Bi-polar disorder used to be referred to as manic-depression and is characterized with highs and lows in  moods and activity. Distractibility can also be part of a bipolar diagnosis. Racing thoughts, impetuous activities also characterize what is diagnosed as bipolar disorder. These days, bi-polar disorder is broken down into Bi-polar I, (bipolar 1) and Bipolar II (bipolar 2) as well as being further distinguished when the manic episodes come often, “rapid-cycling”.

 

       The diagnosis of bipolar disorder has increased exponentially in a short period of time, from 20,000 cases in youths and children in 1993 to 800,000 in 2003, which represents about 1% of the young population. See Archives of General Psychiatry, September 2007.

 

        At times, ADHD can resemble bi-polar disorder in its symptoms and some doctors in mental health have related that it can be difficult to distinguish which diagnosis to give in some children.

 

Some symptoms of bipolar disorder:

 

* Excessively euphoric mood
* Extreme irritability
* Fast thinking
* Inability to concentrate
* Difficulty sleeping
* Poor judgment
* Increased sex drive
* Abuse of drugs
* Aggressive behavior
* Denial that anything is wrong

Depression:

* Feeling sad, empty, hopeless, guilty
* High levels of anxiety
* Loss of interest in activities once enjoyed
* Decreased energy; feeling lethargic and fatigued
* Difficulty concentrating and making decisions
* Change in appetite
* Unexplained aches and pains
* Thoughts of death or suicide

 

Source: Psychology Today, August 2, 2007

Bipolar Disorder: A mistaken diagnosis, by Melissa Kristal

 

Bipolar I Disorder:

Persons experiences a major depressive epidosde (as in major depression) and has had one or more manic episodes.

 

Biplar II Disorder

The person experiences a major depressive episode and has had one or more hyponmanic episodes (almost manic, not quite fully manic).

 

Cyclothymia

During two year period, experience episodes resembling dysthymia, but also has had one or more periods of hypomania--characterized by elevated, expansive, or irritable mood not of psychotic proportions. 

 

(Dysthymia: Depressed mood for most of the day, most days, and at least two other depressive symptoms, but not of suffieint persistence or severity to be considered major depression. No manic or hyponmanic episodes.)

 

Major Depression

One or more major depressive episodes in absence of any manic or hypomanic episodes. Symptoms consist of a prominent and persistent depressed moood or loss of pleasure for at least two weeks, accompanied by four or more symptoms such as poor appetite, insomnia, psychomoter retardation, fatigue, feelings of worthlessness or guilt, inability to concentrate, and thoughts of death or suicide.

 

Source for definitions of mood disorders: Abnormal Psychology and Modern Life, by Carson (Duke University, Butcher(University of Minnesota), Mineka(Northwestern University); Pub:Allyn & Bacon, Boston;11th edition; 2000.

 

Medications:

The most common treatment for bipolar disorder these days is medication, usually antipsychotics. There are two types of antipsychotics, typical and atypical. Anticonvulsant medications are also prescribed. Typical antipsychotics are an older type, they are heavily sedating and have numerous side effects. They are used as a mood stabilizer. Atypical antipsychotics were made available in the mid-1990s and have a less sedating quality and have fewer side effects.  Such drugs are administered to both adults and children.

 

While it was thought that the newer atypical antipsychotics would be more effective in controlling mood swings than older drugs, recent studies seem to indicate that they are not more effective and that older drugs may actually be more effective in controlling symptoms. 

 

           Some mood stabilizers used in treating bipolar disorder are: lithium, valproate, carbamazepine, or lamotrigine. The most widely known drug for bipolar disorder is lithium, which has  a chemical structure that identifies it as a salt, has been used for many years in treating bipolar disorder.

 

Some have experienced relief of symptoms with lithium. For some the relief was temporary, for some there lithium is not effective and there is really no way of knowing if a certain drug is or is not effective except with experimentation.

 

The down side of litium is that it can cause drowsiness or a feeling of being in an unnatural mental state. Some have had trouble adjusting to lithium over the long term. Many who have started on it, while experiencing some relief, have later had to swith to other medications. While lithium is chemcially a salt, it is not a "natural medicine," like a vitamin or enzyme, but it is a mood altering drug.

