, depending on its severity, or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy,

title: Bipolar disorder not otherwise specified

text: 1.4%. Bipolar disorder not otherwise specified Bipolar disorder not otherwise specified (BD-NOS) is a diagnosis for bipolar disorder (BD) when it does not fall within the other established sub-types. Bipolar disorder NOS is sometimes referred to as subthreshold bipolar disorder. BD-NOS is a mood disorder and one of three subtypes on the bipolar spectrum, which also includes bipolar I disorder and bipolar II disorder. BD-NOS was a classification in the DSM-IV and has since been changed to Bipolar "Other Specified" and "Unspecified" in the 2013 released DSM-5 (American Psychiatric Association, 2013). Bipolar disorder is difficult to diagnose. If a person

text: Bipolar disorder not otherwise specified Bipolar disorder not otherwise specified (BD-NOS) is a diagnosis for bipolar disorder (BD) when it does not fall within the other established sub-types. Bipolar disorder NOS is sometimes referred to as subthreshold bipolar disorder. BD-NOS is a mood disorder and one of three subtypes on the bipolar spectrum, which also includes bipolar I disorder and bipolar II disorder. BD-NOS was a classification in the DSM-IV and has since been changed to Bipolar "Other Specified" and "Unspecified" in the 2013 released DSM-5 (American Psychiatric Association, 2013). Bipolar disorder is difficult to diagnose. If a person displays

title: Bipolar disorder in children

text: Bipolar disorder in children Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a mental disorder in children and adolescents that, like bipolar disorder (BD) in adults, is characterized by extreme changes in mood and behavior accompanying periods of depressed or irritable moods and periods of elevated moods called manic or hypomanic episodes. These shifts are sometimes quick, but usually they are gradual. The average age of onset of PBD is unclear, but the risk increases with the onset of puberty. PBD is typically more severe and has a poorer prognosis than BD with onset in late-adolescence or adulthood.

title: Bipolar disorder in children

text: in childhood or adolescence. Nevertheless, onset before age 10 was thought to be rare, below 0.5% of the cases. During the second half of the century misdiagnosis with schizophrenia was not rare in the non-adult population due to common co-occurrence of psychosis and mania, this issue diminishing with an increased following of the DSM criteria in the last part of the 20th century. Bipolar disorder in children Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a mental disorder in children and adolescents that, like bipolar disorder (BD) in adults, is characterized by extreme changes in mood and behavior

title: Bipolar disorder

text: Bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder that causes periods of depression and periods of abnormally elevated mood. The elevated mood is significant and is known as mania or hypomania, depending on its severity, or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy, or irritable. Individuals often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced during manic phases. During periods of depression, there may be crying, a negative outlook on life, and poor eye contact with

title: History of bipolar disorder

text: introduce the terms "bipolar" (for those with mania) and "unipolar" (for those with depressive episodes only). In 1968, both the newly revised classification systems ICD-8 and DSM-II termed the condition "manic-depressive "illness"" as biological thinking came to the fore. The current nosology, bipolar disorder, became popular only recently, and some individuals prefer the older term because it provides a better description of a continually changing multi-dimensional illness. Empirical and theoretical work on bipolar disorder has throughout history "seesawed" between psychological and biological ways of understanding. Despite the work of emphasizing the psychosocial context, conceptions of bipolar disorder as a genetically

title: Bipolar disorder

text: depressive episodes that alternate with manic or hypomanic episodes, or with mixed episodes that feature symptoms of both mood states. The concept of the bipolar spectrum is similar to that of Emil Kraepelin's original concept of manic depressive illness. Unipolar hypomania without accompanying depression has been noted in the medical literature. There is speculation as to whether this condition may occur with greater frequency in the general, untreated population; successful social function of these potentially high-achieving individuals may lead to being labeled as normal, rather than as individuals with substantial dysregulation. The DSM and the ICD characterize bipolar disorder as

title: Bipolar II disorder

text: many patients with severe psychiatric illness. The mood disorders (depression and bipolar manic-depression) are by far the most common psychiatric conditions associated with suicide. At least 25% to 50% of patients with bipolar disorder also attempt suicide at least once. With the exception of lithium--which is the most demonstrably effective treatment against suicide-remarkably little is known about specific contributions of mood-altering treatments to minimizing mortality rates in persons with major mood disorders in general and bipolar depression in particular. Suicide is usually a manifestation of severe psychiatric distress that is often associated with a diagnosable and treatable form of depression

title: Bipolar disorder

text: is more likely to be seen in adults. Early onset bipolar disorder is more likely to manifest as depression rather than mania or hypomania. The diagnosis of childhood bipolar disorder is controversial, although it is not under discussion that the typical symptoms of bipolar disorder have negative consequences for minors suffering them. The debate is mainly centered on whether what is called bipolar disorder in children refers to the same disorder as when diagnosing adults, and the related question of whether the criteria for diagnosis for adults are useful and accurate when applied to children. Regarding diagnosis of children, some

title: Bipolar disorder

text: experts recommend following the DSM criteria. Others believe that these criteria do not correctly separate children with bipolar disorder from other problems such as ADHD, and emphasize fast mood cycles. Still others argue that what accurately differentiates children with bipolar disorder is irritability. The practice parameters of the AACAP encourage the first strategy. American children and adolescents diagnosed with bipolar disorder in community hospitals increased 4-fold reaching rates of up to 40 percent in 10 years around the beginning of the 21st century, while in outpatient clinics it doubled reaching 6 percent. Studies using DSM criteria show that up to

title: Bipolar disorder

text: likely affected by confirmation bias. Some evidence suggests that some heritable component of bipolar disorder overlaps with heritable components of creativity. Probands of people with bipolar disorder are more likely to be professionally successful, as well as to demonstrate temperamental traits similar to bipolar disorder. Furthermore, while studies of the frequency of bipolar disorder in creative population samples have been conflicting, studies that have a positive finding report that full blown bipolar disorder is rare. In the 1920s, Emil Kraepelin noted that manic episodes are rare before puberty. In general, bipolar disorder in children was not recognized in the first

title: Bipolar II disorder

text: Bipolar II disorder Bipolar II disorder (BP-II; pronounced "type two bipolar" or "bipolar type two" disorder) is a bipolar spectrum disorder (see also: Bipolar I disorder) characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for bipolar II disorder requires that the individual must never have experienced a full manic episode (unless caused by an antidepressant; otherwise one manic episode meets the criteria for bipolar I disorder). Hypomania is a sustained state of elevated or irritable mood that is less severe than mania and does not significantly impact quality of life. Unlike

title: Bipolar disorder

text: medications are used to treat bipolar disorder. The medication with the best evidence is lithium, which is an effective treatment for acute manic episodes, preventing relapses, and bipolar depression. Lithium reduces the risk of suicide, self-harm, and death in people with bipolar disorder. It is unclear if ketamine (a common general anaesthetic used in surgery) is useful in bipolar . Lithium and the anticonvulsants carbamazepine, lamotrigine, and valproic acid are used as mood stabilizers to treat bipolar disorder. These mood stabilizers are used for long-term mood stabilization but have not demonstrated the ability to quickly treat acute bipolar depression. Lithium

