People seeking to help or diagnose individuals suffering from bipolar disorder may need to sort through a whole range of emotional states – only some of which that can be characterize as mental illness. The classic manic-depressive sequence may not play out in persons that are in fact bipolar. Milder forms of bipolar disorder may not be detected at all or escape detection for a number of years. Bipolar extremes may closely resemble other forms of depressive mental illness. Since around 50 per cent of persons diagnosed with bipolar disorder abuse drugs and alcohol those substance may interfere with diagnosis also.

The following facts need to be considered by anyone seeking to diagnose this type of mental illness:
• About 20 per cent of people that present to a healthcare professional with complaints of depression are suffering from bipolar disorder.
• As many as three professionals have misdiagnosed about half the cases of bipolar disorder before those cases are correctly identified as bipolar disorder.
• The average delay between initial symptoms and treatment of bipolar disorder is ten years. Some of that problem is attributable to misdiagnosis.

What Makes Bipolar Disorder Mistaken For Mere Depression So Often?
Psychiatric workers encounter classic depression in patients very frequently. In people with bipolar II disorder episodes of depression outnumber manic episodes by a factor of 35 to 1. In people with bipolar I disorder episodes of depression outnumber manic episodes by a factor of just 3 to 1. Those three factors should serve to convince those tasked with the job of diagnosing people with mental problems that bipolar disorder should not be ruled out quite so quickly when symptoms of depression are in evidence.

When we look at mania our caution regarding ruling out bipolar disorder too quickly is reinforced. Recall that in cases of bipolar I disorder depression outweighs mania by a 3 to 1 factor. Add to that the fact that the severe mania that characterizes bipolar I disorder is relatively easy to diagnose and it isn’t surprising that an absence of severe mania in bipolar I disorder patients causes a misdiagnosis. In bipolar II disorder the milder forms of mania (hypomania) may also lead diagnosticians to conclude that no mania is present at all.

The following checklist should help those assessing people with psychological symptoms to carefully consider the possibility of bipolar disorder before ruling it out. Don’t consider this an exercise in “guilt by association” but take heed that the following are often associated with a developing bipolar disorder, especially in teenagers.
Depression
Substance abuse
Thoughts of suicide
Impulsive behavior
Attention-deficit/hyperactivity disorder (AD/HD)
Anxiety

No one factor can confirm the possibility of bipolar disorder, but these indicators can point to that possibility.

Talk therapy affords you the opportunity to discuss emotions, thoughts and actions that you struggle with if you are bipolar. Understanding of your problems may lead to a greater mastery over the behaviors that lead to your inability to function in society. Simple attention to you and your problems can help you to bolster a positive self-mage as well.

Psychiatrists have done us the favor of classifying the types of psychotherapy used to treat bipolar disorder.

Behavioral
As the name implies this therapy centers around reinforcing the behaviors that minimize stresses in your life, often called positive behaviors.

Cognitive
The word cognitive comes from the Latin word for knowing or known. Cognitive therapy puts you in touch with those parts of yourself that control patterns of thinking and moods. Once you know yourself a little better you can start to modify your moods and thoughts in a positive way.

Interpersonal
Relationships of all kinds are dealt with by interpersonal therapy. It aims to reduce the strains on relationships that your illness may have caused.

A support group can play a key role in keeping people with bipolar disorder psychologically healthy or helping to restore them to psychological health. Such groups offer you the opportunity to share your feelings and concerns, learn how to cope and receive an encouraging word now and again. A support group may also prove helpful for family and friends who need to cope with your illness every bit as much as you do, at least at times.

Educational initiatives can also help patients and their families come to terms with bipolar disorder. Unrealistic expectations and fears can be put into a proper perspective. With increased understanding patients and their families can begin to access and develop effective coping strategies. Early signs of an impending episode can also be identified and used to prevent the worst aspects of such episodes from occurring.

Further coping strategies can include the following concrete steps:

Avoid alcohol and drug abuse. These intoxicants can provoke manic depressive episodes. They interfere with the way mood stabilizers and other therapeutic medications work.

Identify symptoms. Early warning signs can be elusive to identify. Patients can cooperate with mental health care personnel and those that know them best to come up with a list of behaviors or thought patterns that appear to have preceded episode in the past.

