Unspecified Bipolar And Related Disorder

Treatment Of Bipolar Spectrum Disorders

Bipolar I Disorder Video Simulation DSM-5-TR Symptoms Case Presentation

Another implication of non-bipolar-disorder conditions falling within a broader bipolar spectrum is the possibility that medicines used to treat bipolar disorder might have value in other disorders. Psychiatrists have long known that mood stabilizers, such as lithium, may be effective to some degree in people with conditions other than bipolar disorder. That includes conditions such as major depressive disorder, impulse control disorders, or some personality disorders.

Psychiatrists may sometimes prescribeà bipolar disorder treatmentsà for people believed to have bipolar spectrum disorders. These medications are typically anti-seizure medications or antipsychotic medications. Examples include:

In bipolar spectrum conditions, these mood stabilizers are generally used as add-on therapies after treating the main mental condition. However, because these types of medicines have not been as well-studied for conditions other than bipolar I or II disorder, some experts caution against presuming that they will be helpful, and question the appropriateness of their widespread use until appropriate large-scale studies are done to establish their safety and efficacy in non-bipolar conditions.

Possible Bipolar Spectrum Conditions

The idea of a broader “bipolar spectrum” involves the idea that people with certain other mental conditions may be in the bipolar spectrum. Mental or behavioral conditions that share some common features with bipolar disorder, and are therefore sometimes included within a possible bipolar spectrum, include:

  • Highly recurrent or treatment-resistant depression
  • Impulsive disorders
  • Eating disorders, such as anorexia and bulimia
  • Personality disorders, such as borderline personality disorder
  • Childhood behavioral disorders, such asà conduct disorder or disruptive mood dysregulation disorder

Researchers are still trying to determine when and how conditions such as these may overlap with bipolar disorder in terms of symptoms, underlying biology, and possible treatment implications.

Bipolar And Related Disorders In Dsm

Published online by Cambridge University Press: 05 July 2016

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
Dietmar Winkler
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
Siegfried Kasper*
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
*Address for correspondence: Siegfried Kasper, MD, Professor and Chair, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 1820, A1090 Vienna, Austria.

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What Are The Different Types Of Mood Disorders

These are the most common types of mood disorders:

  • Major depression. Having less interest in usual activities, feeling sad or hopeless, and other symptoms for at least 2 weeks may indicate depression.

  • Dysthymia. This is a chronic, low-grade, depressed, or irritable mood that lasts for at least 2 years.

  • Bipolar disorder. This is a condition in which a person has periods of depression alternating with periods of mania or elevated mood.

  • Mood disorder related to another health condition. Many medical illnesses can trigger symptoms of depression.

  • Substance-induced mood disorder. Symptoms of depression that are due to the effects of medicine, drug abuse, alcoholism, exposure to toxins, or other forms of treatment.

Hypomanic Episode Without Prior Major Depressive Episode

Bipolar I vs. bipolar II: Symptoms, tests, and treatment
  • 1 or more hypomanic episodes in an individual whose presentation has never met full criteria for a major depressive episode or a manic episode.
  • If this occurs in an individual with an established diagnosis of persistent depressive disorder , both diagnoses can be concurrently applied during the periods when the full criteria for a hypomanic episode are met.

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What Qualifies As A Mood Disorder

Overview. If you have a mood disorder, your general emotional state or mood is distorted or inconsistent with your circumstances and interferes with your ability to function. You may be extremely sad, empty or irritable , or you may have periods of depression alternating with being excessively happy .

What Are The Types Of Bipolar Disorder

There are four types of bipolar disorder, including:

  • Bipolar I disorder: People with bipolar I disorder have experienced one or more episodes of mania. Most people with bipolar I will have episodes of both mania and depression, but an episode of depression isnt necessary for a diagnosis. The depressive episodes usually last at least two weeks. To be diagnosed with bipolar I, your manic episodes must last at least seven days or be so severe that you need hospitalization. People with bipolar I can also experience mixed states .
  • Bipolar II disorder: People with bipolar II experience depressive episodes and hypomanic episodes. But they never experience a full manic episode thats characteristic of bipolar I disorder. While hypomania is less impairing than mania, bipolar II disorder is often more debilitating than bipolar I disorder due to chronic depression being more common in bipolar II.
  • Cyclothymic disorder : People with cyclothymic disorder have a chronically unstable mood state. They experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood , but these periods last fewer than eight weeks.
  • Other specified and unspecified bipolar and related disorders: If a person doesnt meet the diagnostic criteria for bipolar I, II or cyclothymia but has still experienced periods of clinically significant abnormal mood elevation, its considered other specified or unspecified bipolar disorder.