title: Bipolar disorder

text: bipolar disorder susceptibility with each gene exerting a mild to moderate effect. The risk of bipolar disorder is nearly ten-fold higher in first degree-relatives of those affected with bipolar disorder when compared to the general population; similarly, the risk of major depressive disorder is three times higher in relatives of those with bipolar disorder when compared to the general population. Although the first genetic linkage finding for mania was in 1969, the linkage studies have been inconsistent. The largest and most recent genome-wide association study (GWAS) failed to find any particular locus that exerts a large effect, reinforcing the idea

title: Bipolar II disorder

text: state from four to two days. The second change will allow hypomania to be diagnosed without the manifestation of elevated mood;that is, increased energy/activity will be sufficient. The rationale behind the latter revision is that some individuals with Bipolar II manifest only visible changes in energy. Without presenting elevated mood, these individuals are commonly misdiagnosed with major depressive disorder. Consequently, they receive prescriptions for antidepressants, which unaccompanied by mood stabilizers, may induce rapid cycling or mixed states. Bipolar II disorder Bipolar II disorder (BP-II; pronounced "type two bipolar" or "bipolar type two" disorder) is a bipolar spectrum disorder (see also:

title: Bipolar disorder

text: (e.g., aripiprazole) are preferred over antidepressants to augment the effects of mood stabilizers due to the lack of efficacy of antidepressants in bipolar disorder. Short courses of benzodiazepines may be used in addition to other medications until mood stabilizing become effective. Electroconvulsive therapy (ECT) is an effective form of treatment for acute mood disturbances in those with bipolar disorder, especially when psychotic or catatonic features are displayed. ECT is also recommended for use in pregnant women with bipolar disorder. Contrary to widely held views, stimulants are relatively safe in bipolar disorder, and considerable evidence suggests they may even produce an

title: Bipolar II disorder

text: mania, hypomania is not associated with psychosis. The hypomanic episodes associated with bipolar II disorder must last for at least four days. Commonly, depressive episodes are more frequent and more intense than hypomanic episodes. Additionally, when compared to bipolar I disorder, type II presents more frequent depressive episodes and shorter intervals of well-being. The course of bipolar II disorder is more chronic and consists of more frequent cycling than the course of bipolar I disorder. Finally, bipolar II is associated with a greater risk of suicidal thoughts and behaviors than bipolar I or unipolar depression. Although bipolar II is commonly

title: Bipolar disorder

text: that no single gene is responsible for bipolar disorder in most cases. Polymorphisms in "BDNF", "DRD4", "DAO", and "TPH1" have been frequently associated with bipolar disorder and were initially successful in a meta-analysis, but failed after correction for multiple testing. On the other hand, two polymorphisms in "TPH2" were identified as being associated with bipolar disorder. Due to the inconsistent findings in a genome-wide association study, multiple studies have undertaken the approach of analyzing single-nucleotide polymorphisms (SNPs) in biological pathways. Signaling pathways traditionally associated with bipolar disorder that have been supported by these studies include corticotropin-releasing hormone (CRH) signaling, cardiac

title: Bipolar disorder

text: Advanced paternal age has been linked to a somewhat increased chance of bipolar disorder in offspring, consistent with a hypothesis of increased new genetic mutations. Psychosocial factors play a significant role in the development and course of bipolar disorder, and individual psychosocial variables may interact with genetic dispositions. It is probable that recent life events and interpersonal relationships contribute to the onset and recurrence of bipolar mood episodes, just as they do for unipolar depression. In surveys, 30–50 percent of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated with earlier onset, a higher rate of

title: Bipolar disorder

text: substance abuse. Associated features are clinical phenomena that often accompany the disorder but are not part of the diagnostic criteria. In adults with the condition, bipolar disorder is often accompanied by changes in cognitive processes and abilities. These include reduced attentional and executive capabilities and impaired memory. How the individual processes the universe also depends on the phase of the disorder, with differential characteristics between the manic, hypomanic and depressive states. Those with bipolar disorder may have difficulty in maintaining relationships. There are several common childhood precursors seen in children who later receive a diagnosis of bipolar disorder, such as

title: Bipolar II disorder

text: been conducted did not find a significant difference between those with Bipolar I or Bipolar II. There has been a study looking at genetics of Bipolar II disorder and the results are inconclusive; however, scientists did find that relatives of people with Bipolar II are more likely to develop the same bipolar disorder or major depression rather than developing Bipolar I disorder. The "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV) recognizes two types of bipolar disorders—bipolar I and bipolar II. People with bipolar I disorder suffer from at least one manic or mixed episode, and may experience depressive episodes.

title: Bipolar disorder

text: half of the twentieth century. This issue diminished with an increased following of the DSM criteria in the last part of the twentieth century. The DSM5 does not specifically have bipolar disorder in children and instead refers to it as disruptive mood dysregulation disorder. While in adults the course of bipolar disorder is characterized by discrete episodes of depression and mania with no clear symptomatology between them, in children and adolescents very fast mood changes or even chronic symptoms are the norm. Pediatric bipolar disorder is commonly characterized by outbursts of anger, irritability and psychosis, rather than euphoric mania, which

title: Bipolar disorder

text: to account for 60–80 percent of the risk of developing the disorder indicating a strong hereditary component. The overall heritability of the bipolar spectrum has been estimated at 0.71. Twin studies have been limited by relatively small sample sizes but have indicated a substantial genetic contribution, as well as environmental influence. For bipolar disorder type I, the rate at which identical twins (same genes) will both have bipolar disorder type I (concordance) is estimated at around 40 percent, compared to about 5 percent in fraternal twins. A combination of bipolar I, II, and cyclothymia similarly produced rates of 42 percent

title: Biology of bipolar disorder

text: regardless of polarity. Inflammation has been consistently reported in bipolar disorder, and the progressive nature lies in dysregulation of NF-κB. Biology of bipolar disorder Bipolar disorder is an affective disorder characterized by periods of elevated and depressed mood. The cause and mechanism of bipolar disorder is unknown, and the study of its biological origins is ongoing. Although no single gene causes the disorder, a number of genes are linked to increase risk of the disorder, and various gene environment interactions may play a role in predisposing individuals to developing bipolar disorder. Neuroimaging and postmortem studies have found abnormalities in a

title: Bipolar disorder

text: been debate regarding the causal relationship between usage of cannabis and bipolar disorder. Bipolar disorder is commonly diagnosed during adolescence or early adulthood, but onset can occur throughout the life cycle. The disorder can be difficult to distinguish from unipolar depression and the average delay in diagnosis is 5–10 years after symptoms begin. Diagnosis of bipolar disorder takes several factors into account and considers the self-reported experiences of the symptomatic individual, abnormal behavior reported by family members, friends or co-workers, observable signs of illness as assessed by a clinician, and often a medical work-up to rule-out medical causes. In diagnosis,