Anticipate and adapt. The realization that someone is bipolar is only ever part of their therapeutic path. Changes in lifestyle that reduce stress or over-stimulation are helpful. You can discuss your fear of future episodes with your therapist and allay some of that fear by preparing for them.
Establish regular routines and sleep patterns. Whether waking or sleeping your chemical balance is easier to maintain if you follow regular and healthful routines.

Types of Cholesterol

If low density lipoprotein (LDL) is considered as bad cholesterol, high density lipoprotein (HDL) counters as good cholesterol. HDLs are plasma proteins that carry cholesterol in the blood to tissues and liver for excretion. This is why they are considered as good ones. HDLs tend to collect and clear the blood, as well as tissues, from fat or cholesterol deposits; and eliminate them into the bile, down into the intestines, and are released from the body.

Cholesterol Levels

It is important to maintain HDL levels within the range 35 – 70 mg/dL, depending on age.

Low levels of HDLs lead to a risk of developing a heart disease since there is not enough clearance of fats in the bloodstream.

Sources of Good Fats

Now, the question is what fats are considered to be good for the body? There can be lots of them such as essential fatty acids, omega 6 and omega 3, as well as monounsaturated and polyunsaturated fats.

Essential fatty acids are not manufactured by the body, and therefore must be included in the diet. Food sources for omega 6 include vegetable oils and peanuts. It has been shown to reduce cholesterol level and occurrence of heart disease, to prolong blood clotting, and to support brain growth.  Likewise, sources for omega 3 comprise cooking oil, fish oil, margarine, and fatty fish. It also reduces the chance to develop heart diseases and lowers arterial blood pressure. Furthermore, unsaturated fats are primarily of plant origin and are liquid at room temperature. Monounsaturated fats consist of olive oil, peanut oil, nuts, and avocados. On the other hand, vegetable oil can be a source of polyunsaturated fats.

One should make good fat choices in order to select those good for the heart. There is no need to completely eradicate fats in the diet. Just be wise enough to make the right choice.

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Suicide is a very real risk for people with bipolar disorder, whether they’re in a manic or depressive episode — 10%-15% of people with bipolar disorder kill themselves.

About 15 per cent of people with bipolar disorder manage to kill themselves. It is a distinct possibility whether the patient is manic or depressive. Suicide attempts by people with bipolar disorder are yet more common. It’s a frightening fact, but preventive and emergency treatments can serve to lower risks factors considerably.

Self Care
Because most bipolars experience considerable periods of rational behavior an emergency self-care plan is a good idea. This can be put into action when symptoms initially appear. A realization on the part of the patient that their condition may sometimes cloud their judgement is a crucial component of such a plan. These strategies may help.

If thoughts of suicide enter the mind, contact a therapist, a suicide hotline or health care provider such as a psychiatric social worker at once
Get in touch with friends and family
Try to remain calm and in one place until arrives
Take a single dose of any medication designed to alleviate your symptoms (this may not be feasible for certain patients, especially those with drug dependency)

Emergency Care
Interventions into acute episodes of bipolar disorder use just some of the same treatment strategies that are designed to prevent symptoms from occurring.
Anti-psychotic drugs can alleviate extreme symptoms if psychosis is present. Anti-anxiety drugs like benzodiazepines can address extreme agitation.
Although it is the object of considerable controversy Electroconvulsive therapy (ECT) is still used to treat bipolar disorders. ECT is a psychiatric treatment that employs electrical current to create seizures the central nervous system that are of short duration while a patient is anesthetized. Research points to ECT as an effective treatment for depression that is not otherwise responding to medication.
Sleep can help to stabilize the mood in some patients.
Emergency psychiatric counseling or contact with members of a support group or with members of one’s family can prove to be very therapeutic.
The patient may need to stay in a hospital until his or her mood has stabilized and symptoms are under control.

Keep in mind that although they can be disturbing to witness or to experience mood swings are temporary. Most individuals will feel better in time.

While psychotherapy may have fallen out of favor in other treatment contexts it still occupies a fairly prominent position in treating bipolar disorders. In fact, most forms of psychotherapy are in use in treating bipolar conditions. They include behavioral, cognitive and individual or group therapy sessions. Since bipolar episodes are periodic and far from continual, either manic or depressive episodes, psychotherapeutic sessions can serve to enhance a patient’s understanding of their condition and its effect on those around them when periods of rationality prevail.