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What Are The Different Types Of Bipolar Disorder

Though many people, TV shows, and movies talk about bipolar as if its one thing, there are actually four types of the disorder:

  • Cyclothymic Disorder

  • Other Specified and Unspecified Bipolar and Related Disorders

  • Details on each of those below, but they all share a few basic similarities, including significant changes in mood, activity levels, energy, and thought processes. With all, theres a toggle between mania and depression. The biggest difference between the bipolar types is the severity of the symptoms. Depending on the type, the mood swings can last days, weeks, or months, or mania and depression can even happen at the same time.

    What Medications Are Used To Treat Bipolar Disorder

    Psychotic disorders

    Certain medications can help manage symptoms of bipolar disorder. You may need to try several different medications, with guidance from your healthcare provider, before finding what works best.

    Medications healthcare providers generally prescribe to treat bipolar disorder include:

    • Mood stabilizers.
    • Second-generation neuroleptics .
    • Antidepressants.

    If youre taking medication for bipolar disorder, you should:

    • Talk with your healthcare provider to understand the risks, side effects and benefits of the medication.
    • Tell your healthcare provider about any prescription drugs, over-the-counter medications or supplements youre already taking.
    • Tell your healthcare provider right away if youre experiencing concerning side effects. They may need to change your dose or try a different medication.
    • Remember that medication for bipolar disorder must be taken consistently, as prescribed.

    Mood stabilizers for bipolar disorder

    People with bipolar disorder typically need mood-stabilizing medication to manage manic or hypomanic episodes.

    Types of mood stabilizers and their brand names include:

    Thyroid gland and kidney problems can sometimes develop when taking lithium, so your healthcare provider will monitor the function of your thyroid and kidneys, as well as monitor the levels of lithium in your blood, as levels can easily become too high.

    The following are signs of lithium toxicity . Call your healthcare provider immediately or go to the nearest emergency room if you experience:

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    A Note On Bipolar Disorder Other Specified

    The DSM-5 also describes the four classifications as:

    • short-duration hypomanic episodes and major depressive episodes
    • hypomanic episodes and major depressive episodes
    • hypomanic episode without a prior major depressive episode
    • short-duration cyclothymia

    No, unspecified bipolar disorder is not the same as mixed features.

    Bipolar disorder with mixed features is present when someone is experiencing mania and depression simultaneously.

    Bipolar disorder NOS means that you meet some but not all criteria to be diagnosed with bipolar disorder.

    Diagnosis of unspecified bipolar disorder often occurs when symptoms are consistent with the depressive and hypomanic or manic phases typically seen in bipolar disorder.

    Still, there isnt enough information to make a full diagnosis.

    According to the DSM-5, a clinician may choose not to specify why the full criteria arent met.

    Sometimes this may be due to not having enough information, such as in short-term treatment settings like the emergency room.

    The symptoms of bipolar disorder can vary from one individual to another.

    Most people experience periods of depressive episodes followed by mania.

    A period of mania with fewer severe symptoms is called hypomania. Hypomania may be more common with bipolar disorder NOS.

    Unspecified Vs Specified Bipolar Disorder

    As mentioned, the American Psychiatric Association prefers the terms unspecified or other specified for bipolar disorder to better reflect the uncertainty of the diagnoses. .

    Other specified bipolar disorder may be diagnosed when a person displays specific symptoms of bipolar , but the full criteria for those symptoms aren’t met.

    Unspecified bipolar may be the diagnosis when a person’s symptoms resemble the symptoms of bipolar disorder, but the clinician chooses not to specify the reason the criteria are not met for a specific bipolar disorder, such as in an emergency room where there is insufficient information to make a more specific diagnosis.

