Articles on bipolar disorder

Bipolar Disorder- What Is It? (Symptoms)

Dr. Milan Balakrishnan, Psychiatrist
What Is Bipolar Disorder?Bipolar disorder, also commonly known as manic depression, is a brain disorder that causes shifts in a person’s mood, energy, and ability to function. The symptoms of bipolar disorder can result in damaged relationships, difficulty in working or going to school, and even suicide. There are generally periods of normal mood as well, but left untreated, people with bipolar disorder continue to experience these shifts in mood. The good news is that bipolar disorder can be treated, and people with this illness can lead full and productive lives.What Are the Symptoms of Bipolar Disorder?Bipolar disorder can cause dramatic mood swings—from high and feeling on top of the world, or uncomfortably irritable and excited, to sad and hopeless, often with periods of normal moods in between. The periods of highs and lows are called episodes of mania and depression.MANIC PHASE• Feeling on top of the world. A sensation of sheer and utter happiness that nothing—not even bad news or a horrifying event or tragedy can change.• Sudden or extreme irritability or rage. While mania is often portrayed as a pleasurable experience, that is not thecase for many people with bipolar disorder.• Grandiose delusions. Individuals believe that they have special connections with God, celebrities, or political leaders.• Invincibility or unrealistic beliefs in one’s abilities. The person feels that nothing can prevent him or her from accomplishing any task.• Hyperactivity. Scheduling more events in a day than can be accomplished; inability to relax or sit still.• Excessively risky behavior. Reckless driving, outlandish spending sprees, foolish business investments, or out-of character sexual behavior.• Uncontrollable racing thoughts/rapid speech. Ideas that abruptly change from topic to topic expressed in loud, rapid speech that becomes increasingly incoherent.• Less need for sleep.DEPRESSED PHASE• Intense sadness or despair. The person feels helpless, hopeless, and worthless.• No interest in activities they once enjoyed.• Loss of energy, fatigue.• Sleep difficulties. Either sleeping too much or not at all.• Changes in appetite. Either a noticeable increase in appetite or a substantial weight loss unrelated to dieting.• Difficulty concentrating, remembering, making decisions.• Thoughts of death or suicide.PS. 30th of March is World Bipolar Day. Birthday of Vincent Van Gogh who committed suicide due to the disorder. Follow #WBD2016 #Mumbai on Twitter.

World Bipolar Day !

Dr. Satish S.Nagargoje, Psychiatrist
Mozart, Winston Churchill, Agatha Christie, TS Eliot, F S Fitzgerald, Robert Downey Jr, Francis Ford Coppola, Buzz Aldrin, Ben Stiller, Van Damme, Vincent Von Gough – all great names!But what’s common in all? All have achieved unmatchable, great heights in their respective fields! Their names speak for themselves! What else? Do you find them odd, inconsistent, risk taking, impulsive, irresponsible, despite their all greatness. Have you found yourself wondering, how can a person of such great abilities can behave in so irrational manner?Yeah, they did act so, they lived life of highs and lows, full of inconsistencies, thanks to a psychological condition they had in common, Bipolar Disorder!Have you heard about it? Do you know someone with this condition? What is this?Lets discuss this on occasion of World Bipolar Day ! Its celebrated on 30 th March every year, the birthday of legendary painter, Vincent Von Gough, who was posthumously diagnosed as probably having Bipolar Disorder. This day is celebrated to psycho-educate people and spread awareness about this condition and destigmatise the illness.Bipolar disorder is a chronic, persistent, psychological condition, in which a person’s mood dwells between two poles – mania and depression (hence bipolar!), in phases , for some significant duration of time, affecting their personal, professional and social life. When in manic phase, person experiences excess talkativeness, overfriendliness, flight of ideas, over energetic, decreased need for sleep, over confident, increased risk taking behavior, increased libido, over spending, excess use of addictive substances etc. They sometimes experience hypomanic phase, in which they experience similar symptoms of less intensity.When in depressive phase, they experience low mood, low confidence, indecisiveness, low energy, poor concentration, lack of interest in life and day to day activities, decreased or increased sleep and apatite, suicidal thoughts etc. Their life is an emotional roller coaster ride, where they have less control on life events, and are driven by emotions most of the time. They suffer through their personal, professional, social life due to same. Addiction and suicidal attempts are more common in people suffering from Bipolar disorder. There is no cure for Bipolar Disorder, but with regular use of medication and counselling, frequency- intensity- duration of symptoms of the illness can be controlled, helping them to develop insight into their illness. And they can also lead a healthy, happy, respectful life, with some help from family and society! “As Martin Luther King once said, I have a dream that one day our nations will rise up and create all men equal. And I have a dream that my son, who has lived most of his life with bipolar disorder, will one day live in a nation where he will not be judged by his illness, but rather by the content of his character. I believe that World Bipolar Day will help bring my dream to fruition.” Knowledge is power ! Learn about Bipolar Disorder ! Ask your doctor for more information !Keep smiling ! Keep shining !

