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Bipolar Disorder Counseling in Broken Arrow for Tulsa Metro Area Residents

By Alina Morrow, LPC

Disclaimer: The article below is for informational purposes only and should not be considered as direct advice, a personal diagnosis, or as an individual treatment plan. Always consult with a mental health professional or medical doctor if you have concerns.

Introduction & Overview

Bipolar disorder, also known as manic depression, is a psychological (mood) disorder characterized by dramatic mood swings between mania (a mental state when the person feels happy, full of energy and extremely active) and depression (a mental state when the person feels down, sad, has no energy and is incapable of being active and productive).

Bipolar

Every person experiences ups and downs over their life span. The difference between normal mood swings and bipolar mood swings is the severity level of the symptoms and their impact on the persons life. Bipolar disorder mood swings interfere with all the aspects of the persons life: social, personal, and work related. The person has poor work or school performances, develops dysfunctional relationships with those that he or she comes in contact with, and may also plan to commit suicide. These mood swings can be frightening, disturbing, and distressful for the person that suffers from this disorder, for his or hers family, and those people that interact with the sick person.

Approximately 2.6 percent of the population or 5.7 million Americans suffer from bipolar depression, and this disorder is equally prevalent between men and women. It affects people from every social class, race, age group, and ethnic group.

Bipolar disorder usually develops in late adolescence or early adulthood and continues throughout life. There are cases when the disorder is diagnosed in children or elders. Bipolar disorder seems to run in the family. If one of the parents suffer from bipolar disorder, children have a higher risk to develop the disorder than general population.

A Mental Health Report of US Surgeon General has listed bipolar disorder on of the 10 leading causes of disability in the USA together with unipolar depression, schizophrenia, and obsessive-compulsive disorder.

Symptoms of Bipolar Disorder

Bipolar disorder symptoms are divided in two main categories:

1. Symptoms of mania, include:

  • Increased energy and activity,
  • Restlessness,
  • Excessively euphoric, good, or “high” mood,
  • Extreme irritability,
  • Increased talking
  • Racing thoughts (flight of ideas),
  • Distractibility and lack of concentration,
  • Decreased need for sleep,
  • Unrealistic beliefs in his/hers abilities,
  • Poor judgment and impulsive behaviors,
  • Increased sexual drive,
  • Drugs’ abuse,
  • Provocative, intrusive, or aggressive behavior.

2. Symptoms of depression, include:

  • Sad, anxious, or empty mood,
  • Feelings of guilt, worthlessness, helplessness, hopelessness, or pessimism,
  • Lack or decreased interest or pleasure in almost all activities,
  • Decreased energy and increased fatigue,
  • Restlessness of irritability,
  • Insomnia or hypersomnia,
  • Changes in appetite accompanied by weight gain or loss,
  • Chronic pains and aches that are not caused by physical injuries or illnesses,
  • Suicide thoughts and even suicide attempts.

Bipolar Disorder Types

There are three types of bipolar disorder:

Bipolar I
Bipolar I Disorder is a form of bipolar disorder where the person experiences one or more manic episodes or mixed episodes.

A maniac episode is a distinct period characterized by

  1. an abnormal and persistent elevated, expansive, or irritable mood;
  2. an inflated self-esteem or grandiosity;
  3. decreased need to sleep;
  4. distractibility;
  5. increased need to talk or pressure to keep talking;
  6. increased involvement in goal-directed activities with high potential of painful consequences; and
  7. psychomotor agitation that lasts at least 1 week.

A mixed episode is a distinct period characterized by rapidly alternating moods between sadness, irritability, and euphoria.

Bipolar I disorder is a recurrent disorder, more than 90 percent of those that experience a manic episode will have future similar episodes. The average onset of bipolar I disorder is around the age of 20 for both men and women.

Bipolar II
Bipolar II Disorder is a form of bipolar disorder where the person experiences one or more major depressive episodes (period characterized by depressed mood and lack of interest in nearly all activities that last at least 2 weeks) followed by at least one hypomanic episode (a mild form of mania).

This type of bipolar disorder seems to be more common among women than men. Gender seems to be related to the number and type of hypomanic and major depressive episodes. In men, the number of hypomanic episodes is equal or exceeds the number of major depressive episodes, while in women, major depressive episodes are predominant.

Bipolar II disorder prevalence is approximately 0.5 percent.

Cyclothymia
Cyclothymia (also known as cyclothymic disorder) is a chronic, fluctuating mood disturbance that involves numerous periods of hypomanic symptoms and depressive symptoms.

Hypomanic symptoms include the following:

  • Abnormal and persistent elevated, expansive, or irritable mood.
  • An inflated self-esteem or grandiosity.
  • Decreased need to sleep.
  • Distractibility.
  • Increased need to talk or pressure to keep talking.
  • Increased involvement in goal-directed activities with high potential of painful consequences, but without gross lapses of judgment or impulsive behavior.
  • Psychomotor agitation.

