Tracking and tweaking mood fluctuations

Human beings are animals programmed by nature to react instantly in response to threats and changes in our environment. You flinch when something flies at your head. You blush when you embarrassed. Over the course of any given day, your moods wax and wane. You can feel sad in the morning, elated in the afternoon, and relieved by dinnertime.

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Straying from your meds

Most  people have trouble accepting any diagnosis that requires them to change the way they live or increase the energy they must invest to remain healthy. If you tell a guy who eats four Mega Burgers a week that he needs to start consuming more broccoli and spinach and taking pills to control his high cholesterol, you´re sure to meet some resistance. Even if he accepts the diagnosis, order leaner cuts of meat, and increases his dietary intake of fruits and vegetables, he´s likely to slip occasionally and gorge on the full-fat menu items… with extra mayo.

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Utilizing your preventive medication

When you´re mired in the midst of a major mood episode, your doctor´s primary goal is to end the episode as quickly as possible, usually by prescribing psychiatric medication. This process treats the phase accute of the illness. If you´re having manic symptoms, your doctor likely prescribes lithium or another antimanic medication or increases the dose of the antimanic medication you´re taking. Íf you´re having a bout of depression, your doctor may prescribe one or more antidepressants or increase the dose of the antidepressant you´re currently taking.In either case, your doctor may prescribe a sedative to help you sleep.

For times when you´re symptom free, your doctor likely prescribes a maintenance dose of medication to function  as a prophylaxis- a fancy word for “preventive” You may be tempted to forgo the prophylaxis when you feel fine or when you feel hypomanic  (better than fine). However, continuing to take your medication is critical for the following reasons:
· Medication decreases your susceptibility to future mood episodes.
· Preventing mood fluctuations minimizes the risk of new episodes.
· Many medications require several days or weeks to build uo to a therapeutic level in your level in your system- the level at which they can effectively maintain your mood. By taking your medications as prescribed, you keep them at their therapeutic levels.
· Keeping medication levels stable prevents withdrawal symptoms, which can trigger mood episodes.
· Retaining mood stability increases the effectiveness of therapy and helps reduce interpersonal conflicts that may lead to stress.
Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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The Diagnostic Dilemma

Bipolar disorders is actually a number of different disorders- Bipolar I being the most clearcut and straightforward diagnosis. Bipolar II, Cyclothymic disorder and Bipolar NOS can be trickier to sort out because the symptoms on the manic end of the spectrum can be harder to specify or notice. On the depressive side of the coin, a whopping major depression can be fairly easy to spot, but variations of it can be less visible. Furthermore, when the first episode of major depression presents itself, you don´t know if manic symptoms will develop down the road; although family or personal history may hold some clues, the information isn´t 100 percent reliable.

Additionally, bipolar disorder is likely to occur with other symptoms that can be misleading in the diagnostic process.

Anxiety symptoms, psychosis, and substance abuse are the most common overlapping disorders in adults, with ADHD being a common related disorder in kids.

You´re more likely to receive varying diagnostic opinions if your diagnosis isn´t Bipolar I. When you seek a second opinion, you should pay as much attention to how the doctor arrived at the diagnosis itself. What symptoms has she considered? How has she put them altogether with other information, such as family history? What additional diagnoses does she think are present? The answers you receive paint a diagnostic portrait that helps you understand what´s going on with your brain; this picture provides you with something much more valuable than a label and a prescription.

