Bipolar Disorder

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Vitamin D [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]:

Please note, this management does NOT treat the condition itself. It may mildly help in preventing some of the symptoms, and even then has insufficient evidence to back up this claim at present. Please note, this acts as a PREVENTATIVE treatment, and not necessarily symptomatic relief.

Recommendation: No recommendation (There is insufficient evidence to support claims that Vitamin D can help prevent mood disorders)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

Bipolar Disorder

Bipolar disorder is a mental illness wherein the person has dramatic extremes of mood. Affected people are exaggeratedly energetic when they experience mania and sad or hopeless when they experience depression. ^[1] This psychiatric condition seriously affects the everyday living of the person. ^[2] Bipolar disorder can lead to ruined relationships, poor academic performances and even suicide. ^[3]

Epidemiology

About 4 million people in the United States are affected. ^[4] Bipolar disorder is often developed during the late teens or early adult stages. It is estimated that 50% of the cases start before reaching 25 years old. ^[3] The disorder is also listed worldwide as the fifth leading cause of disability and ninth leading cause of years lost brought about by death or disability. Men have greater tendency to develop it earlier in life than women. ^[4]

Causes

The exact cause of bipolar disorder has not been determined. It is believed to be a result of multiple factors. Bipolar disorder is thought to arise from imbalance of brain chemicals called neurotransmitters like norepinephrine, serotonin and dopamine. It is noted that if a family member has the disease, the other family members have increased likelihood of developing it as well with the highest risk carried by an identical twin. However, significant genetic and environmental factors must be at hand for the disease to develop. ^[5] Stress is an important factor proposed to be a major cause of bipolar disorder. ^[4]

Signs and Symptoms

Distinct periods called "mood episodes" are experienced by patients with bipolar disorder. The mood episodes are "manic episode" and "depressive episode". "Mixed state" may occur when there are symptoms of both mania and depression.

Symptoms of manic episode are mood changes such as feeling overly happy and outgoing or extremely irritated. There may also be behavioural changes like being restless, taking less sleeps and being impulsive on activities like sex and money spending.

Symptoms of depressive episode include loss of interest and feeling of emptiness. The individual may also feel tired, irritable and have difficulty concentrating. There may also be suicidal thoughts and attempts. ^[3]

Diagnosis

Diagnosis is based on signs and symptoms. Physical examination and a detailed interview are used to assess the patient. Laboratory exams may be requested to rule out medical conditions that may mimic or may cause the symptoms. ^[5]

Treatment

Currently, there is no cure for bipolar disorder but affected people can live a relatively stable life when given proper remedy. Since bipolar disorder is a lifelong and recurrent disease, long-term management is needed. ^[4] Drugs that stabilize mood are often given in conjunction with psychiatric counselling. Therapy is more successful with strong social support. ^[5]

References:

1 http://www.nlm.nih.gov/medlineplus/bipolardisorder.html

2. http://bipolar.about.com/od/diagnosissymptoms/a/bipolardisorder.htm

3. http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

4. http://www.medicinenet.com/bipolar_disorder/article.htm

5. http://www.emedicinehealth.com/bipolar_disorder/page2_em.htm#Bipolar%20Disorder%20Causes

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