title: Bipolar disorder

text: of mania or depression within 2 years of syndromal recovery, and 19 percent switched phases without recovery. Symptoms preceding a relapse (prodromal), specially those related to mania, can be reliably identified by people with bipolar disorder. There have been intents to teach patients coping strategies when noticing such symptoms with encouraging results. Bipolar disorder can cause suicidal ideation that leads to suicidal attempts. Individuals whose bipolar disorder begins with a depressive or mixed affective episode seem to have a poorer prognosis and an increased risk of suicide. One out of two people with bipolar disorder attempt suicide at least once

title: Bipolar disorder

text: difference in monoamine levels, but found abnormal norepinephrine turnover in people with bipolar disorder. Tyrosine depletion was found to reduce the effects of methamphetamine in people with bipolar disorder as well as symptoms of mania, implicating dopamine in mania. VMAT2 binding was found to be increased in one study of people with bipolar mania. Attempts at prevention of bipolar disorder have focused on stress (such as childhood adversity or highly conflictual families) which, although not a diagnostically specific causal agent for bipolar, does place genetically and biologically vulnerable individuals at risk for a more severe course of illness. There has

title: Bipolar disorder

text: the Hypomania Checklist. The use of evaluation scales cannot substitute a full clinical interview but they serve to systematize the recollection of symptoms. On the other hand, instruments for screening bipolar disorder tend to have lower sensitivity. There are several other mental disorders with symptoms similar to those seen in bipolar disorder. These disorders include schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and certain personality disorders, such as borderline personality disorder. Although there are no biological tests that are diagnostic of bipolar disorder, blood tests and/or imaging may be carried out to exclude medical illnesses with clinical presentations

title: Bipolar disorder

text: mood abnormalities (including major depressive episodes) and attention deficit hyperactivity disorder (ADHD). The diagnosis of bipolar disorder can be complicated by coexisting (comorbid) psychiatric conditions including the following: obsessive-compulsive disorder, substance-use disorder, eating disorders, attention deficit hyperactivity disorder, social phobia, premenstrual syndrome (including premenstrual dysphoric disorder), or panic disorder. A careful longitudinal analysis of symptoms and episodes, enriched if possible by discussions with friends and family members, is crucial to establishing a treatment plan where these comorbidities exist. The causes of bipolar disorder likely vary between individuals and the exact mechanism underlying the disorder remains unclear. Genetic influences are believed

title: Bipolar disorder

text: suicide attempts, and more co-occurring disorders such as post-traumatic stress disorder (PTSD). The number of reported stressful events in childhood is higher in those with an adult diagnosis of bipolar spectrum disorder compared to those without, particularly events stemming from a harsh environment rather than from the child's own behavior. Less commonly, bipolar disorder or a bipolar-like disorder may occur as a result of or in association with a neurological condition or injury. Conditions like these and injuries include stroke, traumatic brain injury, HIV infection, multiple sclerosis, porphyria, and rarely temporal lobe epilepsy. Abnormalities in the structure and/or function of

title: Bipolar disorder

text: during their lifetime and many attempts are successfully completed. The annual average suicide rate is 0.4 percent, which is 10–20 times that of the general population. The standardized mortality ratio from suicide in bipolar disorder is between 18 and 25. The lifetime risk of suicide has been estimated to be as high as 20 percent in those with bipolar disorder. Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 1 to 3 percent in the general population. However, a reanalysis of data from the National Epidemiological Catchment Area survey in the United

title: Biology of bipolar disorder

text: located in these regions have been hypothesized as a mechanism for bipolar disorder. A number of lines of evidence suggests abnormalities in neurotransmission, intracellular signalling, and cellular functioning as possibly playing a role in bipolar disorder. Studies of bipolar disorder, particularly neuroimaging studies, are vulnerable to the confounding effects such as medication, comorbidity, and small sample size, leading to underpowered independent studies, and significant heterogeneity. The etiology of bipolar disorder is unknown. The overall heritability of bipolar is estimated at 79%-93%, and first degree relatives of bipolar probands have a relative risk of developing bipolar around 7-10. While the heritability

title: Bipolar disorder

text: benefit in rapid cycling subtype of bipolar disorder. The effectiveness of topiramate is unknown. Antipsychotic medications are effective for short-term treatment of bipolar manic episodes and appear to be superior to lithium and anticonvulsants for this purpose. Atypical antipsychotics are also indicated for bipolar depression refractory to treatment with mood stabilizers. Olanzapine is effective in preventing relapses, although the supporting evidence is weaker than the evidence for lithium. Antidepressants are not recommended for use alone in the treatment of bipolar disorder and have not been found to be of any benefit over that found with mood stabilizers. Atypical antipsychotic medications

title: Biology of bipolar disorder

text: Biology of bipolar disorder Bipolar disorder is an affective disorder characterized by periods of elevated and depressed mood. The cause and mechanism of bipolar disorder is unknown, and the study of its biological origins is ongoing. Although no single gene causes the disorder, a number of genes are linked to increase risk of the disorder, and various gene environment interactions may play a role in predisposing individuals to developing bipolar disorder. Neuroimaging and postmortem studies have found abnormalities in a variety of brain regions, and most commonly implicated regions include the ventral prefrontal cortex and amygdala. Dysfunction in emotional circuits

title: Bipolar disorder

text: herpes encephalitis, HIV, influenza, or neurosyphilis. Certain vitamin deficiencies such as pellagra (niacin deficiency), Vitamin B12 deficiency, folate deficiency, and Wernicke Korsakoff syndrome (thiamine deficiency) can also lead to mania. A review of current and recent medications and drug use is considered to rule out these causes; common medications that can cause manic symptoms include antidepressants, prednisone, Parkinson's disease medications, thyroid hormone, stimulants (including cocaine and methamphetamine), and certain antibiotics. Bipolar spectrum disorders includes: bipolar I disorder, bipolar II disorder, cyclothymic disorder and cases where subthreshold symptoms are found to cause clinically significant impairment or distress. These disorders involve major

title: Bipolar disorder

text: severe cases, the individual may develop symptoms of psychosis, a condition also known as "severe bipolar disorder with psychotic features". These symptoms include delusions and hallucinations. A major depressive episode persists for at least two weeks, and may result in suicide if left untreated. The earlier the age of onset, the more likely the first few episodes are to be depressive. Since a diagnosis of bipolar disorder requires a manic or hypomanic episode, many affected individuals are initially misdiagnosed as having major depression and then incorrectly treated with prescribed antidepressants. In bipolar disorder, mixed state is a condition during which

title: Bipolar I disorder

text: many of the above changes are still under active consideration and are not definite. For more information regarding proposed revisions to the DSM-5, please visit their website at dsm5.org. For a helpful guide to understanding the DSM-IV, please visit their website at Bipolar I disorder Bipolar I disorder (BD-I; pronounced "type one bipolar disorder") is a bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most patients also, at other times, have one or more depressive episodes, and all experience a hypomanic stage before progressing to full mania. It

