Bipolar affective disorder
Bipolar affective disorder( BAP) or manic-depressive psychosis in most cases manifests itself as manic( active) or depressed( apathetic) states of a person( individually or mixed among themselves), a disorder of the psychic perception of oneself as a person. The mixing of states in such patients can often be observed in the coexistence of simultaneously directly opposite states - a deep depression proceeds with a state of euphoria, sadness and anguish come with unreasonable excitement. The states are unstable and constantly succeed each other, there may be a period of time between them( in psychiatry - intermissions or interphases), when the patient is completely mentally healthy, really feels himself and performs his actions quite consciously. Patients with BAP often suffer from associated psychiatric disorders, such as schizophrenia, anxiety and depressive conditions.
The frequency of this diagnosis is difficult to reduce in a clear statistics, on average, the BAR occurs in 4-5 people out of 1000, equally often this disorder affects both men and women, most often manifested in the age of 20 to 30 years. Note that the symptoms of BAR were manifested in due time by the famous artist from Holland, Vincent van Gogh, which shows that the disease is known for a long time. For the first time the term manic-depressive psychosis was designated in 1896 by Emil Krepelin.
The causes of the appearance of the disease have not been accurately established so far, the last decade research has been conducted to confirm the theory of hereditary predisposition and possible genetic malfunction that leads to BAP.Specialists identify several main factors that have a bipolar affective disorder:
- is the strongest postpartum depression in women;
- long-term use in large quantities of alcohol and drugs;
- frequent stressful conditions;
- previously diagnosed unipolar depression;
- state of the environment.
The peculiarity of the disease is that it is difficult to diagnose, similar symptoms can be experienced by people with AIDS, syphilis and lupus. Often, to establish the correct accurate diagnosis, it takes 5 to 8 years from the first referral of a person for medical care( all this time the doctor examines the patient and monitors changes in his condition).Strong recurrences of BAP on average appear 1-3 times a year, in some patients 1 time in 2-3 years. The number of successive phases( mania, apathy, aggression, agitation, depression) in each patient is strictly individual, for a lifetime there can be only one phase. With MAP of mild and moderate severity, manic and depressive phases have a duration of several weeks to one and a half years( most often several months).Intermission( the phase of health) in these patients lasts from 3 to 10 years. In severe disease, the phases can alternate with each other several times a day, which complicates treatment. The depressive phase in such patients is most dangerous, since suicidal thoughts appear. The danger of BAP is not only in the possibility of suicide. Because of frequent changes in mood and emotional imbalance, the person's ability to work is severely limited.
How to understand that you or your loved one have such a disorder?
The main common symptoms are:
- impairment of mental and physical condition;
- unusual behavior;
- sleep disturbance;
- causeless mood swings.
For the manic and depressive stage the symptoms are divided, they should be considered separately.
In this stage, the patient has an elevated mood, a state of excitement and euphoria. Distinctive features are:
- increased irritability;
- changeable thoughts;
- strong talkative;
- increased self-esteem;
- reduces sleep time;
- short temper and impulsiveness;
- increases the craving for pleasure and pleasure - an uncontrolled waste of money, frequent changes in sexual partners, use of alcohol, drugs, illegal drugs;
- in case of severe illness there are hallucinations.
The patient is often without mood, sad for no apparent reason, feels useless and helpless. Often at this stage, the patient can take methamphetamines and other drugs to suppress depression. Symptoms are:
- reduced self-esteem and a sense of impairment;
- frequent causeless pain, bouts of crying;
- movement disintegration, slowness and slurred speech;
- loss of appetite;
- insomnia or vice versa increased drowsiness;
- desire to commit suicide;
- a sense of loneliness and guilt;
- a breakdown, the inability to focus on any action.
Visit to a doctor
Before visiting a doctor, a person who has noticed symptoms of BAP, it is worth collecting some information about yourself. To find out who in the family had mental disorders and which ones, to consider the probable causes of stress( the situation in the family, at school and work), take an extract from the outpatient card about previous serious illnesses and injuries, a list of medicines and additives that have been taken now or earlier. The doctor should tell all about his lifestyle, bad habits, symptoms noticed. It is worth making a list of questions about the BAR that you are interested in. The main thing is not to be afraid to go to the reception, because the early diagnosis of the disease will increase the duration of the phases of health, preserve the habitual way of life and take the course of the disease under control.
Prognosis and treatment of
BAR has difficulties not only in diagnosis, but also in treatment. Cure of this disease is impossible, but you can take it under control and greatly alleviate the condition of the patient. In the severe course of the disease and manic stage, lithium preparations are used for treatment - they reduce aggression and excitement, improve the overall condition. When taking such medications, the number of suicides decreases, the average life expectancy of patients increases. Before the reception begins, a kidney examination is performed( lithium toxins can accumulate in the kidneys), revealing skin diseases - taking lithium drugs can complicate the course of acne and psoriasis. When prescribing therapy with lithium drugs, it is necessary to do a biochemical blood test every 6 months. A good therapeutic effect is olanzapine treatment for those patients who have suffered from 1 to 5 episodes of the disease, with more of them being used as maintenance therapy. To regulate mood, anticonvulsants, antidepressants and sedatives are prescribed.
The heaviest patients receive intravenous antipsychotics. Doses should be taken moderately to avoid lithium intoxication of the body and combine treatment. With age, doses of drugs are reduced, since aging, the body can not fully derive the decay products of the components of the drugs. In cases of ineffective medication, the patient receives electroconvulsive therapy. In addition to medical treatment, patients undergo psychotherapy courses( individual, group and family).Family psychotherapy will teach family members how to live and communicate with their close and native people suffering from BAP.Timely diagnosis of BAP, properly selected treatment and compliance with all instructions of the doctor will save the patient the joy of life and facilitate his condition.