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    What Causes Bipolar Disorder

    Scientists dont yet know the exact cause of bipolar disorder.

    But they do believe theres a strong genetic component. Bipolar disorder is considered one of the most heritable psychiatric conditions more than two-thirds of people with bipolar disorder have at least one close biological relative with the condition. However, just because you have a biological relative with bipolar disorder, doesnt necessarily mean youll also develop it.

    Other factors that scientists think contribute to the development of bipolar disorder include:

    • Changes in your brain: Researchers have identified subtle differences in the average size or activation of some brain structures in people with bipolar disorder. However, brain scans cant diagnose the condition.
    • Environmental factors like trauma and stress: A stressful event, such as the death of a loved one, a serious illness, divorce or financial problems can trigger a manic or depressive episode. Because of this, stress and trauma may also play a role in the development of bipolar disorder.

    Scientists are currently performing research to determine the relationship that these factors have in bipolar disorder, how they may help prevent its onset and what role they may play in its treatment.

    What Is Bipolar Disorder

    Is bipolar genetic?

    Bipolar disorders are described by the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders as a group of brain disorders that cause extreme fluctuation in a persons mood, energy, and ability to function.

    Bipolar disorder is a category that includes three different condition–, and .

    • Bipolar I disorder is a manic-depressive disorder that can exist both with and without psychotic episodes

    • Bipolar II disorder consists of depressive and manic episodes which alternate and are typically less severe and do not inhibit function

    • Cyclothymic disorder is a cyclic disorder that causes brief episodes of hypomania and depression

    Bipolar and related disorders are given a chapter of their own in the DSM-5, between and . People who live with bipolar disorder experience periods of great excitement, overactivity, delusions, and euphoria and other periods of feeling sad and hopeless . As such, the use of the word bipolar reflects this fluctuation between extreme highs and extreme lows. The diagnosis is frequently assigned to young patients presenting with a . In these cases, diagnosis is exclusively based on psychiatric history provided by family and caregivers, not on the current psychopathological assessment by the psychiatrist.

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    The Major Difference Between Bipolar I And Bipolar Ii Disorder Lies In The Severity Of The Manic Episodes

    With Bipolar I, the mania is more severe, characterized by exceptional energy, restlessness, trouble concentrating, feelings of euphoria, and lack of sleep. Psychotic symptoms including delusions of grandeur may be present. People with Bipolar I illness may engage in risky behaviors and may need acute inpatient hospitalization.

    In May 2016, HopeWay featured Kevin Hines at our annual Covington Educational Event. He spoke about his struggle with Bipolar Disorder that led to his near-fatal suicide attempt from San Francisco’s Golden Gate Bridge in 2000. Kevin survived and is now helping others living with mental health challenges by sharing his story. For more information about Kevin’s story, click HERE.

    From a Charlotte Observer article about HopeWay, the following was written:

    Many of us at HopeWay have had the opportunity to hear Beth talk about her mental illness. She has an amazing ability to describe her struggle so that people who have never had a mental illness can imagine what it might be like. For more information about Beth’s story, click HERE.

    Beth and our CEO, Dr. Kuroski-Mazzei, were just featured in a video series, “Compass & Light: A Series on Mental Health” by Silent Images. We encourage you to watch them talk about bipolar disorder:

    Why Is Bipolar Disorder No Longer Called Manic

    In the last few decades, the medical world, especially the field of psychiatry, has intentionally made a shift from using manic-depressive illness or manic depression to describe bipolar disorder. There are several reasons for this shift, including:

    • Healthcare providers used to use manic depression to describe a wide range of mental health conditions. As mental health condition classification systems, including the Diagnostic and Statistical Manual of Mental Disorders , have become more sophisticated, the new term bipolar disorder allows for more clarity in diagnosis.
    • Theres a lot of stigma and negativity associated with the terms manic and mania, especially due to the use of maniac. Similarly, people use the term depression casually to describe periods of sadness that dont qualify as clinical depression. Using bipolar disorder takes the focus away from these two words. Bipolar disorder is more of a clinical, medical term and less emotionally loaded than manic depression.
    • The term manic depression excludes the cyclothymic or hypomanic versions of the condition.

