Total 43 News Articles

  • 30 Dec
    eWellness Expert

    What is Bipolar Disorder?

     

    3 face of bipolar disorder

    Definition

    Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

    There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

    • Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
    • Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
    • Cyclothymic Disorder (also called cyclothymia)— defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
    • Other Specified and Unspecified Bipolar and Related Disorders— defined by bipolar disorder symptoms that do not match the three categories listed above.

    Signs and Symptoms

    People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy, activity, and sleep go along with mood episodes.


    People having a manic episode may:

    People having a depressive episode may:

    • Feel very “up,” “high,” or elated
    • Have a lot of energy
    • Have increased activity levels
    • Feel “jumpy” or “wired”
    • Have trouble sleeping
    • Become more active than usual
    • Talk really fast about a lot of different things
    • Be agitated, irritable, or “touchy”
    • Feel like their thoughts are going very fast
    • Think they can do a lot of things at once
    • Do risky things, like spend a lot of money or have reckless sex
    • Feel very sad, down, empty, or hopeless
    • Have very little energy
    • Have decreased activity levels
    • Have trouble sleeping, they may sleep too little or too much
    • Feel like they can’t enjoy anything
    • Feel worried and empty
    • Have trouble concentrating
    • Forget things a lot
    • Eat too much or too little
    • Feel tired or “slowed down”
    • Think about death or suicide

    Sometimes a mood episode includes symptoms of both manic and depressive symptoms. This is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.

    Bipolar disorder can be present even when mood swings are less extreme. For example, some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomanic episode, an individual may feel very good, be highly productive, and function well. The person may not feel that anything is wrong, but family and friends may recognize the mood swings and/or changes in activity levels as possible bipolar disorder. Without proper treatment, people with hypomania may develop severe mania or depression.

    Diagnosis

    Proper diagnosis and treatment help people with bipolar disorder lead healthy and productive lives. Talking with a doctor or other licensed mental health professional is the first step for anyone who thinks he or she may have bipolar disorder. The doctor can complete a physical exam to rule out other conditions. If the problems are not caused by other illnesses, the doctor may conduct a mental health evaluation or provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

    Note for Health Care Providers: People with bipolar disorder are more likely to seek help when they are depressed than when experiencing mania or hypomania. Therefore, a careful medical history is needed to ensure that bipolar disorder is not mistakenly diagnosed as major depression. Unlike people with bipolar disorder, people who have depression only (also called unipolar depression) do not experience mania. They may, however, experience some manic symptoms at the same time, which is also known as major depressive disorder with mixed features.

    Bipolar Disorder and Other Illnesses

    Some bipolar disorder symptoms are similar to other illnesses, which can make it hard for a doctor to make a diagnosis. In addition, many people have bipolar disorder along with another illness such as anxiety disorder, substance abuse, or an eating disorder. People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.

    Psychosis: Sometimes, a person with severe episodes of mania or depression also has psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the person’s extreme mood. For example:

    • Someone having psychotic symptoms during a manic episode may believe she is famous, has a lot of money, or has special powers.
    • Someone having psychotic symptoms during a depressive episode may believe he is ruined and penniless, or that he has committed a crime.

    As a result, people with bipolar disorder who also have psychotic symptoms are sometimes misdiagnosed with schizophrenia.

    Anxiety and ADHD: Anxiety disorders and attention-deficit hyperactivity disorder (ADHD) are often diagnosed among people with bipolar disorder.

    Substance Abuse: People with bipolar disorder may also misuse alcohol or drugs, have relationship problems, or perform poorly in school or at work. Family, friends and people experiencing symptoms may not recognize these problems as signs of a major mental illness such as bipolar disorder.

    Risk Factors

    Scientists are studying the possible causes of bipolar disorder. Most agree that there is no single cause. Instead, it is likely that many factors contribute to the illness or increase risk.

    Brain Structure and Functioning: Some studies show how the brains of people with bipolar disorder may differ from the brains of healthy people or people with other mental disorders. Learning more about these differences, along with new information from genetic studies, helps scientists better understand bipolar disorder and predict which types of treatment will work most effectively.

    Genetics: Some research suggests that people with certain genes are more likely to develop bipolar disorder than others. But genes are not the only risk factor for bipolar disorder. Studies of identical twins have shown that even if one twin develops bipolar disorder, the other twin does not always develop the disorder, despite the fact that identical twins share all of the same genes.

    Family History: Bipolar disorder tends to run in families. Children with a parent or sibling who has bipolar disorder are much more likely to develop the illness, compared with children who do not have a family history of the disorder. However, it is important to note that most people with a family history of bipolar disorder will not develop the illness.

    Treatments and Therapies

    Treatment helps many people—even those with the most severe forms of bipolar disorder—gain better control of their mood swings and other bipolar symptoms. An effective treatment plan usually includes a combination of medication and psychotherapy (also called “talk therapy”). Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment helps to control these symptoms.