Also to be remembered is that medicines address the symptoms, they do not treat the illness iteself, so while a person may experience some relief from the symptoms related to bipolar disorder, this does not mean, that the disorder is in remission or that it is being cured. There is still an underlying "illness," if one wishes to use that term, or mental state below the surface that continues, which is why when many persons try to discontinue treatment, relapses do often occur, sometimes more earnestly.

 

Medications for bipolar disorder:

                                                     Examples:

1. Typical antipsychotics                    Haldol

2. Atypical antipsychotics                   Risperdal, Seroquel

3. Anticonvulsants                             Depakote

4. Other mood stabilizers                   Lithium

5. Antidepressants stimulants              Prozac, amphetamines, 

                                                     Ritalin (not a true amphetamine)

 

 

Antidepressants and bipolar disorder

Antidepressants alone are not effective in treating bipolar disorder, and studies have indicated that antidepressants combined with mood stabilizing drugs are not more effective in improving symptoms of bipolar disorder than mood stabilizing drugs alone.  The New England Journal of Medicine; G. Sachs; March 28, 2007. Also, it is possible that antidepressants actually can make matters worse in terms of bipolar disorder. (some studies indicate that antidepressants increase likelihood of suicidal thoughts in children, teens, and adults 18-24).

 

Anyone attempting to come off psychiatric medications of any kind, including antidepressants, should do so gradually rather than abruptly. See article, How to Quit the Cure, Newseeek.

 

What causes “chemical imbalances” in our mind?

Joel Robertson in his book Natural Prozac, gives a most informative and insightful discussion on depression and even for those experiencing some of the symptoms of bipolar disorder. The thought is  developed  that what we take in through our senses into the mind can have an effect on our brain chemistry. Through what we choose to let enter into our brains through our senses, which is largely controllable, we can  to a certain extent,  control or influence the chemical balance of our minds. 

 

The daily flow of water on the ground causes channels and rifts (example-the Grand Canyon). The daily flow of stimuli through our brains, love from our family, beautiful music, or conversely, violence or harshness, sets up mental patterns that become etched in the synapses and neurons in our brains. We eventually become “hardwired” a certain way. To a certain extent, we have freedom to choose what our “brain-food” will be, which has a tremendous impact on our behavior and emotions, our mind’s chemical balance.

                                                                                                     The causes of bipolar disorder itself are many and varied. Everyone is unique, and what is true for one person may not be true for another. Furthermore, bipolar disorder is the most misdiagnosed, overdiagnosed condition among all mental health disorders. The label, bipolar disorder, is based on a subjective, (observational or based on the opinion of the clinician) rather than scientific, so while one clinician might diagnosis bipolar disorder, another might have a different idea. However, fairly conclusively, we can say that the idea that bipolar disorder is a "chemical imbalance" that can be corrected with medications, is most likely a very surface evaluation of the subject, or erroneous, a "falacy," or "deceptive" are two words that have been used in one mainstream college textbook on abnormal psychology . Any serious, more in depth look at the subject looks much more deeply. For a more in depth look at the issue, please see here.

 

To be positive, these are some areas where one might consider looking in the area of lifestyle changes and coping strategies that can be helpful for anyone who is dealing with the symptoms of bipolar disorder.

 

                                  Music

There are several lines of thought with bipolar disorder and the roots of it that can be explored. First is music. Music effects both our minds, the chemical balance of our minds, and our moods. The lead singer, Axel Rose, of Guns and Roses is well known for  his bipolar disorder, (also his use and disdaine for medication), but also, the hard driving rock and roll that is a daily part of his and millions of other young person's lives can be, in some young people, a significant factor. (For young people who listen to Limp Bizkit, Korn or Lincoln Park daily, one wonders how they cannot develop bipolar or some other disorder.)

 

For young ladies, and some young men, some of the hip hop today is pretty intense, some of it is drug-charged, that is at times, cocaine-fueled passion-music, and the visual MTV imagery can be sensually overwhelming, both visually and to the oratory senses. For some young ladies and men, these can be contributing factors in weakening the mind towards susceptability towards mental health disorders of various types.

 

There is a a "rage" and "desperation" in much of the music that is popular today for young people, including much alternative music, heavy metal, grunge, and hard core. The mind often has no time to rest and is in a constant state of overstimulation. Dopamine level in the mind is overstimulated, and this can result in highs and lows in one's mood, as well as contribute to, among other things, the rage that can effect a child or youth's personality.