I Am bipolar..how Do I Help Myself?

Dr. Milan Balakrishnan, Psychiatrist
Is there anything I can do to help my treatment?Absolutely, yes. First, you should become an expert on your illness. Since bipolar disorder is a lifetime condition, it is essential that you and your family or others close to you learn all about it and its treatment. Read our related blogs on depression and bipolar disorder.You can often help reduce the minor mood swings and stresses that sometimes lead to more severe episodes by paying attention to the following:Maintain a stable sleep pattern:Go to bed around the same time each night and get up about the same time each morning. Disrupted sleep patterns appear to cause chemical changes in your body that can trigger mood episodes.Maintain a regular pattern of activity: Don't push yourself too hardDo not use alcohol or illicit drugs:Drugs and alcohol can trigger mood episodes and interfere with the effectiveness of medications. You may sometimes find it tempting to use alcohol or illicit drugs to “treat” your own mood or sleep problems—but this almost always makes matters worse.Enlist the support of family and friends: However, remember that it is not always easy to live with someone who has mood swings. If all of you learn as much as possible about bipolar disorder, you will be better able to help reduce the inevitable stress on relationships that the disorder can cause. Even the “calmest” family will sometimes need outside help dealing with the stress of a loved one who has continued symptoms.It is okay to seek professional help. Family therapy or joining a support group can also be very helpful.Try to reduce stress at work: Of course, you want to do your very best at work. However, keep in mind that avoiding relapses is more important and will, in the long run, increase your overall productivity. Try to keep predictable hours that allow you to get to sleep at a reasonable timeLearn to recognize the “early warning signs” of a new mood episode:Early signs of a mood episode differ from person to person and are different for mood elevations and depressions.The better you are at spotting your own early warning signs, the faster you can get help. Slight changes in mood, sleep, energy,self-esteem, sexual interest, concentration, willingness to take on new projects, thoughts of death (or sudden optimism), and even changes in dress and grooming may be early warnings of an impending high or low. Pay special attention to a change in your sleep pattern, because this is a common clue that trouble is brewing. Since loss of insight may be an early sign of an impending mood episode, don’t hesitate to ask your family to watch for early warnings that you may be missing.All this will help you tackle bipolar and reduce relapses so bring it on BIPOLAR!!

Psychiatric Drugs: Myths and Facts

Dr. Aditya Gupta, Psychiatrist
There are several myths regarding psychotropic medications in our society. Through this article I will try to break few of them, to aware the public and remove stigma. Each myth will be followed by the associated fact.Medications will change my personality/ make my brain weak - Medications work to correct what is wrong. It doesn’t change who you are nor make you weak.Medications are addictive – with the exception of few, psychotropics cause little if any physical dependency. If taken under medical supervision safely tapering off them is possible.Medications are for weak people, who can’t deal with everyday problems. – psychotropics are not stress reducers, they correct genuine disorders. Far from being a sign of weakness, it takes considerable strength to admit that you have an illness.Psychiatrists give drugs to everyone who comes to them, I only need counseling.–Psychiatrists are the only health professionals who are trained to evaluate all biological, psychological and social factors involved with an illness. They are trained in psychotherapy as well as medication treatment and know which method to apply and when. Have faith in your doctor.Why do I need to see a psychiatrist, can’t my physician/neurologist prescribe for me? –Psychiatrist is the only specialist in mental illness and in medications used to treat it. You wouldn’t expect your orthopaedician to operate your eyes, nor should your physician be expected to know everything about prescribing and monitoring psychotropic medications.Psychotropics are effective but not some magic bullets. Recovery from severe mental illnesses often takes weeks or months, but the results are worth the wait.