Those around them include most prominently family members, whom it is important to involve in therapeutic efforts and efforts to understand the disease. Family members can play a significant therapeutic and a preventative role in regard to bipolar episodes.

As mentioned previously lithium has long been the drug of choice for treating bipolar disorders. In fact, this is all the more remarkable since science still doesn’t completely understand how it works in reducing mania in particular. It’s also effective as a preventative for depression. Nowadays it can be used in conjunction with antidepressant medications.

Lithium does have side effects and doesn’t always work as intended. Other mood stabilizers have proven their effectiveness in treating manic and depressive phases of the disease. Using these substances in combination with lithium is also fairly common. Pharmacological advances continue apace. Treatment-resistant cases are reported to respond well to Lamictal.

Combination therapy involving mood stabilizers as well as antidepressants is quite common in treating depressive phases of the disorder. Serotonin reuptake inhibitors are probably the most commonly employed drugs in this context, owing to their lack of side effects as compared to other drugs.

Treating Depression without Drugs
Depressive episodes are still treated using electroconvulsive therapy (ECT). In fact, since falling out of favor around 40 years ago improvements in ECT have led to a steady resurgence in its popularity. It is most often used for severely manic or depressed individuals, especially those who do not or cannot be treated pharmacologically. That group would include individuals with drug sensitivities and pregnant women. The speed at which ECT therapy shows improvement makes it worth considering for patients who are at great risk for committing suicide.

Innovations in nonpharmacological treatment for depression have also come online. They include: VNS (Vagal Nerve Stimulation) and TMS (Transcranial Magnetic Stimulation).

When bipolar depression is associated with seasonal affective disorder light therapy has proven to be effective. A light box emitting full spectrum light for as little as 20 minutes a day has proven to be a successful treatment.

If moods can be thought of poles (as in polar opposites) the moods of people with bipolar disorder can swing unpredictably and wildly between two very opposite emotional states. These two states are often wild elation or agitation and profound depression. It is also true that bipolar people can experience more normal emotional states for extended periods of time even when they are not being treated for their condition.

The wildly elated state is the “manic” side of bipolar disorder. Behavioral symptoms of this abnormal state include restlessness, excessive energy, recklessness, euphoria, delusion thinking and feelings of immense power. Very common behaviors include excessive generosity, uncontrolled spending sprees and impulsive sexual escapades.

Seemingly without warning that mood can alter and the bipolar individual becomes profoundly depressed, angry, suspicious, irritated, confused or simply morose. The bipolar person may be overcome with a sense of worthlessness and sadness, may weep uncontrollably for little apparent reason, and be unable to sleep or take pleasure in anything.

The course of bipolar disorder is complex and unpredictable. Diagnosis can prove difficult. Duration of the bipolar emotional states can vary wildly among bipolar patients and within a single patient as well — from a few hours to a number of years with all the markers in between. Frequency of bipolar episodes also varies considerably.

Psychiatrists familiar with bipolar disorder tend to discuss the moods experienced by their patients as a spectrum of emotions and behaviors. Mood swings experienced by people with bipolar disorder may even be welcomed at times, because they can become exceptionally productive and creative at least for a while.

The destructive and pathological aspects of the disorder come to the fore when patients enter extreme emotional states and lose complete touch with reality. Their mania makes them abandon any respect for the rules of law, finance or sexual morays; they spend wildly and engage in outlandish or completely promiscuous sexual behaviors.

When they become unreasonably depressed they also become a danger to themselves and commonly entertain serious thought of suicide.

Bipolar disorder, for some obvious reasons, has a profound effect on families as well. Many psychiatrists consider bipolar disorder to be the hardest of all the psychological disorders for families to cope with. Perhaps what make this disorder so hard to understand are not the periods of abnormal behavior, but the periods of normalcy. It can be difficult to believe that someone who seems so normal one day can behave so strangely or feel so badly the very next day.

It’s important to remember this regarding bipolar disorder. If you suspect that you or someone you care about has bipolar disorder you should see a psychiatrist. Also take note that effective treatments are available for bipolar disorder as well.

Self medication has always had its perils. Self medication using herbal supplements without consulting with your doctor can be yet more dangerous. At the very least you should do your homework and consult with your doctor. In that way you may be able to initiate an intelligent discussion of the options available for treating your condition.
Be advised that supplements and herbal remedies can interact negatively with medications you are currently using.

