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Bipolar disorder

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Биполярное расстройство

It is a very puzzling psychological phenomenon that is increasingly common in real life. Many famous people, such as Van Gogh, Catherine Zeta-Jones, Hemingway made their “coming out” and admitted that they suffered from this disease.

What is bipolar disorder? Previously, bipolar disorder was called maniac depressive psychosis, but after several types of the disorder were found, maniac depressive syndrome has become the subtype of the broader title of this psychological pathology that is bipolar disorder.

psych-1Bipolar disorder involves alternating phases of mania and lingering deep depression. If most of us have at least some idea of how depression shows, many tend to not quite correct treat manic side. Manic phase is not simply an elevated mood and hyperwakefulness, but also the phase in which a person becomes a victim of episodes of delirium due to lack of sleep and exhaustion of the nervous system. Some patients in the period of manic activity cannot sleep for many days or sleep only a few hours a day. It may be noted that the decrease in sleep time is one of the elements, which is a precursor to the manic phase. In some cases, reducing of sleep time during the depressive phase can cause the manic phase. Unfortunately, most patients are hospitalized in France during manic disorders, to stabilize them and protect their nervous system. At the beginning of this phase, the patient may feel happy, as he/she becomes more workable due to the fact that mental processes are accelerated significantly. Often, they feel their superiority over the others and imagine themselves invulnerable. It is because of this 50% of people suffering from the bipolar disorder will have a problem with alcohol or drugs, as in the period of  the “fast phase” they cannot stop and do not know limits.

Unfortunately, many do not understand how the bipolar disorder can be dangerous. In France, doctors clearly recognize that this pathology is fatal, because in 15% of cases, a person who has not received adequate treatment, commit suicide.

What is the cause of this pathology and what provokes it? One of the leading French doctors specializing in treatment of the bipolar disorder Renee Friedman believes that there is undoubtedly a genetic factor, but there is also an external factor. A childhood trauma can also cause the onset of illness. Despite the fact that the gene, which could carry the information about the disease, have not been detected, the presence of disease in families, such as in the case of Hemingway, the sister, brother and mother of which were also victims of the bipolar disorder, unfortunately, committed suicide. Statistics show that the average risk of becoming bipolar accounts for between 1% and 3%, however, if one of the close relatives sick with bipolar disorder, the risk increases to 10%. And if both parents are bipolar, the risk that the child will be bipolar increases to 30%. It is noteworthy that in twins if one of them is suffering from the bipolar disorder, the risk that the second one will be the victim of the disease is increased to 50%, but if they are not identical twins, the risk is of only 10%. In the 80s, a lot of scientists actively looked for a gene that could be responsible for the existence of this syndrome, but today there is an opinion that it is not one gene, but a large number of the, which can simultaneously carry information about the disorder. The last argument in favor of the fact that this is a genetic factor is an adopted child suffering from the bipolar disorder, if one of his/her parents suffered from this disease. This is the research that have long been not a great discovery for the majority of psychiatrists in the world.

On January 20, 2017 a reference book for bipolar disorder will be published in France for all psychiatrists. This reference book will have all the necessary information on treatment and monitoring of patients with the bipolar disorder.

Why is it important to know the cause of the disease? It’s all to understand how to treat it. In the case of bipolar disorder, French doctors are inclined to believe that this is a biological brain disorders, not mental. This is confirmed by the phases the patient has, since when going from one phase to another, many patients say about the feeling as if something was switched in the brain. That is, we are clearly seeing the controller dysfunction in the brain. So, initially the controller, roughly speaking, “is broken”, but external factors can exacerbate its operation, they are breaking up, loss of a loved one or failure in studies and work.

Large studies have shown that among preterm infants and children whose mother have suffered from an infectious disease during pregnancy, the risk is also increased, which allows to also conclude that we are talking about a possible malformation in the brain. There is a new hypothesis that viral diseases caused by retroviruses, can also be the cause of the bipolar disorder. Despite the fact that the bipolarity of the second type is considered less dangerous since mania is less expressed (we call it hypomania), the risk of suicide is the same for the two types. From a medical point of view, the bipolarity of the second type is much more difficult to treat, because the majority of patients during the period of mania, which is less pronounced than in patients with the bipolar disorder of the first type, feel very good, and do not consider the treatment necessary. Often, a patient goes to the doctor only in the period of depression, and is silent about mania, the physician may incorrectly assign antidepressants, which may aggravate the disease. Thus, if antidepressants are not effective, you have to reconsider the diagnosis. For the reliability of the diagnosis, French experts do not talk to the patient himself/herself about the symptoms, but with his/her loved ones, because the patient may not always be objective in his/her feelings.