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    Symptoms Of Manic Episodes

    Episodes of mania and hypomania are prevalent features of bipolar disorder. While the signs of mania may at first be a pleasant diversion from the dark depressive episodes, the manic phase can also be destabilizing and self-destructive.

    Symptoms include:

    • Racing thoughts and difficulty staying focused, easily distracted
    • Impulsive behaviors, using poor judgment
    • Risky behaviors, such as substance use or sexual promiscuity

    How Is Bipolar Disorder Diagnosed

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    To diagnose bipolar disorder, your healthcare provider may use many tools, including:

    • A physical exam.
    • A thorough medical history, which will include asking about your symptoms, lifetime history, experiences and family history.
    • Medical tests, such as blood tests, to rule out other conditions that could be causing your symptoms, such as hyperthyroidism.
    • A mental health evaluation. Your healthcare provider may perform the evaluation, or they may refer you to a mental health specialist, such as a psychologist or psychiatrist.

    To be diagnosed with bipolar disorder, you must have experienced at least one episode of mania or hypomania. Mental health providers use the Diagnostic and Statistical Manual of Mental Disorders to diagnose the type of bipolar disorder a person may be experiencing.

    To determine what type of bipolar disorder you may have, your mental health provider assesses the pattern of symptoms and how much they affect your life during the most severe episodes.

    People with bipolar disorder are more likely to also have the following mental health conditions:

    Because of this, as well as the fact that memory is often impaired during mania so people cant remember experiencing it, it can be difficult for healthcare providers to properly diagnose people with bipolar disorder.

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    Bipolar Disorder: Symptoms And Treatment

    Bipolar disorder, also known as manic-depression, affects 2.6% of the U.S. adult population each year. Characterized by unusual shifts in mood and energy levels, bipolar disorder can cause periods of extremely intense, elated and energized behavior called a manic episode, to sad and hopeless periods of depression. Manic episodes that cause less of an elevated mood or energy levels are characterized as hypomanic episodes.

    Left untreated, bipolar disorder can cause severe problems with day-to-day functioning, and can even cause hallucinations and delusions. There are several subcategories of the disease, and each one requires different treatment methods. Although bipolar disorder is a severe and lifelong condition, there are many effective treatment methods for bipolar sufferers. The following article will explore the different types of bipolar disorder in detail, who is most at risk of developing the condition, and what someone can do to treat bipolar disorder effectively.

    Diagnosing Bipolar Disorder: A Complex Process

    Diagnosing bipolar disorder can be as complex as the disorder itself. Unlike conditions that require a simple blood test or short questionnaire, the process of diagnosing bipolar disorder often includes ruling out other conditions and undergoing extensive health evaluations, including blood tests and brain scans, as well as a comprehensive personal, family, and social history. It’s important to be completely honest with your healthcare provider to ensure proper diagnosis and treatment.

    According to the Depression and Bipolar Support Alliance , many people with bipolar disorder deal with symptoms for up to 10 years before being properly diagnosed, and just one in four individuals receive an accurate diagnosis within the first three years of the onset of symptoms. For this reason, it’s incredibly important to seek help. You can get in touch with one of our experienced online therapists here.

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    What Is The Outlook Of Bipolar Disorder

    The prognosis for bipolar disorder is often poor unless its properly treated. Many people with bipolar disorder who receive appropriate treatment can live fulfilling and productive lives.

    Bipolar disorder results in approximately nine years reduction in expected life span, and as many as1 in 5 people with bipolar disorder commit suicide. An estimated 60% of all people with bipolar disorder have drug or alcohol dependence.

    This is why its essential to seek medical care and stay committed to treatment for bipolar disorder.

    Regular and continued use of medication can help reduce episodes of mania and depression. By knowing how to recognize the symptoms and triggers of these episodes, theres a better chance for effective treatment and finding coping methods that may prevent long periods of illness, extended hospital stays and suicide.

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