 

                                  Violence in the media

Violent Sports: Similarly, violence in the media, whether it be through movies, or even overexposure to violent sports. The violence and sadism of the "sport" of pro-wrestling is something that can become a part of the psyche of children and teens. Wrestling in the US is typically aired twice, sometimes three times weekly, and many children follow this entertainment with passion. For some persons, other forms of  violence such as NFL Football and hockey,  can be a contributing factor towards chemical imbalances and the "rage" that is often associated with a bipolar diagnosis and mood swings.

 

Pornography: Another thought for both counselors and parents, as well as for those who are suffering with bipolar disorder is pornography's role in bipolar disorder. Pornography addiction is common and it can be a major contributing factor in bipolar disorder. Children are being exposed to pornography from as young as eight years old, and in one special education class, three of eight ten year olds were already indulging in pornography.

 

Movies: Violence in film has escalated as well. Violent movies, once R-rated are now PG13, many of which are  violent, and children as young as kindergarten are viewing extremely violent R-rated movies, horror movies, and "slasher" type movies on a regular basis, often times when parents are not at home, or with older siblings. In one grade school class over 50% of 2nd graders watched violent R-rated horror, slasher movies. In another class in the same city, 50% of 1st graders watched such movies, sometimes with their  parents. Violent and somewhat violent video games also can contribute to "rage" inside of a youngster.

 

Violent TV, Video games: Many children and youths often spend up to 6 hours daily on the media, much of it violent or somewhat violent. It is probable that the increase in violent content in the various forms of media can be contributing to the corresponding increase of the diagnosis of such disorders as bipolar disorder and ADHD, which can be coexisting or have related symptoms. 

 

                                     Substance Abuse

There is also a strong correlation between bipolar disorder and substance abuse, both past and present. Alcohol and drug abuse are said to be contributing factors or part of the diagnosis in 60% of cases of bipolar disorder.

 

                       Some other links to bipolar disorder

It has been suggested that depression or ADHD treated with medication sometimes leads to bipolar disorder. One of the reasons for this might be that there are often unpleasant side effects with antidepressants. This can cause one's medication to be switched from one to another, and sometimes combinations are experimented with, sleeping pills added to the mix and so on. At times, because of side effects, some might abruptly end their medication regimine. This mixing and starting and stoppping of powerful drugs, which antidepressants are, for children or adults, can lead, for some, towards symptoms of bipolar disorder.

 

                                  Children, Youths                                                                                                                                        

Children are being increasingly treated with strong medications for bipolar disorder. The rate of diagnosis of bipolar disorder in youths increased 40x in just ten years, from years 1993 to 2003. Bipolar Disorder is also one of the most commonly misdiangosed mental health conditions. Around 90% of those diagnosed with bipolar disorder are treated with medications. The use of multiple medications, from two different types, to up to six different medications is a common practice.

 

Many of these medications, if not most, are sedating in their effects. In the case of newer atypical antipsychotics, for  some, they can be sedating, to a certain extent, not as much so as older typical antipsychotics or anticonvulsants, such as Depakote, which is actually a drug developed for  epilepsy, but for others, the effects can be mood stabilizing.

 

At the same time, even the atypical antipsychotics, especially when combined with other medications, which is most often the case, can have an effect on the mental state of the youth or child, and even adult, putting one's mind into a different level. Some have described a somewhat "detached" feeling from drugs prescribed for bipolar disorder, including atypical antipsychotics.

 

Parents, however, are often desperate to find a solution to a child's or youths problems with anger and intermittent depression, and doctors are quick to treat with medications, as it is an easier and a quicker remedy than therapy.

 

Children as young as two years old have been on multiple medications, and this can be very dangerous. (the much publicized death of a four year old this year-2007, of a four year old girl who had been on medication since she was two.) 

 

Many children and youths have been noted to have "a rage" inside of them, which concerns parents and educators, as well as those in the medical professions. However, it must be noted, that the positive benefits of medicinal intervention, especially in view of the fact that only 40% of those who are prescribed medications for bipolar disorder also receive any type of therapy, are debatable and still in question. While some have experienced some temporary relief from symptoms, others have had to search for the right "mixture" of pharmaceutical treatments, which can prove to be elusive or a temporary remedy at best, sometimes leading to furhter long term difficulties.

