Bipolar disorder, known as "manic depressive illness" and "bipolar mood disorder", occurs in individuals; It is seen as mood attacks covering various periods, including "mania-hypomania", "depression" and "mixed".
Every year, March 30 is commemorated as "World Bipolar Day".
Bipolar disorder attacks can be completely cured!
Bipolar disorder; Manic depressive illness is an important psychiatric disorder, also known as bipolar mood disorder. It is characterized by mood attacks covering various periods such as 'Mania/Hypomania', 'Depression' and 'Mixed'.
If we were to define these periods, depression; While it includes symptoms such as depression, unhappiness, inability to enjoy life, thoughts of worthlessness, pessimism, difficulty concentrating, weakness, body aches, sleep, appetite changes, suicidal thoughts; Mania/hypomania is an attack that disrupts functionality, such as exuberance, exaggerated increase in self-confidence, irritability, increased talking, flight of ideas, rapid distraction, hyperactivity, spending a lot of money, inappropriate behavior, easy risk taking, inability to sleep, decreased need to eat, quarrelsomeness. periods. The coexistence of some symptoms of depression and mania is called a 'mixed episode'. The disease progresses with attacks, and the duration and severity of attacks may vary from person to person or over the years. Attacks often heal completely; However, in some people, some symptoms, called residual symptoms, may continue.
Misconceptions about bipolar disorder
It is useful to correct some common misconceptions about Bipolar Disorder.
The disease is perceived as constant mood changes, or people who experience various behavioral problems are called bipolar. This is completely wrong, bipolar is not a personality trait or behavioral problems, contrary to popular belief, they are healthy except for attack periods that need to be treated. Apart from this, there are also stigmatizing false beliefs such as they cannot marry, cannot have children, cannot work, they can marry like every individual who has reached the maturity of marriage, except for shift work that disrupts the sleep pattern (sleep pattern is important to prevent attacks from being triggered). They can work and get pregnant under doctor's supervision.
Attacks are triggered during stressful periods
Attacks occur in certain seasons; It can be triggered especially in stressful periods such as spring months, military service, and special situations such as postpartum. In the occurrence of the disease; Genetic predispositions, changes in biological substances in the brain, stress and trauma may be effective.
The disease often begins in the 20s. The general incidence is around 1-2%. This frequency is similar in men and women. This rate can increase to approximately 8-9% in people whose first-degree relatives have the disease. Genetic predisposition is very important in the disease, but we cannot talk about direct genetic transmission. Genetic predisposition comes to the fore especially in bipolar disorder, which begins in childhood and adolescence. The age of onset can be as low as 7-8 years. It is more difficult to diagnose at these ages and it can often be confused with other diseases or conditions. The disease can start at any age, including those over the age of 60. In these cases, it is necessary to investigate the relationship with other physical diseases and to closely monitor the risk of suicide and drug side effects.
Family support is of great importance
Bipolar disorder treatment is divided into two: attack treatments and preventive treatment. Attack treatments vary depending on the depression/mania/mixed episode at the time. Treatment can be inpatient or outpatient, depending on the severity of the attack. As well as various medications used in treatment, additional methods can also be used, these are; These are treatments such as ECT, TMS, Deep TMS. In preventive treatment, psychotherapy support as well as mood stabilizing medications are important. In addition, in order to be protected from attacks, it is important to follow up at the outpatient clinic, use medications as recommended, monitor the blood levels of preventive medications, recognize the early signs of the disease, have regular sleep, and stay away from alcohol and substances. Also here for families; supporting patients in treatment, recognizing the disease and being knowledgeable about triggering factors, precursor symptoms, drug side effects, stigma of the disease, providing psychosocial support, etc. tasks are falling.
The course of the disease in women varies according to periods
Although gender differences in the disease are not very obvious, depressive and mixed periods, seasonal recurrences are more common in women, and some other psychiatric diseases such as anxiety disorders or thyroid diseases are more common. It is more frequently accompanied by medical conditions such as: The importance of the disease in women varies during pregnancy, puerperium and menopause. Postpartum period and menopause may trigger attacks. Although pregnancy itself does not pose a risk, stopping drug treatments may trigger attacks again.
How does the process progress during pregnancy?
Bipolar Disorder patient When women decide to become pregnant, they share this with their psychiatrist, and it is decided how the treatment should continue for each patient. Drug use during pregnancy is made according to the course of the disease, the severity of the attacks, and the evaluation of fetus-mother, profit-loss on a patient-specific basis.
If it is decided to discontinue drug treatment completely; Discontinuation of pregnancy protection should be after the period deemed appropriate by the physician after the drugs have been completely discontinued. It may be protective for the patient whose drug treatment is discontinued to receive psychotherapy support during pregnancy, pay attention to sleep patterns, and avoid stress. Patients are generally worried about attacks occurring during pregnancy and being helpless about treatment. It is important to inform the patient during this process. Again, there are treatments that can be applied depending on the patient and the severity of the disease. Considering the health of the mother and the fetus, treatment can be applied by choosing safer drug groups and the lowest doses. It is recommended that pregnant women who are treated with medication undergo more frequent psychiatric examinations and gynecological checkups, and the level of the medication in the blood should be monitored. Apart from drug treatments, TMS treatment is a safe treatment method that can be applied to suitable patients without affecting the fetus. ECT treatment and clinical hospitalizations are the treatment methods used during pregnancy, especially in severe attacks. If the patient realizes that she has become pregnant while taking medication, she should consult her doctor as soon as possible; some medications may need to be stopped immediately.
Risky. Period: Postpartum
In addition, since there is a risk of passing drugs to the baby through breastfeeding, treatments are selected by evaluating the health and benefits of the mother and baby. Drug treatments are planned in low doses and to ensure minimal transfer to the baby. The baby and mother are monitored for side effects. If necessary, breastfeeding can be discontinued by contacting the pediatrician and making a feeding plan for the baby. TMS can be chosen in suitable patients with the advantage that it does not affect breastfeeding.
Psychotherapy should be applied during pregnancy and puerperium
Psychotherapy should be recommended during both pregnancy and puerperium. During this period, it is important for the patient to sleep uninterruptedly at night, for the family to undertake the duty of night feeding, and for the physical and psychological support of the family. When deciding on treatments during breastfeeding, the mother's desire to breastfeed and the baby's need to breastfeed should be taken into consideration; However, it should also be considered that the mother's health is important, treatment is mandatory, and the baby needs a healthy mother for its development.
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