Dietary Supplements Defined

The FDA defines dietary supplement ingredients as one or more combinations of the following substances:
• Herbs or botanicals
• Minerals
• Vitamins
• Amino acids
• Dietary substances to supplement the diet that increase intake (e.g. enzymes or tissue storm organs or glands)
• Concentrates, constituents, or extracts

What is 5 HTP and What Good Can It Do?

It has been found that 5-hydroxytryptophan (5-HTP) is an effective treatment for mild depression. It can control the levels of eight brain chemical called serotonin and achieve a calming effect. It appears to influence sleep patterns, overall mood, and resistance to pain. Most certain levels can result in anxiety depression irritability and the lack of patience.

You should speak with your doctor before a taking 5-HTP supplements of any kind. There have been reports of adverse side effects and interactions with other medications that are used to treat bipolar disorders associated with this supplement. Furthermore, 5HTP simply cannot be regarded as a replacement for bipolar medications.

What is DHEA and what good can it do?
Until you are about 25 years old your body produces its own supply of a hormone called dehydroepiandosterone (DHEA). At that point production of the hormone declines and may eventually stop altogether. DHEA is touted by advertisers as having anti aging properties and anti-depressive properties. Many of us who are past the age of 25 might feel happy to feel 25 again, but claims made for this hormone have yet to be proven conclusively true. Some studies on patients with Addison’s disease showed promise while other studies on patients who were HIV positive appeared to have little effect on mood or well being. Side effects of the DHEA are few.

What about St. John’s wort?
Herbal therapy with St. John’s wort (Hypericum perforatum) has shown encouraging results for alleviating the symptoms of mild depression. It appears to act on or in conjunction with the same three brain chemicals associated with bipolar disorder, serotonin, epinephrine, and dopamine. It would still be advisable to consult your doctor before commencing therapy with this herb.

Warning Signs
When we use the word “prevented” in the context of bipolar disorder we can only be discussing the prevention of its symptoms from occurring or escalating in the behavior of individuals. One good way of preventing the symptom of this mental illness from occurring is watching for the warning signs of the disorder.

What science has concluded regarding therapeutic efforts for bipolar disorder is that they should for the most part seek to prevent symptoms from recurring after a bipolar episode.

Essentially the symptoms and signs of bipolar disorder are two extremely abnormal mood states.
Symptoms of the abnormal state known as mania include restlessness, excessive energy, recklessness, euphoria, delusion thinking, excessive talking, extreme spending and generosity, drug and alcohol abuse, high-risk sexual encounters, less need for sleep, feelings of immense power, grandiose business schemes and hallucinations.

Symptoms of the abnormal state known depression include a sense of worthlessness and sadness, weeping uncontrollably for little apparent reason, an inability to sleep or take pleasure in anything, excessive sleeping, slow speech, changes in appetite, drug or alcohol abuse, suicidal ideation and inexpiable aches or pain.

Treatment
Lithium and Lamictal are commonly used to treat bipolar disorder. Both are regarded by psychiatrists as mood stabilizers. Should these medications fail to achieve their intended effects other psychiatric medications such as mood elevators, sedatives and antidepressants may be prescribed for persons with bipolar disorder.

There is a longstanding tradition of using psychotherapy to treat bipolar disorders as well. This type of therapy can help a patient develop and maintain coping mechanisms that will allow them to handle the everyday ups and downs of life. It may also be designed to encourage them to take their medications since extremes of mood can make it hard for a patient to act according to their own best interests in the wake of heightened euphoria or profound depression.

Family counseling can also be important for maintaining a stable psychological environment for the bipolar patient. Bipolar disorder can be particularly hard on family relations.

Group counseling can be of special benefit to bipolar persons who mistakenly believe that they are the only individuals on earth who feel the way that they do.

If they are fortunate enough to receive an appropriate amount of personal, psychological and medicinal care many individuals with bipolar disorder can live happy and productive lives with minimal or absent symptom logy. Treatment of symptoms often involves some trial and error since each case of bipolar disorder is different.

