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Bipolar Disorder - Manic Depression


Bipolar disorder, also known as manic depression, is one of the most treatable of the mental illnesses. Approximately two million Americans suffer from bipolar disorder, which involves episodes of mania -- in which a person feels extremely "high", energetic, and/or irritable -- followed by a period of depression, which is characterized by feelings of sadness and hopelessness. These mood swings of bipolar disorder can be separated by periods during which the person experiences normal moods. The illness typically begins in adolescence or early adulthood. Generally, bipolar disorder treatment is sought less than three months after symptoms are first experienced.



Bipolar disorder can be difficult to recognize and diagnose. The illness may appear as symptoms of other illnesses or may co-occur with problems such as substance abuse. Also, during hypomania, the individual may be very energetic, reckless, and have unrealistically grandiose thoughts or ideas -- and not realize that there is a problem. At different times, people with the disease exhibit symptoms of mania and depression.


Symptoms of Mania

  • Increased energy, activity, restlessness, racing thoughts and rapid talking

  • Tendency to become easily distracted 

  • Denial that anything is wrong 

  • Excessive "high" or euphoric feelings 

  • Extreme irritability

  • Decreased need for sleep

  • Extreme exaggeration of one's abilities and powers

  • Uncharacteristically poor judgment 

  • Hypersexuality 

  • Abuse of drugs, including cocaine, alcohol and sleeping medications 

  • Provocative, intrusive, or aggressive behavior


Symptoms of Depression

  • Insomnia, sleeping too much, awakening in early morning, interrupted sleep

  • Fatigue or loss of energy

  • Irritability and restlessness

  • Reduced appetite and weight loss, or weight gain and increased appetite

  • Indifference to very important situations

  • Loss of interest or lack of pleasure in activities, including sex

  • Difficulty concentrating, remembering, or making decisions

  • Feelings of guilt and hopelessness; a sense of being worthless

  • Thoughts of death or suicide, including suicide attempts

  • Abuse of drugs, including cocaine, alcohol and sleeping medications

  • Persistent physical symptoms that don't respond to treatment (such as chronic pain or digestive disorders)



Bipolar disorder may be linked to a variety of causes.

  • Heredity No specific genetic link to bipolar disorder has been found; however, studies show that 80 to 90 percent of individuals with bipolar illness have relatives with some form of depression. It is generally thought that some individuals inherit a predisposition to bipolar disorder.

  • Environmental Stress Stress takes many forms, from biological trauma during fetal development to the crises of everyday life. Such stresses interact with inherited vulnerabilities to produce disruptions in brain chemistry that underlie bipolar illness.




Appropriate medications, such as lithium, Tegretol, Depakote, and sometimes antipsychotic medications, are essential in controlling the illness. Without these medications, bipolar illness can result in extremely harmful outcomes.


Psychoeducation and Support

Once stabilized on medicine, individuals with bipolar illness can make use of education, support, and vocational groups. Individual counseling can often provide the necessary support for maintaining appropriate treatment.






Shizophrenia is a serious disorder that affects how people think, feel, act, and respond to conditions around them. About one percent of the world population suffers from the illness. In the United States, this equates to roughly 2.5 million individuals.


Someone with schizophrenia has difficulty distinguishing between what is real and what is imaginary. The person is often socially unresponsive and withdrawn, and has trouble expressing normal emotions in social situations. The vast majority of sufferers are not violent and pose no threat to others. Symptoms vary among individuals and usually appear between the ages of 15 and 25, often earlier in males than females. Generally, treatment for schizophrenia is sought two to four years after the first onset of symptoms.