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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Accepting your bipolar badge

The path leading from denial to acceptance is a rocky road, but you can stick to the following steps to take the bumps in stride:

1. Ask your psychiatrist to explain the reasons she arrived at your diagnosis and treatment plan.
Knowing the symptoms, background information, and other facts that helped your psychiatrist arrive at your diagnosis is more likely to convince you of  its veracity. You deserve an explanation.
2. Get a second opinion, but don´t tell your second doctor what your first doctor thinks.
Two concurring opinions weigh more than one. And if the two doctors don´t occur, you may need to dog a little deeper by consulting another doctor or doing a little research on your own. Accept your diagnosis only after carefully and honestly assessing all the information from professionals and feedback from loved ones.
3. Look back at what your life was like before diagnosis.
Did low-levels symptoms negatively affect your relationships, your plans and your happiness? Looking to the past may help you realize that your life wasn´t a bowl of cherries before the diagnosis and that your life can be much better with the proper treatment.
4. Ask your friends and family to provide honest feedback about your moods and behaviors in the past.
When experiencing Hypomania or mania, you may not objectively perceive your behaviors, which can lead to denial.
5. Read stories of people who have bipolar disorder, especially those who are on the road to recovery.
Patty´s Duke A Brilliant Madness: Living with Manic-Depressive Illness and Kaye Jamison´s An Unquiet Mind: A Memoir of Moods and Madness are excellent reads. Jane Pauley has also written a biography that includes a description of her personal experience with bipolar disorder called skywritting: A Life Out of the Blue. Reading about other´s experiences with bipolar disorder can often help you recognize parallels in your life.
6. Attend bipolar disorder support group.
Having a forum you can connect with others who face similar struggles can help you bear your burdens and discover useful coping strategies.
7. Realize the upside of bipolar disorder
Many people go through their entire lives without experiencing the extremes of mood and emotion that you´re capable of experiencing. Kaye Jamison´s Touched with Fire: Manic Depression and the Artistic Temperament can help you appreciate the positive aspects of bipolar disorder.

Of course, working on acceptance assumes that you´re in a receptive and rational state of mind. If you´re experiencing a mood episode that immediate treatments, your doctor may treat your symptoms whether or not you accept the diagnosis, for your own health and safety.

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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Practicing an Ounce of Prevention

Maintaining car´s health with regular oil changes and the occasional tune-up helps keep it running trouble free for thousands of miles. Maintaining your physical health reduces the risk of cancer, heart disease, and other major illnesses. Maintaining your mental health delivers similar benefits; yet, even after being diagnosed with bipolar disorder, people often ignore medical orders and continue to roll the dice in a game they are almost certain to lose.

Don´t gamble with your mental health. After you´ve been diagnosed with bipolar disorder, establish a preventive maintenance plan to ward off relapse and minimize the damage of unavoidable mood episodes. Take the following actions:
· Accept your diagnosis.
· Take your medicine as prescribed.
· Monitor your moods for early warning signs, and consult your doctor at the first sign of trouble.
· Identify and eliminate your stressors.
· Build a strong support network

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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Shedding light on the kindling effect

Managing bipolar disorder proactively is important not only in helping prevent mood episodes, but also in thwarting what some doctors refer as to the kindling effect—the worsening of the disorder over time. The kindling effect is a process that´s known to occur in the brains of people with seizures. Seizures are electrical storms in the brain, triggered by chemical changes or other physical stresses on the brain cells. With every storm, the brain can become more and more sensitized. Eventually, the brain can seize over and over again without any type of trigger. The cells seem to “memorize” the electrical storms and repeat them. Neurologists aggressively focus on treating seizures to prevent kindling, which progressively increases the frequency and severity of seizures.
Seizures and mood disorders_ particularly bipolar disorder- are thought to have many similarities, chemically and electrically. Some experts suggest that the kindling effect can occur in bipolar disorder—that each mood episode is like a storm that with each episode the brain becomes more sensitized, eventually having more frequent episodes that require fewer emotional triggers. According to the theory, early in the course of the illness, a major stressor is required to trigger a mood episode, but as more and more episodes spontaneously instead of waiting for a trigger.

Doctors haven´t clearly identified the kindling effect in bipolar disorder, and if it occurs, it´s likely much more complex that what happens with seizures. Perhaps some brains are more vulnerable to kindling than others. Whether or not the kindling model accurately pertains to bipolar disorder, reducing the frequency of mood episodes is beneficial for your health and quality of life in many ways.