If we go back to the bipolar disorder of the first type, very often doctors confuse schizophrenia with bipolar disorder, as in the period of mania, a person can have not only the obsession, but hallucinations, i.e., it may seem that a person from radio or TV is talking to him/her, this phenomenon may be aggravated, if the person takes drugs.

The most disastrous for patients with the bipolar disorder is late diagnostics and bad treatment. In France, 9 platforms were created that help to quickly identify the bipolar disorder. These 9 centers, experts in the field of bipolar disorder, were founded with the support of the Ministry of Development, and their main task is not only to help in diagnostics, but also to offer innovative approaches in treatment. As part of these centers, an association was created that raises money for research in this area. France psychiatrists cooperate with these centers very closely and help them in diagnostics and treatment, as well as in support after treatment.

We asked one of the experts in the field of bipolar disorders what a young girl, who suffers from the bipolar disorder and who wants to have children can do. This is an interesting question, especially when you consider the fact that the risk that the child will be bipolar increases. We were told that any pregnancy bears different risks, and if you are afraid of the risks, you will not have children. However, there are recommendations for pregnant women with bipolar disorder, namely, to undergo treatment and to balance the general condition, since in spite of the fact that initially this is a genetic factor, the disease wakes up at an early age due to trauma, that is, baby needs a healthy environment.

Many patients, as a child, even before they became bipolar, according to their close friends, were more sensitive and experienced emotions brighter than ordinary children. It is important to understand that when we speak of mania as such, it does not mean that a person will be constantly cheerful, it means that he/she has heightened senses on all sorts of emotions, and if he/she finds out bad news, in the period of mania his/her anger will be multiplied. The same is true regarding the depressive period, when patients have absolutely no emotions regarding either good or bad news.

If parents notice signs of hypersensitivity in their child, this does not mean that the child should take psychotropic medications, it should be borne in mind, but take him/her as he/she is and consider his/her sensitivity as a feature of his/her character.

In France, the most popular drug for treating the bipolar disorder is lithium. It is followed by timoregulators, mood stabilizers, mood stabilizers and antipsychotics. Lithium is considered to be a very effective treatment in combination with psychotherapy, but if a doctor determines incorrect individual dose for the patient, there is a risk of overdose, which is why, the doctor should perform a blood test on a regular basis in order to avoid side effects. Some women in 40s  may have problems with the thyroid gland, but these problems are solved easily with medication and hormonal therapy and are not an indication to stop treatment with lithium. Can it be assumed that this treatment will last for life? No. The treatment lasts two to three years after the norm has been determined in a clinical setting. Then, the treatment will be renewed every 10 years, or if there is a relapse, in other words decompensation. With regards to treatment with lithium during pregnancy, a new study showed that the risk for the baby is very low, and that the risk in case of stopping treatment is much higher than the risk, which lithium poses for the baby.

Only a doctor can decide to stop the treatment, because the patient cannot quite understand that he feels good not because he/she is healthy, but because he/she is under the influence of the drug, plus the entire treatment should be completed progressively.

Taser or TMS (transcranial magnetic stimulation) still remain in the arsenal of non-drug treatment of the bipolar disorder. Electroshock sounds ominous but it helps to save many lives. The main objective of this procedure is to provoke an artificial cerebral epilepsy, which in turn will cure depression. All this happens under anesthesia. Although the exact physiopathology of how it works has not been discovered yet, this method is considered extremely effective. When provoking a neural jolt, we restart the brain.

One last important point is the psycho-emotional training, in order people suffering from bipolarity could understand and manage their condition themselves. A person must take it as it is and learn to live with it. After a course on psycho-emotional behavior, it will be much easier for a person with the bipolar disorder to anticipate possible attacks, thus preventing relapse.

  1. Бирка :

    Очень нравится подход в цивилизованых странах, у нас биполярное расстройство за болезнь не считают, лечить нормально не умеют, про диагностику вообще молчу.

  2. Алёна :

    Сестре не могли поставить диагноз биполярное расстройство более 11 лет, травили антидепрессантами, более того, когда поставили диагноз продолжали убивать мозги этой гадостью. Если это действительно не психичаская проблема, а болезнь мозга, как написано в статье, то антидепрессанты тут явно не помогут. Во всех развитых странах уже знают как лечить таких людей, только у нас с умным видом делают вид что лечат, а главное пока убивают здоровье, заставляют поверить, что всё под контролем.

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