6 Important Thoughts About Life

Dr. Swapna Patker, Psychologist
Depression is becoming common these days. People have many reasons to feel sad depressed and suicidal. More the advancement, more the expectations from life and more the disappointments. Less marks in exams, love break up, death of loved ones, professional disturbances, joblessness, loneliness, insults and helplessness are a few highlighted reasons that lead to severe depressions and suicides. Younger generation is less tolerant and gives up on the intimidation of every thing that's not as per their thinking. Of course, the pressure on the generation now is too high, to perform well, to live well, to look good and to be accepted. In the bargain, the mental health goes for a toss. Suicide is not an option at all. Meeting a psychologist and taking help is more easy, ethical and intelligent than leaving this world for some reason that could be sorted. 6 Important Thoughts that you need to know about life are: 1. Depression is a choice. If you allow too much negativity to seep in your thought process, you are bound to feel low. Positive attitude of people keeps depression away from their minds. Practice positivity for a depression free life. 2. Don't depend your life on people's judgements about you. Believe and respect yourself. Don't fall for over appreciation or hurting comments and insults of people. Don't give up your mood or  life because someone said something wrong to you. Be aware of yourself and don't let anyone tell you your worth. Take control of your self image and self worth. 3. Be comfortable with yourself. The way you look, the way you are and the way life is treating you is your life. Accept it. There are sarcastic and condescending people in this world, learn to mute them in real life. Don't let that affect your peace. Your life is precious; it's not worth giving it up for people who do not accept you the way you are. Learn to accept facts about yourself and plan to make the most out of whatever you already possess. 4. Mental wellness is more important than physical beauty and worldly pleasures. Skin colour, disability or illnesses should not be issues of depression in life. Love yourself. Some people intend to corner you and make things difficult for you. Don't fall for their trap. Safeguard yourself from people who are not concerned about your well being. 5. Each one feels low or lonely at some point time in life. Some succumb to the pressures of emotional turbulences and some get swayed away into the limbo called hopelessness. Take charge of your feelings and elevate yourself every time such negative thoughts touch your mind. 6. Help is available. If you ever feel that your mental pressures are beyond your control, take help of a psychologist or a counselor. Don't hesitate. It's better to take help and sort things than spoil or give up a precious life . Life is beautiful, if you can see it that way. Life will treat you the way you see it. Practice positivity and love yourself.

In the Grasp of Anxiety - When Worrying Has Become a Disorder

Ms. Pallavi Tomar, Psychologist
Everyone is familiar with anxiety.It may pop up as a feeling of unexplained apprehension, or a flood of constant worrying thoughts, a sudden burst of panic, or even an intense dread or fear. These feelings are all to situations, things and people perceived as overwhelming, unsafe or threatening. In all its manifestations, it is unpleasant and it is quite natural to want to avoid or eliminate these feelings.But before we move on to discussing anxiety as a disorder, lets understand the evolutionary function of this seemingly out of control beast.The essential evolutionary function of an anxiety response is to prepare an individual to deal effectively with danger and threat. That is why it exists at all.Take a look at a few symptoms and the function they may serve:The feeling of restlessness and increased heart rate may keep us physically prepared for action.Our interpretation of ambiguous information as threatening may actually be aimed at reducing the probability of missing any threats around us.Our mind racing with multiple thoughts of all that which can happen may actually keep us prepared for all possibilities and scenarios.The lack of sleep will allow us to be constantly alert.It propels us, makes us strive, challenges us and pushes our limits. Toss away anxiety and you may lose out a great deal of your motivation, persistence, excitement and caution.So ideally if anxiety is experienced in the right manner, for the right reasons and for the right duration – it is only natural!But how do we recognize the transformation of this natural experience of anxiety into a disorder?There are a few things to consider. Anxiety reactions manifest in three basic forms:As an emotion: The fear, the apprehension, the worry, and the despair.As a thought: Of an impending doom, of things going wrong, of death, of injury.As a physical response: To avoid, to evade, to check, to run, to become immobile, increased heart rate, difficulty breathing etc.In an anxiety disorder, these three basic forms of anxiety may be experienced as difficulties in any of the four below mentioned domains.Intensity – Is the experience of anxiety exaggerated and far too intense than what may be warranted in a situation? Does the individual find it difficult to contain and manage the anxiety? Is the individual finding it difficult to cope with the intensity of the signs and symptoms?Frequency – Are the signs of anxiety experienced too frequently by the individual? Is the individual repeatedly reacting to the same stressor/threat without developing newer ways to cope or deal with it?Pervasiveness – Are the signs or symptoms of anxiety experienced at most times across all situations? Does it seem to be pervading across all aspects of an individual's life?Dysfunction – Is the experience of anxiety impacting the individual's functioning in their personal, professional or social life? Does the individual have to make too many changes to accommodate and cope with the experience of anxiety? Is it affecting others around the individual?If your answer is affirmative to any of these questions, your experience of anxiety may not be serving the evolutionary purpose it is essentially meant for. But before you go ahead and diagnose yourself, I encourage you to talk to a mental health professional about your concern.