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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Proacting: Preventing Flare ups

               
If you tell the average person he has a terminal cancer, he´s likely to curl up in the fetal position and weep. How you respond to your diagnosis and how ambitiously you pursue treatment and therapy have a huge effect on the outcome. If you deny that you have a problem, lose hope, or try to self-medicate with alcohol and other substances, the disorder wins. If you discover the right medication, confront your hidden demons through therapy, and remain vigilant, you prevail

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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Reacting: Extinguishing the flames

Envelop by a full-blown mania or depression, you face limited choices. If you pose no threat to yourself or others, you can choose to wait out the storm and hope the racing currents subside. But if your behavior becomes unbearable or dangerous- if you have suicidal thoughts or become increasingly belligerent, for example- you or someone else your behalf can seek medical intervention in one or more of the following forms:
· Hospitalizacion: When you pose a threat to yourself or others or need the safety and retreat that hospitalization provides.
· Intensive outpatient therapy: allows you to focus on getting well by day and return home in the evening.
· Medication: To lift the depression or quell the mania.
· Therapy: to immediately address destructive thoughts or behaviors.


Reacting can extinguish the flames, but it can also leave you and those around you burnet out, in your weakened state, you are more susceptible to fire-ups. And if your behavior during the episode hurt you your loved ones, their frustration or bitterness can compound the stress you already bear.

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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So, Doc, What´s the Prognosis?

The choice between a negative or positive prognosis is up to you, doctor, and your family and friends. If you accept the diagnosis, can discover an effective medicine or combination of medicines, and if your family and friends you and pitch in your support you, the prognosis is very positive indeed. On the other hand, if you try to ignore the problem, it will likely get worst.

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Predisposed, not predetermined

Being genetically predisposed to bipolar disorder doesn´t guarantee that you´ll experience symptoms. Genetically predisposition only makes you susceptible to developing bipolar disorder. Think of it as a susceptible to skin cancer: If you are born with pale skin, you may be susceptible to extreme sunburn and skin cancer, but if you prudently avoid overexposure to the sun, you can prevent the cancer.

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Shaking the family tree

An accurate diagnosis of your condition can benefit greatly from an examination of your family history, but you never know what´s going to fall when you start shaking your family tree. If you ask your relatives whether anyone in the family has ever been diagnosed with bipolar disorder, you may receive plenty of blank stares and all too little useful information. Try asking this series of more probing questions:

· Has anyone in the family has alcohol or substance abuse problems?
Many people with bipolar disorder  selfmedicate with alcohol and drugs.

· Have any family members been diagnosed with schizophrenia? In the not- so distant past, doctors commonly misdiagnosed bipolar disorder and schizophrenia.

· Has any member been treated for any mental illness? If a family member has received treatment for depression, psychosis, or other mental illnesses, he may not have received the correct diagnosis.

· Has anyone in the family had to “go away for a while” to an institution, sanatorium, or rehab center?  Families often like to cover up memories of relatives who had to be hospitalized for mental illnesses by saying that they had to “go away for a while”.

· Have any family members been known to be particularly energetic or eccentric? In the past, people politely described relatives with various degrees of mental illnesses

· Has anyone in the family suffered from physical symptoms such as chronic exhaustation, pain, or digestive problems? These can be physical manifestations of the illnesses.

If you were adopted, consider tracking down your birth records and contacting members of your biological family for medical information. This can help with diagnosis any genetically related illnesses, including bipolar disorder, heart disease, and cancer.

Family can be particularly secretive, especially when it comes to protecting the reputation of the dead. They can become even more defensive if you confront them while you´re in the throes of mania. Explain how important an accurate and detailed family history is for your diagnosis.