title: Bipolar disorder

text: is preferred for long-term mood stabilization. Carbamazepine effectively treats manic episodes, with some evidence it has greater benefit in rapid-cycling bipolar disorder, or those with more psychotic symptoms or a more schizoaffective clinical picture. It is less effective in preventing relapse than lithium or valproate. Valproate has become a commonly prescribed treatment and effectively treats manic episodes. Lamotrigine has some efficacy in treating bipolar depression, and this benefit is greatest in more severe depression. It has also been shown to have some benefit in preventing bipolar disorder relapses, though there are concerns about the studies done, and is of no

title: Bipolar disorder

text: TV specials, for example the BBC's "", MTV's "True Life: I'm Bipolar", talk shows, and public radio shows, and the greater willingness of public figures to discuss their own bipolar disorder, have focused on psychiatric conditions, thereby, raising public awareness. On April 7, 2009, the nighttime drama "90210" on the CW network, aired a special episode where the character Silver was diagnosed with bipolar disorder. Stacey Slater, a character from the BBC soap EastEnders, has been diagnosed with the disorder. The storyline was developed as part of the BBC's Headroom campaign. The Channel 4 soap "Brookside" had earlier featured a

title: Biology of bipolar disorder

text: cognitive functions that are disrupted in bipolar disorder. For example, while structural neuroimaging studies do not always find abnormal PFC volume in bipolar disorder, when they do, PFC volume is reduced. Furthermore, reduced PFC volume is associated with response inhibition deficits and duration of illness. When the PFC at large is not examined and the focus is narrowed to the OFC/vPFC, results more consistently observed reductions, although not in bipolar youth. The sgACC volume is observed to be reduced not only in bipolar disorder, but also in unipolar disorder, as well as people with a family history of affective disorders.

title: Bipolar disorder

text: percent for bipolar II, and 2.4 percent for subthreshold symptoms. There are conceptual and methodological limitations and variations in the findings. Prevalence studies of bipolar disorder are typically carried out by lay interviewers who follow fully structured/fixed interview schemes; responses to single items from such interviews may suffer limited validity. In addition, diagnoses (and therefore estimates of prevalence) vary depending on whether a categorical or spectrum approach is used. This consideration has led to concerns about the potential for both underdiagnosis and overdiagnosis. The incidence of bipolar disorder is similar in men and women as well as across different cultures

title: Treatment of bipolar disorder

text: bipolar patients. However, due to the lack of ability to attract subjects the trial was never started. Acute cannabis intoxication transiently produces perceptual distortions, psychotic symptoms and reduction in cognitive abilities in healthy persons and in severe mental disorder, and may impair the ability to safely operate a motor vehicle. Cannabis use is common in bipolar disorder; and is a risk factor for a more severe course of the disease by increasing frequency and duration of episodes. It is also reported to reduce age at onset. Treatment of bipolar disorder The emphasis of the treatment of bipolar disorder is on

title: Associated features of bipolar disorder

text: non-prescribed drugs such as alcohol, tobacco and other recreational drugs. There is some evidence that the subset of bipolar patients with a history of psychosis may smoke more heavily than the general population. Associated features of bipolar disorder The associated features of bipolar disorder are clinical phenomena that often accompany bipolar disorder (BD) but are not part of the diagnostic criteria for the disorder. There are several childhood precursors in children who later receive a diagnosis of bipolar disorder. They may show subtle early traits such as mood abnormalities, full major depressive episodes, and attention-deficit hyperactivity disorder. BD is also

title: Bipolar disorder

text: in clinical settings outside of the U.S. while the DSM criteria are used clinically within the U.S. and are the prevailing criteria used internationally in research studies. The DSM-5, published in 2013, included further and more accurate specifiers compared to its predecessor, the DSM-IV-TR. Semi structured interviews such as the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) and the Structured Clinical Interview for DSM-IV (SCID) are used for diagnostic confirmation of bipolar disorder. Several rating scales for the screening and evaluation of bipolar disorder exist, including the Bipolar spectrum diagnostic scale, Mood Disorder Questionnaire, the General Behavior Inventory and

title: Bipolar disorder

text: others. The risk of suicide among those with the illness is high at greater than 6 percent over 20 years, while self-harm occurs in 30–40 percent. Other mental health issues such as anxiety disorders and substance use disorder are commonly associated with bipolar disorder. The causes are not clearly understood, but both environmental and genetic factors play a role. Many genes of small effect contribute to risk. Environmental risk factors include a history of childhood abuse and long-term stress. About 85% of the risk is attributed to genetics. The condition is classified as bipolar I disorder if there has been

title: Bipolar disorder

text: similar to that of bipolar disorder. Neurologic diseases such as multiple sclerosis, complex partial seizures, strokes, brain tumors, Wilson's disease, traumatic brain injury, Huntington's disease, and complex migraines can mimic features of bipolar disorder. An EEG may be used to exclude neurological disorders such as epilepsy, and a CT scan or MRI of the head may be used to exclude brain lesions. Additionally, disorders of the endocrine system such as hypothyroidism, hyperthyroidism, and Cushing's disease are in the differential as is the connective tissue disease systemic lupus erythematosus. Infectious causes of mania that may appear similar to bipolar mania include

title: Bipolar disorder

text: 1 percent of youth may have bipolar disorder. Treatment involves medication and psychotherapy. Drug prescription usually consists in mood stabilizers and atypical antipsychotics. Among the former, lithium is the only compound approved by the FDA for children. Psychological treatment combines normally education on the disease, group therapy and cognitive behavioral therapy. Chronic medication is often needed. Current research directions for bipolar disorder in children include optimizing treatments, increasing the knowledge of the genetic and neurobiological basis of the pediatric disorder and improving diagnostic criteria. Some treatment research suggests that psychosocial interventions that involve the family, psychoeducation, and skills building (through

title: Bipolar II disorder

text: the same disability when it comes to occupational functioning, interpersonal relationships, and autonomy. This disruption in cognitive functioning takes a toll on their ability to function in the workplace, which leads to high rates of work loss in Bipolar II patient populations. After treatment and while in remission, Bipolar II patients tend to report a good psychosocial functioning but they still score less in that department than patients without the disorder. These lasting impacts further suggest that a prolonged exposure to an untreated Bipolar II disorder can lead to permanent adverse effects on functioning. Bipolar II Disorder has a chronic

title: Treatment of bipolar disorder

text: take some trial and error to find the best medication or combination for a specific patient. Psychotherapy also has a role in the treatment of bipolar disorder. The goal of treatment is not to cure the disorder but rather to control the symptoms and the course of the disorder. Generally speaking, maintenance treatment of bipolar disorder continues long after symptom control has been achieved. Following diagnostic evaluation, the treating clinician must determine the optimal treatment setting in order to ensure the patient's safety. Assessment of suicide risk is key, as the rate of suicide completion among those with bipolar disorder

