Bipolar I disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. It affects 1.2% of the American population which translates to 3.3 million people who suffer from this disorder. It is equally prevalent in men and women and occurrences peak in late adolescence and early adulthood. Bipolar disorder is believed to be caused by chemical imbalances in the brain. The symptoms of bipolar disorder are jumping between states of mania and depression. The manic state is defined by "distinct period of an elevated, expansive, or irritable mood state" . Symptoms of the manic state include talking very fast, being restless and being easily distracted. The depressive state is characterized by constant feelings of sadness, anxiety, loneliness, misery, indifference and fatigue. The difference between bipolar I disorder and bipolar II disorder is a matter of severity. Someone with bipolar II disorder experiences hypomanic episodes as opposed to manic episodes. Hypomania is not as serious as mania and does not hinder a person's daily functioning or cause a need for hospitalization. The actual cause of bipolar disorder I remains unknown but a variety of factors seems to be involved in causing bipolar disorder I in a person. These factors include genetics, brain structure and functioning and environmental factors. Until today there is no cure for bipolar disorder I but proper treatment is available. Thus, what are the treatments available that allow patients better control of their symptoms?
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Mood stabilizing medications are often the first choice to deal with bipolar disorder. A mood stabilizer is a type of psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts. Many of these medications are anticonvulsants, with the exception of lithium. Mood stabilizers are effective in reducing mood swings and regulating fluctuations in mood. Bipolar disorder appears to happen when there are too few or too many neurotransmitters, chemicals which act by relaying, amplifying or modulating signals between nerve endings in the brain. Mood stabilizers balance the neurotransmitter levels and affect the manner in which they interact with nerves in the brain. As bipolar I disorder is a lifelong disease , treatment with mood stabilizers is often lifelong as well. Early detection and treatment is crucial, because the earlier a person begins treatment the better are his/her chances of getting and staying better. When medication is stopped, patients usually relapse, often within the first six months. Following a relapse, treatment may be more difficult, as medication may no longer be effective in certain patients. As with most forms of medications, patients often suffer from several side effects.
Lithium, the most commonly prescribed treatment for bipolar disorder is the only true mood stabilizer. It is believed b some that lithium is effective in depression only where the underlying disorder is bipolar in nature. Published studies show its efficacy in all phases of bipolar treatment, including acute mania and mania prevention, and acute depression and depression prevention. Lithium affects the neurotransmitter dopamine by interfering with its receptors while promoting the increase of serotonin, another neurotransmitter. When ingested, lithium is widely distributed throughout the central nervous system and reacts with a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis. Serotonin has numerous effects on the human body including control of appetite, sleep, memory and learning as well as depression. 13) On the other hand, norepinephrine causes heart rate to increase and blood to flow to the heart, brain and muscles in times of stress. In effect, lithium taken as a mood stabilizing drug for bipolar disorder is probably more effectual in preventing mania than depression and could reduce the risk of suicide. Initially, lithium is used in combination with antipsychotic drugs because lithium can take longer, as long as one month, to take effect. It is also taken as a prophylaxis (a medical procedure whose purpose is to prevent) for depression and mania in bipolar disorder.
Another mood stabilizing medication that is noted as it treats both manic and depressive symptoms is lamotrigine. Lamotrigine is used in the treatment of both epilepsy and bipolar disorder. It is an approved drug for the maintenance treatment of bipolar disorder. Several different studies have shown that lamotrigine has antidepressant effects as well as mood stabilizing effects.
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Some people respond better to one mood stabilizer than another. Factors such as other medical conditions (e.g., kidney disease) and side effects help determine which mood stabilizer a physician may prescribe.
This source is reliable since it is in agreement with many other sources, and the following extract. "Lithium therapy is often effective in preventing the cycling between manic and depressive episode, and susceptible patients are often maintained on lithium therapy over very long time periods." (Carson, Butcher, & Coleman, 1988) . In addition, the article is based onfksjfklfas.
- Abnormal Psychology and Modern Life Eighth Edition, Carson,R.C., Butcher,J.N., Coleman, J.C., Scott, Foresman and Company.