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What is Bipolar Disorder?
It’s possible that you or someone you know is affected by bipolar disorder. Bipolar disorder can be a life-altering illness, but it is also treatable. With the right blend of medication and counseling, many people with bipolar disorder can live healthy, happy lives.
Dr. Wu of Meadows Psychiatry LLC is a board-certified psychiatrist with vast experience treating adolescents and adults with bipolar disorder and a wide variety of other mental health conditions. He specializes in cognitive-behavioral therapy but also has a firm grasp of psychopharmacology, ensuring that you are prescribed medication tailored to treat your bipolar disorder with the best results and minimal side effects.
What is bipolar disorder?
Bipolar disorder (previously known as manic depression) is a mental disorder characterized by mood swings between extremes – emotional lows (depression) and highs (hypomania). Mood swings can affect energy levels, sleep, judgment, thinking ability, behavior, and activity.
Mood episodes can be rare or regular throughout the year. Some people may have emotional symptoms between these episodes, while others do not. Despite being a lifelong mental illness, the mood swings and accompanying symptoms can be controlled with an effective treatment plan.
After a thorough psychiatric assessment, Dr. Wu will develop a customized treatment plan, which includes medication and psychotherapy to help improve your quality of life.
Types of bipolar disorder
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
What is Bipolar I Disorder?
Patients with bipolar I disorder have suffered at least one episode of mania in their life. A manic episode is a period of persistent and abnormally expansive, irritable, or elevated mood typically lasting seven days.
A person with bipolar I disorder can experience episodes of major depression before or after having a manic episode. Often, they may cycle between episodes of major depression and episodes of mania, which disrupt their daily life.
Other associated manic symptoms can include:
Significantly increased physical activity levels, which can present as being abnormally jumpy, upbeat, or “wired”
An exaggerated sense of self-confidence or well-being
Making poor decisions like taking sexual risks or making a foolish investment
What is Bipolar II Disorder?
Patients with bipolar II disorder have experienced at least one hypomanic episode. Symptoms of hypomania are the same as those of a manic episode; except the severity of the symptoms tends to be milder and occur for at least 4 days.
In addition to experiencing at least one hypomanic episode, patients with bipolar II disorder should have experienced at least one major depressive episode.
A major depressive episode involves having at least five of the depressive symptoms listed below during a two-week period and signifies a change from previous functioning:
Individuals with bipolar disorder often have mental disorders like substance use disorder and anxiety disorders. The former usually exacerbates symptoms of hypomania and depression.
What is cyclothymic disorder (also known as cyclothymia)?
Adults with cyclothymic disorder have multiple periods of hypomanic symptoms (that don’t meet the full diagnostic criteria for hypomanic episodes) and multiple periods of depressive symptoms (that don’t meet the full diagnostic criteria for a major depressive episode) for at least 2 years. In adults, the hypomanic periods and depressive periods occur for at least half of the 2 year timeframe.
Children and adolescents with cyclothymic disorder have multiple periods of hypomanic symptoms (that don’t meet the full diagnostic criteria for a hypomanic episode) and multiple periods of depressive symptoms (that don’t meet the full diagnostic criteria for a major depressive episode) for at least 1 year. In children and adolescents, periods of hypomanic symptoms and periods of depressive symptoms occur for at least half of the 1 year timeframe.
Of note, a person with cyclothymic disorder may not have hypomanic symptoms or depressive symptoms for up to 2 months.
What is unspecified bipolar and related disorder?
This is used as a diagnosis when symptoms commonly found in a bipolar and related disorder cause significant problems in a person’s ability to function in daily life but don’t meet the full diagnostic criteria for any of the different types of bipolar and related disorders.
Specifiers for Bipolar and Related Disorders:
- with rapid cycling – this is used as a specifier for bipolar I or II disorder when 4 or more distinct mood episodes of major depression, mania, or hypomania have occurred in the past 12 months. A distinct mood episode is distinguished by a period of remission that lasts at least 2 months.
A distinct mood episode can also be distinguished when there is a switch of the mood episode to the opposite end of the spectrum. For example, a manic episode switches into a major depressive episode.
- with mixed features – this is used as a specifier for bipolar I or II disorder when several depressive symptoms and several manic/hypomanic symptoms are present in the same mood episode.
- with seasonal pattern – this is used as a specifier for bipolar I or II disorder when the onset of a particular mood episode (major depression, mania, or hypomania) occurs during a particular season or time of the year.
- These specifiers go a long way in helping mental health professionals discuss and treat your mental condition successfully.
An accurate diagnosis of bipolar disorder may include the following:
- Physical exam –Oftentimes, your primary care physician will perform a physical examination in addition to ordering lab work to rule out any underlying medical illnesses or physiological conditions that can mimic symptoms of bipolar disorder.
- Psychiatric assessment – Dr. Wu of Meadows Psychiatry LLC will talk to you about your behavioral patterns, feelings, and thoughts. You might also fill out a questionnaire and a psychological self-assessment. Close family members and friends might also be requested to shed some light on your symptoms.
- Mood charting – Dr. Wu will request you to keep a daily record of your mood, sleep patterns, and other symptoms that may help with diagnosis.
- Diagnosis criteria – Dr. Wu will compare your symptoms to those of bipolar and other mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association.
Diagnosis of bipolar illness in teenagers and children is similar to that of adults. However, the symptoms in children and adolescents are different and might not fit the diagnostic criteria for bipolar disorder in adults.
Children and teens are affected by other mental disorders, which can include Disruptive Mood Dysregulation Disorder, Oppositional Defiant Disorder, Reactive Attachment Disorder, and Conduct Disorder. Dr. Wu is experienced in handling mental disorders that affect both adults and teens.
How is bipolar disorder treated?
Bipolar disorder treatment is often done with prescription drugs. Bipolar disorder medication includes:
- Mood stabilizers – these are key in controlling episodes of hypomania or mania. Examples include carbamazepine, lamotrigine, lithium, and valproic acid.
- Antipsychotic drugs – these may be prescribed along with mood stabilizers. They include risperidone, aripiprazole, olanzapine, quetiapine, ziprasidone, and lurasidone.
- Antidepressant drugs can be used to treat depressive symptoms from bipolar depression. But since they can often trigger manic episodes if taken by themselves, they are only typically prescribed in low doses in conjunction with mood stabilizers and/or antipsychotics.
Because of his expertise in medication management, Dr. Wu will monitor your prescription medications to increase efficacy and minimize side effects.
In addition to bipolar medication, Dr. Wu may explore certain treatment options, including:
- Psychotherapy – he’ll use cognitive-behavioral therapy to identify and replace negative and unhealthy behaviors and beliefs. Meadows Psychiatry LLC also utilizes concepts of social rhythm therapy to develop a constant daily routine for mood management.
- Lifestyle recommendations – Dr. Wu will educate and advise you on the proper diet, exercise, and sleep routine to help you manage your symptoms of bipolar disorder