title: Bipolar II disorder

text: or the other differentiates two distinct diseases; the proposition was initially met with skepticism. However, studies since confirm that bipolar II is a "phenomenologically" distinct disorder. Empirical evidence, combined with treatment considerations, led the DSM-IV Mood Disorders Work Group to add bipolar II disorder as its own entity in the 1994 publication. (Only one other mood disorder was added to this edition, indicating the conservative nature of the DSM-IV work group.) In May 2013, the DSM-5 was released. Two revisions to the existing Bipolar II criteria are anticipated. The first expected change will reduce the required duration of a hypomanic

title: Associated features of bipolar disorder

text: Associated features of bipolar disorder The associated features of bipolar disorder are clinical phenomena that often accompany bipolar disorder (BD) but are not part of the diagnostic criteria for the disorder. There are several childhood precursors in children who later receive a diagnosis of bipolar disorder. They may show subtle early traits such as mood abnormalities, full major depressive episodes, and attention-deficit hyperactivity disorder. BD is also accompanied by changes in cognition processes and abilities. This includes reduced attentional and executive capabilities and impaired memory. How the individual processes the world also depends on the phase of the disorder, with

title: Bipolar I disorder

text: manic episode - only less severe hypomanic episode(s). The essential feature of bipolar I disorder is a clinical course characterized by the occurrence of one or more manic episodes or mixed episodes (DSM-IV-TR, 2000). Often, individuals have had one or more major depressive episodes. One episode of mania is sufficient to make the diagnosis of bipolar disorder; the patient may or may not have history of major depressive disorder. Episodes of substance-induced mood disorder due to the direct effects of a medication, or other somatic treatments for depression, drug abuse, or toxin exposure, or of mood disorder due to a

title: Bipolar I disorder

text: general medical condition need to be excluded before a diagnosis of bipolar I disorder can be made. In addition, the episodes must not be better accounted for by schizoaffective disorder or superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or a psychotic disorder not otherwise specified. Routine medical assessments are often prescribed to rule-out or identify a somatic cause for bipolar I symptoms. These tests can include ultrasounds of the head, x-ray computed tomography (CAT scan), electroencephalogram, HIV test, full blood count, thyroid function test, liver function test, urea and creatinine levels and if patient is on lithium, lithium levels are

title: Bipolar disorder in children

text: children and adolescents with bipolar disorder in the United States increased from 20,000 in 1994–95 to 800,000 in 2002–03. The data suggest that doctors had been more aggressively applying the diagnosis to children, rather than that the incidence of the disorder has increased. An origin for controversy is the rise in the number of diagnoses in the US; the diagnosis is more likely in the US than in the UK. The British National Institute on Health and Clinical Excellence (NICE) guidelines on bipolar disorder in 2006 described the broadened criteria used in the US to diagnose bipolar disorder in children

title: Bipolar disorder

text: against individuals with a diagnosis of bipolar disorder. Kay Redfield Jamison, a clinical psychologist and professor of psychiatry at the Johns Hopkins University School of Medicine, profiled her own bipolar disorder in her memoir "An Unquiet Mind" (1995). In his autobiography "" (2008), Chris Joseph describes his struggle between the creative dynamism which allowed the creation of his multimillion-pound advertising agency Hook Advertising, and the money-squandering dark despair of his bipolar illness. Several dramatic works have portrayed characters with traits suggestive of the diagnosis that has been the subject of discussion by psychiatrists and film experts alike. A notable example

title: Biology of bipolar disorder

text: bipolar disorder is also associated with elevated CACNA1C mRNA expression in the prefrontal cortex, and increased calcium channel expression in neurons made from patient induced pluripotent stem cells. No significant association exists for the BDNF Val66Met allele and bipolar disorder, except possibly in a subgroup of bipolar II cases, and suicide. Due to the inconsistent findings in GWAS, multiple studies have undertaken the approach of analyzing SNPs in biological pathways. Signaling pathways traditionally associated with bipolar disorder that have been supported by these studies include CRH signaling, cardiac β-adrenergic signaling, Phospholipase C signaling, glutamate receptor signaling, cardiac hypertrophy signaling, Wnt

title: Bipolar disorder

text: vPFC, and mania the right vPFC. Abnormal vPFC activity, along with amygdala hyperactivity is found during euthymia as well as in healthy relatives of those with bipolar, indicating possible trait features. Euthymic bipolar people show decreased activity in the lingual gyrus, while people who are manic demonstrate decreased activity in the inferior frontal cortex, while no differences were found in people with bipolar depression. People with bipolar have increased activation of left hemisphere ventral limbic areas and decreased activation of right hemisphere cortical structures related to cognition. One proposed model for bipolar disorder suggests that hypersensitivity of reward circuits consisting

text: some symptoms of bipolar disorder but not others, the clinician may diagnose bipolar NOS. The diagnosis of bipolar NOS is indicated when there is a rapid change (days) between manic and depressive symptoms and can also include recurring episodes of hypomania. Bipolar NOS may be diagnosed when it is difficult to tell whether bipolar is the primary disorder due to another general medical condition, such as a substance use disorder. Individual approaches to treatment are recommended, usually involving a combination of mood stabilizers and atypical antipsychotics. Psychotherapy may be beneficial and should be started early. The prevalence of BD-NOS is

title: Bipolar disorder

text: story about bipolar disorder when the character Jimmy Corkhill was diagnosed with the condition. 2011 Showtime's political thriller drama "Homeland" protagonist Carrie Mathison is bipolar, which she has kept secret since her school days. In April 2014, ABC premiered a medical drama, "Black Box", in which the main character, a world-renowned neuroscientist, is bipolar. A link between mental illness and professional success or creativity has been suggested, including in accounts by Socrates, Seneca the Younger, and Cesare Lombroso. Despite prominence in popular culture, the link between creativity and bipolar has not been rigorously studied. This area of study also is

title: Bipolar disorder

text: bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months. "Rapid cycling", however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more mood disturbance episodes within a one-year span and is found in a significant proportion of individuals with bipolar disorder. These episodes are separated from each other by a remission (partial or full) for at least two months or a switch in mood polarity (i.e., from a depressive episode to a manic episode or vice versa). The

title: Bipolar I disorder

text: to be 1%. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released in May 2013. There are several proposed revisions to occur in the diagnostic criteria of Bipolar I Disorder and its subtypes. For Bipolar I Disorder 296.40 Most Recent Episode Hypomanic and 296.4x Most Recent Episode Manic, the proposed revision includes the following specifiers: with Psychotic Features, with Mixed Features, with Catatonic Features, with Rapid Cycling, with Anxiety (mild to severe), with Suicide Risk Severity, with Seasonal Pattern, and with Postpartum Onset. Bipolar I Disorder 296.5x Most Recent Episode Depressed will include all

title: Bipolar disorder

text: responsive to treatment. Onset after adolescence is connected to better prognoses for both genders, and being male is a protective factor against higher levels of depression. For women, better social functioning prior to developing bipolar disorder and being a parent are protective towards suicide attempts. People with bipolar disorder often experience a decline in cognitive functioning during (or possibly before) their first episode, after which a certain degree of cognitive dysfunction typically becomes permanent, with more severe impairment during acute phases and moderate impairment during periods of remission. As a result, two-thirds of people with BD continue to experience impaired