Depressive symptoms include:

  • Depressed mood and/or diminished interest or pleasure in nearly all activities.
  • Changes in appetite, weight, sleep and psychomotor activity.
  • Decreased energy.
  • Feelings of worthlessness or guilt.
  • Difficulty thinking, concentrating, and making decisions.
  • recurrent thoughts of death, suicide ideation, plans, or attempts.

Depressed and hypomanic symptoms’ periods are shorter, less severe, and do not occur with regularity as in bipolar I and II disorder.

Cyclothymic disorder is equally present in men and women. It usual occurs during adolescence or early adulthood with an insidious onset and a chronic evolution.

Bipolar Disorder Treatment

Bipolar disorder can be effectively treated and prevented. Even people that suffer from most severe forms of bipolar disorder can achieve substantial symptoms stabilization with proper treatment. Unfortunately, many of those that suffer from bipolar disorder do not perceive the manic episodes as needing treatment due to the good feeling they experience, therefore they refuse to be treated. Treatment is usually sought when the problems and painful consequences (such as job loss, excessive debt, losing a loved person, and drug or alcohol abuse) occur.

Bipolar disorder is a recurrent disorder that needs a long-term prevention type treatment that combines medication with psychotherapy. A better outcome is achieved when the treatment is continued rather than when it occurs off and on.

There are two main treatment approaches:

I. Medication:
The most effective medication used to treat bipolar disorder is known as mood stabilizers. There are several options available for mood stabilization:

1. Mood-stabilizing medication, such as Lithium which is the first mood stabilizing medication approved by FDA to treat mania. This medication proves to be effective in controlling mania symptoms and preventing recurrence of manic and depressive episodes. Lithium is prescribed for children and adolescents that suffer from bipolar disorder.

2. Anticonvulsant medications: This category includes two medications: valproate (Depakote) and carbamazepine (Tegretol). These two drugs have mood stabilizing effects and have proven to be effective in treating difficult forms of bipolar episodes. Valproate and carbamazepine are prescribed for children and adolescents that suffer from bipolar depression. However, there is evidence that valproate may cause adverse hormone changes in teenage girls and polycystic ovary syndrome in women that have been treated with this drug before the age of 20. For a better outcome, anticonvulsant medication is administrated in combination with lithium.

There are several other new anticonvulsant medications, such as lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax), that can be prescribed for bipolar disorder patients. However, these new medication are being studied in clinical trails to determine their effectiveness in stabilizing mood swings.

3. Atypical antipsychotic medication: This category includes: clopazine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quatrain (Seroquel), and ziprasidone (Geodon). However, this medication is still being studied in clinical trials to determine whether it is effective in treating bipolar disorder. There is evidence that clozapine is being helpful to stabilize mood swing in people that do not respond to lithium or anticonvulsant medication. Olanzapine also has proven its efficacy in controlling acute mania symptoms.

In some cases, other type of medication can be prescribe for a short period of time to control other symptoms associated with bipolar disorder. For example if insomnia becomes a problem, the psychiatrist might prescribe high-potency benzodiazepine medication (such as clonazepam - Klonopin, or lorazepam - Ativan®). This type of medication is highly addictive and is prescribed for a short period of time. To avoid the addictive effect, the specialist might prescribe a sedative (such as zoplidem - Ambien).

Medication prescribed to control and prevent mood swing can cause a series of side effects that include: dry mouth, weight gain, nausea, tremors, reduced sexual drive and performance, anxiety, hair loss, and movement problems.

II. Psychotherapy:
In addition to medication, psychotherapy is an effective treatment that provides support, education, guidance and help for those that suffer from bipolar disorder and their families. Usually, this type of treatment focuses on adjusting to life problems caused by the disorder, identifying the onset of both types of episodes (maniac and depressive), developing functional responses, and helping the person to accept, cope, and manage the disorder.

There are several approaches used to help people with bipolar disorder:

1. Cognitive behavioral therapy: This form of psychotherapy helps those that suffer from bipolar disorder to change their negative and dysfunctional thoughts and behaviors’ patterns associated with the disorder for a better symptoms management.

2. Psychoeducation: This is a form of therapy that focuses on teaching those that suffer from bipolar disorder and their families to understand the disorder, the treatment approach, and to recognize the disorder symptoms and relapse signs.

3. Family therapy: This is a form of psychotherapy that focuses on the family as a unit where each member plays an significant role in the disorder. The purpose of the family therapy is to reduce the level of distress experienced by the family which affects the relationship between its members and can contribute to the sick person symptoms.

4. Interpersonal and social rhythm therapy: This is a form of psychotherapy specially developed to treat those that suffer from bipolar disorder. It is based on sleep deprivation and circadian rhythm disturbance caused by the disorder. It help the person who suffers from bipolar disorder to improve his or her interpersonal relationships and to regularize his or hers everyday routines. A regular daily activity routine, a regular eating routine, and a sleep schedule can help the person to prevent manic episodes.

Related Information:

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Do you suffer with bipolar disorder? Tired of what it is doing to your life? Contact Tulsa Therapist Alina Morrow, LPC, today to make an appointment and get the help and relief you deserve. You can reach me by texting or calling 918-403-8873 or by Email.

Page Last Updated: October 30, 2016

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