Bipolar I Disorder–Bipolar I disorder is a mental illness characterized by the severity of mood swings from mania to depression and back again. To be diagnosed with bipolar I disorder a person must have experienced a minimum of one manic episode. Their behavior in all likelihood during their one or more episodes served to completely disrupt their life.
Experiencing profound depression is also a typical part of life for people with bipolar I disorder. People with bipolar I disorder frequently cycle between the two extreme moods of depression and mania. Hence the older term “manic-depression”. It should noted, as well, that these peoples’ extreme mood swings do not preclude their experiencing prolonged periods of perfectly normal psychological states between their mood swings.
Bipolar II Disorder–Bipolar II disorder is a mental illness that resembles the more severe form of bipolar disorder known as bipolar I disorder. Their moods cycle between mania and depression over the course of time. What distinguishes bipolar II from bipolar I disorder is that the manic or up moods cannot be described as full-on or complete mania. Their highs are labeled with the term hypomania. To be diagnosed with bipolar II disorder a person must have experienced a minimum of one hypomanic episode. People with this disorder are also prone to suffering episodes of depression. Periods hypomania nor depression do not make up the entire live of these persons. They can live lives that are free of the behaviors and symptoms of bipolar II disorder for extended periods of time.

Where Does Something Called Cyclothymia Fit in?
The mental illness labeled cyclothymia can be thought of as relatively mild mood disorder. Its mood swings don’t attain the extreme peaks and valleys of major depression or mania. Researchers estimate that up to 1% of people in the U.S. have cyclothymia. Because it is a milder form of mental illness the onset of cyclothymia can be difficult to identify. Symptoms usually begin occurring in adolescence. The pattern mood swings is irregular and unpredictable. Mood variations are part of a normal psychological makeup and it can prove hard to distinguish cyclothymia. People with cyclothymia can cycle continuously from hypomanic to depressed, without a normal period in between. They are almost as likely to exhibit extended periods of depression or hypomania. Most experts have concluded that cyclothymic disorder is an extremely mild form of bipolar disorder.

All the different types of bipolar disorders exhibit variations within their types. Duration and frequency are the distinguishing characteristics. Both mania and depression can be seen to exist in the same person at the same time. Rapidly cycling bipolar disorders are marked by four or more episodes occurring within a year. In fact many more can occur, much more frequently. Persons with these symptoms are at greater risk for suicide.

Changes in the levels of brain chemicals called neurotransmitters can help in describing what is occurring in the brain when a patient is bipolar. Exactly what is happening is not completely understood. Levels of noradrenaline and serotonin are associated with depression and bipolar disorder. It has also been shown that levels of a third neurotransmitter called serotonin have an affect on mood and mood disorders.

Is There a Genetic Link?
Scientists have pretty much concluded that bipolar disorder runs in families. Studies that used identical twins indicated that if one identical twin had bipolar disorder, the other twin had a greater chance of developing the condition. It wasn’t a given, however. This indicates that genetics have a role to play, but not the only one since the genes of identical twins are, in fact, identical. Other siblings in the same family also showed a somewhat weaker tendency to develop bipolar disorder. The chance of an identical twin (of the bipolar twin) to also develop bipolar disorder is about 40% to 70% according to the research.

Other studies uncovered the fact that children with one biological parent with bipolar I or bipolar II disorder had an increased likelihood for getting bipolar disorder. Oddly enough, the bipolar parents in the study who had attention-deficit/hyperactivity disorder (AD/HD) were more likely to have children with bipolar disorder — but not AD/HD.

Scientific findings also show that simple depression is more common in families where other individuals have bipolar disorder. Conversely children with one or more bipolar parents seem to possess a propensity to develop other psychiatric disorder such as ADHD, major depression, or substance abuse. Additionally if a child is raised in a home where parents exhibit the symptoms of bipolar disorder in a flamboyant manner it appears that they are more likely to develop bipolar disorder themselves, regardless of genetic factors.

Is Lack of Sleep a Cause?
Sleep loss may cause a bipolar episode such as mania (elation) in some patients. Yet sleep disturbance is more accurately described as a precipitator of bipolar disorder symptoms in persons who are already predisposed to developing the disorder as opposed to being a root cause. Evidence indicates that if a sleep-deprived person who is bipolar enters a manic state, their need for sleep actually decreases even more.

Does the Age of One’s Parents Increase the Risk of Bipolar Disorder?
Research seems to indicate that it does. It suggests that children born who are to older fathers are at increased risk of developing the disorder. This may add another piece to the puzzle beside genetic and environmental factors that influence risks factors for bipolar disorder.