title: Bipolar II disorder

text: switch. The pharmaceutical management of bipolar II disorder is not generally supported by strong evidence, with limited randomised controlled trials (RCTs) published in the literature. Some medications used are: Non-pharmaceutical therapies can also help those with the illness. These include cognitive behavioral therapy (CBT), psychodynamic therapy, psychoanalysis, social rhythm therapy, interpersonal therapy, behavioral therapy, cognitive therapy, art therapy, music therapy, psychoeducation, mindfulness, light therapy, and family-focused therapy. Relapse can still occur, even with continued medication and therapy. There is evidence to suggest that bipolar II has a more chronic course of illness than bipolar I disorder. This constant and pervasive

title: Comparison of bipolar disorder and schizophrenia

text: is one of several psychosocial treatments for schizophrenia. It involves social and job-skills training to improve an individual's ability to function in society. Electroconvulsive therapy (ECT) may be used to treat bipolar disorder when other treatments are ineffective or when medication would be dangerous because of another medical condition. Comparison of bipolar disorder and schizophrenia Both schizophrenia and bipolar disorder are characterized as psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5). Schizophrenia is a primary psychotic disorder, and bipolar disorder is a primary mood disorder but can also involve psychosis. However, because of some

title: Bipolar disorder

text: caregiver-scored rating scales, specifically the mother, has been found to be more accurate than teacher and youth report in predicting identifying youths with bipolar disorder. Assessment is usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to oneself or others. The most widely used criteria for diagnosing bipolar disorder are from the American Psychiatric Association's (APA) "Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition (DSM-5) and the World Health Organization's (WHO) "International Statistical Classification of Diseases and Related Health Problems", 10th Edition (ICD-10). The ICD-10 criteria are used more often

title: Bipolar II disorder

text: On the contrary, as noted above, people with bipolar II disorder experience a milder form of a manic episode, known as a hypomanic episode as well as major depressive episodes. Although bipolar II is thought to be less severe than bipolar I in regards to symptom intensity, it is actually more severe and distressing with respect to episode frequency and overall course. Those with bipolar II often experience more frequent bouts of depressive episodes. Specific criteria defined by the DSM-IV for a bipolar II diagnosis is as follows: Studies have identified major differences between bipolar I and bipolar II in

title: Bipolar disorder

text: individuals with BD inconsistently take their medications for various reasons. Of the various types of the disorder, rapid cycling (four or more episodes in one year) is associated with the worst prognosis due to higher rates of self-harm and suicide. Individuals diagnosed with bipolar who have a family history of bipolar disorder are at a greater risk for more frequent manic/hypomanic episodes. Early onset and psychotic features are also associated with worse outcomes, as well as subtypes that are nonresponsive to lithium. Early recognition and intervention also improve prognosis as the symptoms in earlier stages are less severe and more

title: Bipolar disorder

text: a spectrum of disorders occurring on a continuum. The DSM-5 lists three specific subtypes: When relevant, specifiers for "peripartum onset" and "with rapid cycling" should be used with any subtype. Individuals who have subthreshold symptoms that cause clinically significant distress or impairment, but do not meet full criteria for one of the three subtypes may be diagnosed with other specified or unspecified bipolar disorder. Other specified bipolar disorder is used when a clinician chooses to provide an explanation for why the full criteria were not met (e.g., hypomania without a prior major depressive episode). Most people who meet criteria for

title: Bipolar disorder

text: of frontostriatal circuits causes mania, and hyposensitivity of these circuits causes depression. According to the "kindling" hypothesis, when people who are genetically predisposed toward bipolar disorder experience stressful events, the stress threshold at which mood changes occur becomes progressively lower, until the episodes eventually start (and recur) spontaneously. There is evidence supporting an association between early-life stress and dysfunction of the hypothalamic-pituitary-adrenal axis (HPA axis) leading to its overactivation, which may play a role in the pathogenesis of bipolar disorder. Some of the brain components which have been proposed to play a role are the mitochondria and a sodium ATPase

title: Bipolar II disorder

text: 26.5%, versus 15.4% in bipolar I patients. Screening instruments like the Mood Disorders Questionnaire (MDQ) are helpful tools in determining a patient's status on the bipolar spectrum and getting families involved can also improve chances of an accurate diagnosis and acknowledgment of hypomanic episodes. In addition, there are certain features that have been shown to increase the chances that depressed patients are suffering from a bipolar disorder including atypical symptoms of depression like hypersomnia and hyperphagia, a family history of bipolar disorder, medication-induced hypomania, recurrent or psychotic depression, antidepressant refractory depression, and early or postpartum depression. Treatment typically includes three

title: Treatment of bipolar disorder

text: Treatment of bipolar disorder The emphasis of the treatment of bipolar disorder is on effective management of the long-term course of the illness, which can involve treatment of emergent symptoms. Treatment methods include pharmacological and psychological techniques. The primary treatment for bipolar disorder consists of medications called mood stabilizers, which are used to prevent or control episodes of mania or depression. Medications from several classes have mood stabilizing activity. Many individuals may require a combination of medication to achieve full remission of symptoms. As it is impossible to predict which medication will work best for a particular individual, it may

title: Bipolar II disorder

text: impairment has been shown to be directly linked with increasing percentages of depressive symptoms, and because sub-syndromal symptoms are more common—and frequent—in Bipolar II disorder, they have been implicated heavily as a major cause of psychosocial disability. There is evidence that shows the mild depressive symptoms, or even sub-syndromal symptoms, are responsible for the non-recovery of social functioning, which furthers the idea that residual depressive symptoms are detrimental for functional recovery in patients being treated for Bipolar II. It has been suggested that symptom interference in relation to social and interpersonal relationships in Bipolar II Disorder is worse than symptom

title: Biology of bipolar disorder

text: platelet levels of G and G is also elavated in those with bipolar disorder. Downstream targets of G protein signaling is also altered in bipolar disorder. Increased levels of adenylyl cyclase, protein kinase A(PKA), and cyclic adenosine monophosphate induced PKA activity are also reported. Phosphoinositide signaling is also altered, with elevated levels of phospholipase C, protein kinase C, and G being reported in bipolar. Elevated cAMP stimulated phosphorylation or Rap1(a substrate of PKA), along with increased levels of Rap1 have been reported in peripherally collected cells of people with bipolar. Increased coupling of serotonin receptors to G proteins has been

title: Biology of bipolar disorder

text: hyperintensities play a role dysfunction between limbic and cortical regions. Global brain volume and morphology are normal in bipolar. Regional deficits in volume have been reported in ventrolateral and dorsolateral prefrontal regions. Based on this, it has been suggested that reduced limbic regulation by prefrontal regions plays a role in bipolar. Findings related to the volume of the basal ganglia have been inconsistent. In healthy controls, amygdala volume is inversely related to age. This relationship is reversed in bipolar disorder, and meta analyses have found reduced amygdala volume in pediatric bipolar disorder, and increased amygdala volume in adulthood. This is