 

                           Multiple Concurrent Prescriptions

The practice of prescribing mutliple medications for mental health conditions is very much in question, though an increasingly common practice. Studies have indicated, that a second and third medication is not effective in remedying mental health disorders. What is more, side effects increase as well as the potential for serious complications. Both atypical and typical antipsychotics carry with them serious side effects and risks.

 

All of the thoughts developed on the page, 16 Keys for good mental health can be of help for persons with symptoms related to bipolar disorder. Spirituality is also of vital concern in serious mental health issues.

 

To sum up, there is not one single reason why a person develops bipolar disorder, but there may be many contributing factors. To say that bipolar disorder is a chemical imbalance that needs to be corrected with medication is a rather shallow view of a problem that there likely are reasons for or contributing factors. If these issues underlying the bipolar disorder can be addressed one by one, it can do much to help a person to have good mental  health.

                                              

                                    Exercise

One suggestion that has been made is that stress can trigger bipolar disorder. Vigorous exercise early in the morning can help to keep one calm and balanced throughout the day. Similarly, a brisk walk, outdoors in the evening can work better than a sleeping pill. Persons with bipolar disorder need exercise. Walking, swimming, biking, all point a person in a forward direction and burn off stress that can fuel both depression and manic episodes. Chemically it also has a positive effect on the mind, which can balance out highs and lows in one's mood and can even help lead one to full recovery.

                                                 

                                                 Diet

Similarly, a healthy diet can also be of value, part of a healthy lifestyle that can contribute to good mental health. Avoiding alcohol and  smoking are of the utmost importance for persons with bipolar disorder. Also, avoiding caffeine in coffee can be of help to some who might be prone to overindulge at times. Caffeing lifts the mood and energy level, but with every lift can come a corresponding low, and it can be one contributing factor for some.

By giving balanced attention to diet, avoiding too much sugar, high fat or processed foods, it can contribute to a healthier body, loss of weight and stronger mind.

 

               Taking time to sharpen the saw

Much activity without direction burns a hole in the floor. By taking time to sharpen the saw, it can be of much help for persons with bipolar disorder. The sustained concentration of reading, is of value to smooth out the highs and lows of mood disorders such as bipolar disorder. Taking time for prayer and reading the Bible has helped many. Time spent with friends who are a positive influence, avoiding those whom are prone to be a negative influence, also can help. Time spent with nature also can have  a natural healing effect on the mind.

 

Changing one's lifestyle and habits takes effort. One man suffereing from bipolar disorder said he would rather deal with unpleasant medications than stop viewing pornography, give up violent video games and movies, or cut down drastically on television. (his friends would surely think he had lost his mind). Bad habits are not easily shaken. But for those who are determined to overcome even a disorder as serious as bipolar disorder, it can be done, and can even be accomlished without needing to be on a lifetime of heavy medications.

 

                     ART as a natural mood stabilizer

For persons with bipolar disorder, OCD, ADHD and some other mental health disorders or difficulties, art is an excellent therapy. It can be, for many persons, a natural mood stabilizer, in addition to whatever other steps one might take. It can also be helpful in building self esteem. Visiting art museums, purchasing some books on art around the home, can help a person develop an interest that takes his mind off of the problems he might be dealing, and for some, to develop a skill that is soothing and calming. It helps a person to get away from perfectionist thinking, in that, especially in the beginning, no one's art is perfect, and in that respect, it is helpful as well.

 

Drawing is helpful to develop powers of concentration, and oil painting is especially soothing. Many quiet hours can  pass in drawing or painting, and it can quiet the mind and soothe the soul. For anyone who has symptoms of ADHD or bipolar disorder, art is an excellent choice as a secular occupation or as  a hobby. One such person, who became an art teacher, said that it was the only place she felt really at home, that is, the art classroom, she found peace there as well as fulfillment in working with young people and children. Art can be, for some, a natural mood stabilizer and contribute to healing the mind.

 

See Ezine Expert Author articles for book review of Sharna

Olfman's "Bipolar Children" as featured on this website.

 

 

Any decisions made concerning mental health are personal decisions and winmental health bears no responsibility. The information on this website are for educational and informative purposes only and each person must make their own decisions on mental health treatment. We hope that this information is helpful.