Source: Bipolar Disorder, candida Fink, MD, Joe Kraynak

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What are the odd? -Demystifying Bipolar Disorder

Scientist used to believe that about 2-3 percent of the population suffered from bipolar disorder. Now, the figure applies to the narrow definition of Bipolar I. When you roll in the numbers for Bipolar II, Cyclothymiac disorder and Bipolar NOS, the percentage soars to 5 percent of higher. And that is just for the general population. If your family is genetically loaded with bipolar disorder, your odds of developing it or another psychiatric disorder climb even higher:

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Psychosis…. Sometimes

Psychosis…. Sometimes
Perhaps the most frightening accompaniment to depression or mania is psychosis—delusional thinking, paranoia, and visual or auditory hallucinations. Although psychosis isn´t a necessary part of the bipolar diagnosis, it can accompany a mood episode. The extremes of depression and, more often, mania can traumatize the mind to such an extent that it begins to latch on to self-destructive or grandiose beliefs, become obsessed with fears that have no basis in reality, or perceive sights and sounds that are not present. During a psychotic episode, you may
· Feel as though you have special powers
· Hear voices that other people can´t hear and believe they´re talking about you or sometimes instructing you to perform certain acts.
· Believe that people can read your mind or put thoughts into your head.
· Think that the television or radio is sending you special messages.
· Think that people are following you or trying to harm you when they´re not.
· Believe that you can accomplish goals that are well beyond your abilities and means.
Although psychosis sounds dramatic and easily identifiable, It can be quite subtle and shrouded by enough reality to make “psychosis” seem more like “usually perceptive” Is your boss trying to fire you accurate predictions or critical world events just a coincidence?

Source: Bipolar Disorder, Camila Flink, MD , Joe krainak

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Mixed Manic Episode

To qualify as mixed mania, an episode must simultaneously meet the requirements stipulated for a major depressive episode or a manic episode. Your symptoms must occur nearly every day for a week straight. When experiencing a mixed manic episode you commonly exhibit uncharacteristic emotional storms. You may yell in the morning and cry in the evening or to be boastful one minute and self-deprecating the next. Or you may just experience a constant feeling of agitation or irritability throughout the day.

Source: Bipolar Disorder, Camila Flink, MD , Joe krainak

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Hypomanic Episode

Hypomanic is a less intense mania that doesn´t last as long as a full blown mania and that doesn´t cause significant problems with your interpersonal relations or job. Your mood must be elevated above your normal state and display characteristics that others around you believe are slightly out of character. The episode must last at least four days.

Source: Bipolar Disorder, Camila Flink, MD , Joe krainak

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Bipolar NOS

The three bipolar classifications we cover up to this point are loosely paraphrased from the DMS IV—The diagnosis and Statistical Manual of Mental Disorders, 4th Edition, published by the American Psychiatric Association. DSM-IV defines a fourth class, Bipolar NOS (No Otherwise Specified), which covers all other forms of bipolar disorder that don´t fall into any of the first three categories.

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Cyclothymic Disorder

Cyclotymic disorder is a less extreme form of bipolar, sometimes referred to as “bipolar lite”, “that nevertheless chronically interferes with your life. It involves multiple episodes of hypomania and depressive symptoms, which don´t meet criteria for mania or major depression in intensity or duration.
Your symptoms must last for at least two years without go on to develop a full-blown manic mixed, or depressive episode, leading to an additional diagnosis of Bipolar I or II. Preventive measures like therapy, lifestyle changes, and medication can make a difference in the course of Cyclotymic disorder.

Source: Bipolar Disorder, Camila Flink, MD , Joe krainak

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Bipolar II

Bipolar II is characterized by one or more episodes of major depression with at least one episode of hypomania during a lifetime. The depressive episodes must last at least two weeks, and the hypomania must last at least four days.

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Know your psychiatric disorders

In what could be deemed a major breakthrough, scientists have found a common genetics link between five mental disorders – bipolar disorder, major depressive disorder, autism, schizophrenia and attention deficit hyperactivity disorder (ADHD). They showed substantial overlap of genetic risk factors shared between bipolar disorder, major depressive disorder and schizophrenia and less overlap between those conditions and autism and attention deficit-hyperactivity disorder (ADHD).

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