text: shared genetic etiology between schizophrenia and bipolar disorder. Geoffroy, Etain, and Houenou note that the largest family study available found a combined heritability for bipolar disorder and schizophrenia of approximately 60%, with environmental factors accounting for the remainder. Genetic contributions to schizoaffective disorder appear to be entirely shared with those contributing to schizophrenia and mania. Bipolar I disorder and schizophrenia each occur in approximately 1% of the population; schizoaffective disorder is estimated to occur in less than 1% of the population. During severe episodes of mania or depression people with bipolar disorder may have psychotic symptoms, such as hallucinations or

title: Associated features of bipolar disorder

text: in social adjustment. Bipolar disorder has been associated with people involved in the arts but it is an ongoing question as to whether many creative geniuses had bipolar disorder. Some studies have found a significant association between bipolar disorder and creativity, although it is unclear in which direction the cause lies or whether both conditions are caused by a third unknown factor; temperament has been hypothesized to be one such factor. The individual's attachment to heightened creativity during hypomanic episodes may contribute to ambivalence about seeking treatment or undermine adherence to treatment. Often bipolar individuals are subject to self-medication with

title: Biology of bipolar disorder

text: neurons is also observed. These findings are congruent with the genetic association of bipolar with CACNAC1, an L-type calcium channel, as well as the efficacy of anti-epileptic agents. Normal platelets placed in plasma from people with bipolar disorder do not demonstrate elevated levels of intracellular calcium, indicating that dysfunction lies intracellularly. One possible mechanism is that elevated inositol triphosphate(IP3) caused by hyperactive neuronal calcium sensor 1 causes excessive calcium release. Serum levels of S100B(a calcium binding protein) are elevated in bipolar mania. Some researchers have suggested bipolar disorder is a mitochondrial disease. Some cases of familial chronic progressive external ophthalmoplegia

title: Bipolar disorder

text: therapies such as CBT, DBT, and IPSRT) can benefit in a pharmocotherapy. Unfortunately, the literature and research on the effects of psychosocial therapy on BPSD is scarce, making it difficult to determine the efficacy of various therapies. The DSM-5 has proposed a new diagnosis which is considered to cover some presentations currently thought of as childhood-onset bipolar. There is a relative lack of knowledge about bipolar disorder in late life. There is evidence that it becomes less prevalent with age but nevertheless accounts for a similar percentage of psychiatric admissions; that older bipolar patients had first experienced symptoms at a

text: Comparison of bipolar disorder and schizophrenia Both schizophrenia and bipolar disorder are characterized as psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5). Schizophrenia is a primary psychotic disorder, and bipolar disorder is a primary mood disorder but can also involve psychosis. However, because of some similar symptoms, differentiating between the two can sometimes be difficult; indeed, there is an intermediate diagnosis schizoaffective disorder. While reported and observed symptoms are a main way to diagnose either disorder, recent research studies are allowing psychiatrists to use magnetic resonance imaging (MRI) scans to try to find better,

title: Biology of bipolar disorder

text: bipolar patients overactivated the vACC, pulvinar nucleus, and parahippocampus gyrus/amygdala to a greater degree, while underactivating the dACC. Bipolar subjects overactivated parahippocampus for both fearful and happy expressions, while the caudate and putamen were overactived for happiness and fear respectively. Bipolar subjects also underactivated the ACC for both fearful and happy expressions, while the IFG was underactivated for fearful expressions only. These results were interpreted as reflecting increased engagement with emotionally salient stimuli in bipolar disorder. Specific symptoms have been linked to various neuroimaging abnormalities in bipolar disorder, as well as schizophrenia. Reality distortion, disorganization, and psychomotor poverty have been

title: Bipolar disorder

text: States suggested that 0.8 percent of the population experience a manic episode at least once (the diagnostic threshold for bipolar I) and a further 0.5 percent have a hypomanic episode (the diagnostic threshold for bipolar II or cyclothymia). Including sub-threshold diagnostic criteria, such as one or two symptoms over a short time-period, an additional 5.1 percent of the population, adding up to a total of 6.4 percent, were classified as having a bipolar spectrum disorder. A more recent analysis of data from a second US National Comorbidity Survey found that 1 percent met lifetime prevalence criteria for bipolar I, 1.1

title: Bipolar disorder

text: increased protein kinase A expression and sensitivity. Decreased levels of 5-hydroxyindoleacetic acid, a byproduct of serotonin, are present in the cerebrospinal fluid of persons with bipolar disorder during both the depressed and manic phases. Increased dopaminergic activity has been hypothesized in manic states due to the ability of dopamine agonists to stimulate mania in people with bipolar disorder. Decreased sensitivity of regulatory α adrenergic receptors as well as increased cell counts in the locus ceruleus indicated increased noradrenergic activity in manic people. Low plasma GABA levels on both sides of the mood spectrum have been found. One review found no

title: Bipolar disorder

text: certain brain circuits could underlie bipolar disorder. Meta-analyses of structural MRI studies in bipolar disorder report decreased volume in the left rostral anterior cingulate cortex (ACC), fronto-insular cortex, ventral prefrontal cortex, and claustrum. Increases have been reported in the volume of the lateral ventricles, globus pallidus, subgenual anterior cingulate, and amygdala as well as in the rates of deep white matter hyperintensities. Functional MRI findings suggest that abnormal modulation between ventral prefrontal and limbic regions, especially the amygdala, likely contributes to poor emotional regulation and mood symptoms. Pharmacological treatment of mania increases ventral prefrontal cortex (vPFC) activity, normalizing it relative

title: Bipolar II disorder

text: setting boundaries for one's perceptions and behaviors. Studies indicate that the following events may also precipitate relapse in BP-II patients: Scientists are studying the possible causes of bipolar disorder and most agree that there is no single cause. There have been very few studies conducted to examine the possible causes of Bipolar II. Those that have been done have not considered Bipolar I and Bipolar II separately and have had inconclusive results. Researchers have found that patients with either Bipolar I or II may have increased levels of blood calcium concentrations, but the results are inconclusive. The studies that have

title: Bipolar disorder

text: at least one manic episode, with or without depressive episodes, and as bipolar II disorder if there has been at least one hypomanic episode (but no manic episodes) and one major depressive episode. In those with less severe symptoms of a prolonged duration, the condition cyclothymic disorder may be diagnosed. If the symptoms are due to drugs or medical problems, it is classified separately. Other conditions that may present similarly include attention deficit hyperactivity disorder, personality disorders, schizophrenia and substance use disorder as well as a number of medical conditions. Medical testing is not required for a diagnosis, though blood