Schizophrenia may develop slowly over months or years, but symptoms may also appear suddenly. The illness may come and go in cycles. Persistent behaviors (lasting two weeks or more) that may be early warning signs of schizophrenia include:


·         Hearing or seeing something that isn’t there

·         A constant feeling of being watched 

·         A change in personal hygiene and appearance 

·         Personality change

·         Indifference to very important situations 

·         Deterioration in academic or work performance 

·         Increasing social withdrawal 

·         Irrational, angry, or fearful response to loved ones 

·         Inability to sleep or concentrate 

·         Inappropriate or bizarre behavior

·         Strange physical posturing 

·         Peculiar or nonsensical way of speaking or writing

·         Extreme preoccupation with religion or the occult


Positive and negative symptoms

With schizophrenia, some factors represent disturbing symptoms by virtue of being present in the person’s personality when they shouldn’t be. These "positive" symptoms may include:


·         False or delusional ideas, such as believing that people are spying on the individual, or that s/he is a famous personality.

·         Hallucinations and imaginary voices that give commands or make comments to the individual. Although less common, the person may also see, feel, taste, or smell something that doesn’t really exist. 

·         Disordered thinking and speech that moves from topic to topic without any apparent logic or reasoning. Sometimes, individuals with schizophrenia make up their own words.


Negative symptoms

Sometimes abnormality associated with schizophrenia is characterized by virtue of functions that are missing from the person’s personality. These negative symptoms may include:


·         Social withdrawal

·         Extreme apathy

·         Lack of drive or initiative

·         Lack of emotional response

·         Speaking very little or not at all


Cognitive Dysfunction

It is being increasingly recognized that individuals with schizophrenia often experience problems in attention, memory, problem solving, and organization of thoughts. These problems are referred to as cognitive dysfunction. Cognitive dysfunction is more associated with community function than the degree of hallucinations or delusions.



The most widely accepted causes are thought to result in a biological vulnerability to psychosis.


·         Genetics Schizophrenia tends to run in families, and a person can inherit a tendency to develop the disease. Generally, symptoms appear when the body undergoes hormonal and physical changes, such as those occurring during puberty and early adulthood.

·         Viral infections and immune disorders Symptoms of schizophrenia may appear when an individual’s genetic predisposition to the disease, coupled with stress caused by certain environmental events, leads to a chemical imbalance. Viral infections or highly stressful situations—or a combination of both—may precede symptoms of the illness. Immune disorders may also contribute to the illness. 

·         Brain chemistry People with schizophrenia have an imbalance of the brain chemicals serotonin and dopamine, which are neurotransmitters that allow the brain to send messages among its nerve cells. Because of the chemical imbalance, sensory stimuli can cause dramatic reactions in a person with schizophrenia. Problems in processing sounds, sights, smells, and tastes can also lead to hallucinations or delusions.


Types of schizophrenia

·         Paranoid schizophrenia A person is extremely suspicious, acts in a grandiose manner, believes s/he is persecuted, or experiences a combination of these emotions or behaviors.

·         Disorganized schizophrenia The individual is often incoherent and exhibits disorganized behavior, but may not have delusions.

·         Catatonic schizophrenia The person is withdrawn, mute, negativistic, and sometimes assumes very unusual postures.

·         Residual schizophrenia Although no longer experiencing delusions or hallucinations, the individual has little motivation or interest in life. These symptoms can be most devastating.



No cure for schizophrenia has been discovered, but with proper treatment, many people with this illness can lead productive and fulfilling lives. Early treatment—ideally as early as the first episode—can mean a higher remission rate and a better long-term outcome.



Pharmacological therapy is the first step in the treatment of schizophrenia. Two major types of medications are currently prescribed: conventional antipsychotics; and the new generation of antipsychotic medications, introduced in the 1990s, which are called atypical antipsychotics. Conventional antipsychotics effectively control symptoms such as hallucinations, delusions, and confusion. Side effects are common with these drugs. Atypical antipsychotics are as effective as the older medications but with fewer, less intense side effects. As with all medication, these should not be taken without close professional supervision.


Schizophrenia is usually a lifelong disease, and most people with the illness will probably take medication for the rest of their lives, as do people with diabetes, high blood pressure, or heart disease.


Nonpharmacological therapies, structured

It is important to establish a daily routine for the person suffering from schizophrenia. Different forms of group and individual therapies can help both the clients and family members better understand the illness and share their coping problems.


Rehabilitation can help individuals regain the confidence to take care of themselves and experience a positive life.

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