5 Common Myths About Psychiatry and Psychiatrists

Dr. Era S. Dutta, Psychiatrist
MYTH#1– Everyone who goes to a psychiatrist is MAD/INSANE/PAGAAL.FACT- Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. Psychiatrists are DOCTORS who specializes in mental health,including substance use disorders.MYTH#2- A psychiatrist only TALKS. How is that treatment?FACT- The great leaders of the world make big decisions by TALKing.Talking is one of the tools that psychiatrists use to treat. In fact as a specialty, a psychiatrist is likely to give you far more time to Talk your heart out and unburden your mind.MYTH#3- Psychiatrist will give me pills that will surely make me groggy and sleepy all the time.FACT– As doctors we take oath to do the best for our patient. We never prescribe sleeping pills to those who don’t require it. It is true that a lot of medications have the side effects of making you slightly groggy, but these can be circumvented with small tips from the doctor.MYTH#4- “Once on psychiatric medication, always on psychiatric medication.”FACT– Suppose if you had Tuberculosis (T.B) tomorrow, would the doctor keep you on medication forever? NO. There is a specific course of treatment.Similarly if you suffered from Diabetes or hypertension, there are more chances that you would be prescribed life long medications.Psychiatric medications need to be prescribed for a stipulated period of time. The duration varies from case-to-case, based on many factors. Few chronic conditions may need treatment life long (just like diabetes or high B.P), but not all.MYTH#5- “I stopped the medication and my problems came back. It’s the doctor’s fault as he/she has made me dependent on medicines.”FACT– Suddenly breaking the car can lead to accidents, hence we avoid doing it. Similarly, psychiatric medications are to be tapered or switched gradually which only a qualified psychiatrist can help you with. Managing your own medications and stopping them may cause this problem.

Eating Disorder: Things You Should Know!

Ms. Swati Kapoor, Dietitian/Nutritionist
A harmless remark by an educated parent on the physical attribute of their growing teenage girls resulted in a shocking “anorexia pact” by the duo at the age of 11. Now at the age of 33 and being doctors they don’t lead a normal life. Eating disorders might start at a very early , if not identified and treated can stay with you for life.Anorexia nervosa is one of the most common eating disorder that is associated with abnormally low weight achieved by extreme dieting, fasting and followed by compulsive exercising.  Mostly young girls are afflicted from this disorder especially in the absence of early parental care and support to inculcate healthy eating habits. Eating disorders have been around forever but finally society is accepting the seriousness of this ailment  and encouraging parents, friends to come together and support the person suffering from it.  There is a higher success rate of controlling and reversing it through family and social support .Eating disorders mostly start from home and parents play an extremely critical role in stimulating and curbing them.  Children very closely watch and imitate their parents. If the parents fuss too much about their looks and being thin the kids will imitate them. Similarly if the parents eat a lot of unhealthy food the kids would be inclined towards junk food even when they grow up. Therefore it is mostly parent’s responsibility to inculcate healthy eating habits amongst children.Eating disorder can have serious repercussions on health like weakness, fatigue,  anaemia, heart & kidney problems, osteoporosis, infertility, disruption of sugar levels  and even death. Nature and nurture is equally responsible for this condition. Therefore it is imperative to apply a three pronged approach to dealing with it.First restore the healthy weight of an individual, second to treat the psychological factors that may have caused this situation and lastly ensure there is total support and care to prevent relapse.Healthy Food does not make you fat. Its unhealthy eating patterns like eating too much processed food that only has empty calories and not nutrition. Also controlling the portions even at an early stage is important. This does not mean dieting it means regulating a healthy meal pattern in children where importance is give to a balanced diet that includes fruits, vegetables, dairy and grains. If a healthy food routine is followed the kids will tend to eat less junk as they will be fuller for longer resulting in optimum growth, overall health and better immunity.Also teens suffering from eating disorders tend to be very sensitive and emotional. Its important as a parents need to be more tuned to their emotion needs, provide them that extra affection and care.

