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. , Behavioral genetic studies have suggested that many chromosomal regions and candidate genes are related to bipolar disorder susceptibility with each gene exerting a mild to moderate effect. Clinical features also differ between those with late onset bipolar disorder and those who developed it early in life; the former group present with milder manic episodes, more prominent cognitive changes and have a background of worse psychosocial functioning, while the latter present more commonly with mixed affective episodes, and have a stronger family history of illness. ", Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy, DAVID L.DUNNER Interviewed by Thomas A.   The severity of manic symptoms can be measured by rating scales such as the Young Mania Rating Scale, though questions remain about the reliability of these scales.  The puer archetype is defined by the behaviors of spontaneity, impulsiveness, enthusiasm or mania and is symbolized by characters such as Peter Pan or the Greek god Hermes. ", "Online Bipolar Tests: How Much Can You Trust Them? Around 6-11% of children born to mothers that used the drug during pregnancy are born with birth defects. Psychotherapy also has a role in the treatment of bipolar disorder. For bipolar I disorder, the rate at which identical twins (same genes) will both have bipolar I disorder (concordance) is around 40%, compared to about 5% in fraternal twins. Manic episodes last for at least a week, but can last as long as three to six months. The specifier With Postpartum Onset can be applied to the current (or most recent) Major Depressive, Manic, or Mixed Episode of Major Depressive Disorder, Bipolar I Disorder, or Bipolar II Disorder or to Brief Psychotic Disorder if onset is within 4 weeks after delivery of a child.  A 2008 Cochrane systematic review found limited evidence to support the use of Omega-3 fatty acids to improve depression but not mania as an adjunct treatment for bipolar disorder. "Lithium: the pharmacodynamic actions of the amazing ion". Bipolar I disorder (BD-I; pronounced "type one bipolar disorder") is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Treatment was initiated at 0.125 mg t.i.d.  Lamotrigine has some efficacy in treating depression, and this benefit is greatest in more severe depression. , In light of recent evidence, olanzapine (Zyprexa) has been FDA approved as an effective monotherapy for the maintenance of bipolar disorder. Numerous notable people have had some form of mood disorder.  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. However, severity may differ widely across the globe.  However, the types of medications used in treating BD commonly cause side effects and more than 75% of individuals with BD inconsistently take their medications for various reasons. , There are conceptual and methodological limitations and variations in the findings. | National Guideline Clearinghouse", "The long-term impact of treatment with electroconvulsive therapy on discrete memory systems in patients with bipolar disorder", "Cannabis use and driving: implications for public health and transport policy", "Excessive cannabis use is associated with earlier age at onset in bipolar disorder", "Video Lecture: First and Second Generation Antipsychotics for the Treatment of Bipolar Disorder", https://en.wikipedia.org/w/index.php?title=Treatment_of_bipolar_disorder&oldid=985730315, CS1 maint: DOI inactive as of September 2020, Articles needing expert attention with no reason or talk parameter, Articles needing expert attention from May 2008, Medicine articles needing expert attention, Articles needing additional references from February 2012, All articles needing additional references, Articles with multiple maintenance issues, Articles with unsourced statements from March 2016, Articles with unsourced statements from August 2014, Articles with unsourced statements from June 2019, Creative Commons Attribution-ShareAlike License. , Changes in cognitive processes and abilities are seen in mood disorders, with those of bipolar disorder being greater than those in major depressive disorder.  The risk of affective switches is higher in biplar I depression; antidepressants are generally avoided in bipolar I disorder or only used with mood stabilizers when they are deemed necessary. , Monitoring is generally more frequent when lithium is being initiated, and the frequency can be decreased once a patient is stabilized on a given dose. Murray ED, Buttner N, Price BH.  Environmental risk factors include a history of childhood abuse and long-term stress. People who are in a depressive state are often sad and pessimistic.  It is also associated with co-occurring psychiatric and medical problems, higher rates of death from natural causes (e.g., cardiovascular disease), and high rates of initial under- or misdiagnosis, causing a delay in appropriate treatment and contributing to poorer prognoses. In the case of dead people only, individuals with a speculative or retrospective diagnosis should only be listed if they are accompanied by a source reflective of the mainstream, academic view. Mood stabilizers are often used as part of the treatment process.  The medication with the best overall evidence is lithium, which is an effective treatment for acute manic episodes, preventing relapses, and bipolar depression.  Stacey Slater, a character from the BBC soap EastEnders, has been diagnosed with the disorder. , The onset of a manic or depressive episode is often foreshadowed by sleep disturbance.  Children and adolescents with bipolar disorder have higher rates of significant difficulties with substance abuse, psychosis, academic difficulties, behavioral problems, social difficulties, and legal problems. , Hypomania is the milder form of mania, defined as at least four days of the same criteria as mania, but which does not cause a significant decrease in the individual's ability to socialize or work, lacks psychotic features such as delusions or hallucinations, and does not require psychiatric hospitalization.
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