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About
Bipolar
(View Additional Pages Below) |
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Like most human conditions, Bipolar
Disorders are now considered to exist on a spectrum
rather than in discrete categories. A good way of understanding
the bipolar spectrum shift is to look at an analogy
from another physical disorder - hypertension. The line
between normal and abnormal is determined by looking
at measurable indices that determine when treatment
is indicated - a continuum underlies the categorical
determination. The lines is somewhat arbitrary and may
move over time.
In the past, "manic-depression" as used to be called
was seen categorically-either you had it or you didn't.
Then in the 1970's, researchers learned that some people
didn't experience the full debilitating levels of mania
(e.g., psychosis, extreme levels of agitation, insomnia,
and euphoria) but they did have elevated mood and energy
states. "Bipolar II" was then coined to describe this
less intense form of bipolar disorder. In addition,
family member of people with bipolar disorder have been
repeatedly shown to have an increased risk for mood
disorders but range in the severity of their symptoms
indicated that these different syndromes may be genetically
linked. In fact, studies of identical twins show that
if one twin has bipolar disorder, the other has an 80%
chance of having it too. Because of this emerging evidence,
many are looking at the spectrum even more broadly.
With this perspective as much as 6.4 percent (Judd and
Akiskal, 2003) of the entire population can be thought
to have a bipolar spectrum disorder - significantly
higher prevalence than what was originally thought.
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- Bipolar
I - is
distinguished by severe depression and full-blown
manic episodes. During mania people might experience
boundless energy, racing thoughts, grandiose self-image,
intense restlessness, agitation, and reckless behavior
(e.g., spending great amounts of money, hyper-sexuality,
substance abuse). Sometimes people may also experience
psychosis during acute mania (seeing or hearing
things that are not there or having delusional thoughts).
About 1% of the general populations will have Bipolar
I (National Institute of Mental Health, 2003). Varying
degrees of anger, anxiety, problems with concerntation
and suicidal thoughts may be experienced by many
people along the bipolar spectrum.
- Bipolar
II - is more common, affecting 4-5% of
the general population (Judd and Akiskal, 2003).
While people with Bipolar II experience depression,
they do not experience full-blown mania. Instead,
they have a milder version called hypomania. Hypomania
is characterized by increased energy and a sense
of well-being with decreased need for sleep and
often poor judgment (although not as extreme as
mania).
- Cyclothymia
- is another milder version of bipolar disorder
that vacillates between a mild depression (or dysthymia)
and hypomania. · Rapid Cycling Bipolar Disorder
- occurs when there are frequent mood changes (four
or more episodes of mania and/or depression in a
12-month period).
- Hyperthymia
- another point on the bipolar continuum is characterized
by high energy, confidence, and activity; it is
more energetic than a normal mood but less so than
mild forms of mania (hypomania).
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