The Emotional Roller Coaster: Borderline Personality Disorder

Dr. Kavita Sagarkar, Psychiatrist
For someone suffering from Borderline Personality Disorder (BP) and for the parents, siblings, partner or children of those having BP, it is usually  a frustrating journey literally from hell to nowhere....your very own emotional roller coaster ride!How would you know if someone suffers from BP?The patients of BP usually would be seen by a Psychiatrist during one of these  scenarios....they have become suicidal, attempt to cut their wrists, burn themselves or are threatening to kill themselves or family members because they hate them!  This may have been happening for some time before family members realize it to be a Psychiatric disorder.It is pretty scary for the family. BP patients can get completely out of control with rage, the very family members they idolized may suddenly be the hated ones. So, they are suicidal and depressed. But it is more than just plain Depression. They are literally on a path of self destruction. They tend to over idolize  people and a seemingly small remark can make them get into a rage and lead to self destructive behaviors. They become uncontrollable and unmanageable- one minute ago they were fine and the next minute you might find them suicidal or homicidal!Most of these behaviors  occur with family members only and to outsiders they may appear either  happy individuals or sometimes shy or under confident , that's all! Because of this trait they are usually labelled as being 'manipulative' by family members who get frustrated by their mood swings and constant suicide threats...They also tend to go from one failed relationship to another and usually these relationships are abusive...they tend to get into relationships with controlling, demanding and abusive people and may do almost anything to cling to the relationship...or sometimes just as suddenly their idolization can turn to bitter hatred leading usually to self destructive behaviors in the form of Alcoholism or drug abuse or drug overdose...While the diagnosis may be based on history of the symptoms described above , Psychological tests like Rorschach and MMPI personality tests may also aid in concluding the diagnosis of BP. Usually a history of childhood neglect and/or abuse is there. Even prior to the diagnosis and definitely after the diagnosis, these patients go from one Psychiatrist to the other or from one counselor to another in the hope of getting relief. While it has been proved that people with BP have imbalances in their brain chemicals(Neurotransmitters), medication may at most help in controlling aggression or alleviating Depression to some extent. Also, as symptoms vary at different times it becomes a mess of a number of anti-psychotics, anti- depressants, mood stabilizers , etc..But there is hope...Specific therapies like Dialectical Behavior Therapy( DBT) , Rational Emotive Therapy and  NLP(Neuro-Linguistic Programming) based techniques can help patients and families deal with BP.The goal of therapy is multi-fold.First and foremost, is Emotion regulation,  bringing about control on our emotions through various mindfulness techniques , NLP based techniques and understanding how our perceptions cause us distress. Second, would be impulse control through simple techniques like body scan and 3 minute  breathing technique. Learning to identify triggers and moving from reactivity to responsiveness. Try this 'Step out of the waterfall' technique for impulse control..as you feel yourself falling into a cascade of negativity like a cascading waterfall, imagine stepping out of the waterfall and observing calmly the rushing water go by...soon you will realize that  the negative impulse did not last....you can now think about things affecting you calmly.Third, is to bring about improvement in Interpersonal relationships and lastly, to improve self- image. These patients usually have a love-hate relationship with family members as well as suffer from self-loathing. They are dialectical in their thinking patterns, opposing thoughts co-exist within them .  This can be handled by correcting faulty belief systems usually developed in childhood due to neglect or abuse. The road ahead may be long and arduous but together we can succeed! 

Take This Quiz to Check if You Have a Sleep Disorder!

Dr. Sukhant Bagdia, Pulmonologist
The Epworth Sleepiness Scale (ESS) is a scale intended to measure daytime sleepiness that is measured by use of a very short questionnaire. This can be helpful in diagnosing sleep disorders in people complaining of snoring during sleep. It was introduced in 1991 by Dr Murray Johns of Epworth Hospital in Melbourne, Australia. This questionnaire asks you to rate your probability of falling asleep on a scale of increasing probability from 0 to 3 for EIGHT different situations that most people engage in during their daily lives, though not necessarily every day. The scores for the eight questions are added together to obtain a single number. A number in the 0–9 range is considered to be NORMAL while a number in the 10–24 range is considered to be ABNORMAL which indicates that expert medical advice need to be taken.How to SCORE the increasing PROBABILITY of DOZING:0 = no chance of dozing1 = slight chance of dozing2 = moderate chance of dozing3 = high chance of dozingSCORING finally according to following situations:SITUATIONCHANCE OF DOZING1. Sitting and reading_?0__?1__?2__?3_2. Watching TV_?0__?1__?2__?3_3. Sitting inactive in a public place (e.g a theater or a meeting)_?0__?1__?2__?3_4. As a passenger in a car for an hour without a break_?0__?1__?2__?3_5. Lying down to rest in the afternoon when circumstances permit_?0__?1__?2__?3_6. Sitting and talking to someone_?0__?1__?2__?3_7. Sitting quietly after a lunch without alcohol_?0__?1__?2__?3_8. In a car, while stopped for a few minutes in traffic_?0__?1__?2__?3_Total your SCORE and JUDGE your PROBABILITY for Snoring Related Health Problem.