title: Bipolar disorder

text: individual will often deny that anything is wrong. What might be called a "hypomanic event", if not accompanied by depressive episodes, is often not deemed problematic, unless the mood changes are uncontrollable, or volatile. Most commonly, symptoms continue for a few weeks to a few months. Symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, irritability or anger, loss of interest in previously enjoyed activities, excessive or inappropriate guilt, hopelessness, sleeping too much or not enough, changes in appetite and/or weight, fatigue, problems concentrating, self-loathing or feelings of worthlessness, and thoughts of death or suicide. In

title: Associated features of bipolar disorder

text: differential characteristics between the manic, hypomanic and depressive states. Some studies have found a significant association between bipolar disorder and creativity. Some limited long-term studies indicate that children who later receive a diagnosis of bipolar disorder may show subtle early traits such as subthreshold cyclical mood abnormalities, full major depressive episodes, and possibly ADHD with mood fluctuation. There may be hypersensitivity and irritability. There is some disagreement whether the experiences are necessarily fluctuating or may be chronic. Having parents with bipolar disorder is associated with increased risk of psychiatric disorders. There is limited research on the association between stimulant treatment

title: Bipolar II disorder

text: things: the treatment of acute hypomania, the treatment of acute depression, and the prevention of the relapse of either hypomania or depression. The main goal is to make sure that patients do not harm themselves. The most common treatment for reducing bipolar II disorder symptoms is medication, usually in the form of mood stabilizers. However, treatment with mood stabilizers may produce a flat affect in the patient, which is dose-dependent. Concurrent use of SSRI antidepressants may help some with bipolar II disorder, though these medications should be used with caution because it is believed that they may cause a hypomanic

title: Biology of bipolar disorder

text: abnormalities support the prefrontal-striatal-pallidial-thalamic limbic network underlying dysfunction in emotional regulation in bipolar disorder. Strakowski, Along with DelBello and Adler have put forward a model of "anterior limbic" dysfunction in bipolar disorder in a number of papers. Green at al 2007 suggested a model of bipolar disorder based on the convergence of cognitive and emotional processing on certain structures. For example, the dACC and sgACC were cognitively associated with impairment of inhibition of emotional responses and self monitoring, which could translate to emotional stimuli having excessive impact on mood. Deficits in working memory associated with abnormal dlPFC function could also

title: Bipolar II disorder

text: depression. A large part of this plan involves the patient being very aware of warning signs and stress triggers so that they take an active role in their recovery and prevention of relapse. Several studies have shown that the risk of suicide is higher in patients who suffer from Bipolar II than those who suffer from Bipolar I, and especially higher than patients who suffer from major depressive disorder. In results of a summary of several lifetime study experiments, it was found that 24% of Bipolar II patients experienced suicidal ideation or suicide attempts compared to 17% in Bipolar I

title: Bipolar II disorder

text: interference in other chronic medical illnesses such as cancer. This social impairment can last for years, even after treatment that has resulted in a resolution of mood symptoms. The factors related to this persistent social impairment are residual depressive symptoms, limited illness insight (a very common occurrence in patients with Bipolar II Disorder), and impaired executive functioning. Impaired ability in regards to executive functions is directly tied to poor psychosocial functioning, a common side-effect in patients with Bipolar II. The impact on a patient's psychosocial functioning stems from the depressive symptoms (more common in Bipolar II than Bipolar I). An

title: Bipolar II disorder

text: course of the illness leads to an increased risk in suicide and more hypomanic and major depressive episodes with shorter periods between episodes than bipolar I patients experience. The natural course of bipolar II disorder, when left untreated, leads to patients spending the majority of their lives unwell with much of their suffering stemming from depression. Their recurrent depression results in personal suffering and disability. This disability can present itself in the form of psychosocial impairment, which has been suggested to be worse in bipolar II patients than in bipolar I patients. Another facet of this illness that is associated

title: Bipolar I disorder

text: taken. Drug screening includes recreational drugs, particularly synthetic cannabinoids, and exposure to toxins. Mood stabilizers are often used as part of the treatment process. Antidepressant-induced mania occurs in 20-40% of people with bipolar disorder. Mood stabilizers, especially lithium, may protect against this effect, but some research contradicts this. Information on the condition, importance of regular sleep patterns, routines and eating habits and the importance of compliance with medication as prescribed. Behavior modification through counseling can have positive influence to help reduce the effects of risky behavior during the manic phase. Additionally, the lifetime prevalence for bipolar I disorder is estimated

title: Bipolar disorder

text: antimanic effect. In cases of comorbid ADHD and bipolar, stimulants may help improve both conditions. Several studies have suggested that omega 3 fatty acids may have beneficial effects on depressive symptoms, but not manic symptoms. However, only a few small studies of variable quality have been published and there is not enough evidence to draw any firm conclusions. A lifelong condition with periods of partial or full recovery in between recurrent episodes of relapse, bipolar disorder is considered to be a major health problem worldwide because of the increased rates of disability and premature mortality. It is also associated with

title: Bipolar disorder

text: of bipolar disorder, and returns to normal levels once the phase is over. The increase in "gamma"-Aminobutyric acid (GABA) is possibly caused by a disturbance in early development causing a disturbance of cell migration and the formation of normal lamination, the layering of brain structures commonly associated with the cerebral cortex. Medications used to treat bipolar may exert their effect by modulating intracellular signaling, such as through depleting myo-inositol levels, inhibition of cAMP signaling, and through altering G coupled proteins. Consistent with this, elevated levels of G, G, and G have been reported in brain and blood samples, along with

title: Bipolar disorder

text: and 11 percent (identical and fraternal twins, respectively), with a relatively lower ratio for bipolar II that likely reflects heterogeneity. There is overlap with major (unipolar) depression and if this is also counted in the co-twin the concordance with bipolar disorder rises to 67 percent in identical twins and 19 percent in fraternal twins. The relatively low concordance between fraternal twins brought up together suggests that shared family environmental effects are limited, although the ability to detect them has been limited by small sample sizes. Behavioral genetic studies have suggested that many chromosomal regions and candidate genes are related to

title: Treatment of bipolar disorder

text: effective and may even induce mania. They should not be used alone, but may be considered as an adjunct to lithium. A recent large-scale study found that severe depression in patients with bipolar disorder responds no better to a combination of antidepressant medications and mood stabilizers than it does to mood stabilizers alone and that antidepressant use does not hasten the emergence of manic symptoms in patients with bipolar disorder. The concurrent use of an antidepressant and a mood stabilizer, instead of mood stabilizer monotherapy, may lower the risk of further bipolar depressive episodes in patients whose most recent depressive

title: Biology of bipolar disorder

text: in the CLOCK gene have been tested for association, although findings have been inconsistent, and one meta analysis has reported no association with either bipolar or major depressive disorder. Other circadian genes associated with bipolar at relaxed significance thresholds include ARTNL, RORB, and DEC1. One meta analysis reported a significant association of the short allele of the serotonin transporter, although the study was specific to European populations. Two polymorphisms in the tryptophan hydroxylase 2 gene have been associated with bipolar disorder. NFIA has been linked with seasonal patterns of mania. One particular SNP located on CACNA1C that confers risk for