    Medications

    Different types of medications can help control symptoms of bipolar disorder. An individual may need to try several different medications before finding ones that work best.

    Medications generally used to treat bipolar disorder include:

    • Mood stabilizers
    • Atypical antipsychotics
    • Antidepressants

    Anyone taking a medication should:

    • Talk with a doctor or a pharmacist to understand the risks and benefits of the medication
    • Report any concerns about side effects to a doctor right away. The doctor may need to change the dose or try a different medication.
    • Avoid stopping a medication without talking to a doctor first. Suddenly stopping a medication may lead to “rebound” or worsening of bipolar disorder symptoms. Other uncomfortable or potentially dangerous withdrawal effects are also possible.
    • Report serious side effects to the U.S. Food and Drug Administration (FDA) MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch  or by phone at 1-800-332-1088. Clients and doctors may send reports.

    For basic information about medications, visit the NIMH Mental Health Medications webpage. For the most up-to-date information on medications, side effects, and warnings, visit the FDA website .

    Psychotherapy

    When done in combination with medication, psychotherapy (also called “talk therapy”) can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:

    • Cognitive behavioral therapy (CBT)
    • Family-focused therapy
    • Interpersonal and social rhythm therapy
    • Psychoeducation

    Visit the NIMH Psychotherapies webpage to learn about the various types of psychotherapies.

    Other Treatment Options

    Electroconvulsive Therapy (ECT): ECT can provide relief for people with severe bipolar disorder who have not been able to recover with other treatments. Sometimes ECT is used for bipolar symptoms when other medical conditions, including pregnancy, make taking medications too risky. ECT may cause some short-term side effects, including confusion, disorientation, and memory loss. People with bipolar disorder should discuss possible benefits and risks of ECT with a qualified health professional.

    Sleep Medications: People with bipolar disorder who have trouble sleeping usually find that treatment is helpful. However, if sleeplessness does not improve, a doctor may suggest a change in medications. If the problem continues, the doctor may prescribe sedatives or other sleep medications.

    Supplements: Not much research has been conducted on herbal or natural supplements and how they may affect bipolar disorder.

    It is important for a doctor to know about all prescription drugs, over-the-counter medications, and supplements a client is taking. Certain medications and supplements taken together may cause unwanted or dangerous effects.

    Keeping a Life Chart: Even with proper treatment, mood changes can occur. Treatment is more effective when a client and doctor work closely together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help clients and doctors track and treat bipolar disorder most effectively.

    Finding Treatment

    • A family doctor is a good resource and can be the first stop in searching for help.
    • For general information on mental health and to find local treatment services, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357).
    • The SAMHSA website has a Behavioral Health Treatment Services Locator  that can search for treatment information by address, city, or ZIP code.
    • Visit the NIMH’s Help for Mental Illnesses webpage for more information and resources.

    For Immediate Help

    If You Are in Crisis: Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

    If you are thinking about harming yourself or thinking about suicide:

    • Tell someone who can help right away
    • Call your licensed mental health professional if you are already working with one
    • Call your doctor
    • Go to the nearest hospital emergency department

    If a loved one is considering suicide:

    • Do not leave him or her alone
    • Try to get your loved one to seek immediate help from a doctor or the nearest hospital emergency room, or call 911
    • Remove access to firearms or other potential tools for suicide, including medications

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  • 30 Dec
    eWellness Expert

    Motivational messages boost health of arthritis patients

    arthritis counselingLondon, Jun 12 (PTI)|2016

    • Acombination of text messages and individual counselling sessions to motivate patients with rheumatoid arthritis may lead to improved patient outcomes, scientists have found for the first time.

      This type of behavioural intervention was effective at reducing daily sitting time by an average of more than two hours in rheumatoid arthritis (RA) patients, and also reduced their cholesterol levels.

      Due to their disease, patients with RA tend to be more sedentary than the general population, which can have serious health consequences, including an increased risk of cardiovascular disease and premature death.

      Patients with RA already have an increased risk of cardiovascular disease and premature death, partly caused by the chronic inflammatory rheumatic disease itself, and partly by traditional risk factors, such as hyperlipidaemia.

      lthough exercise is known to have a positive effect on pain and physical functioning in patients with RA, pain often acts as a barrier against maintenance of a physically active lifestyle.

      more feasible approach for improving health and well-being in RA patients would therefore be to focus on reducing sedentary behaviour and increasing light intensity activity, rather than solely concentrating on increasing moderate and vigorous physical activity.

      "We know that behavioural approaches are effective in reducing sedentary behaviour in healthy populations," said Tanja Thomsen of the Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases in Denmark.

      "Our findings support the introduction of behavioural approaches as an effective way to improve the health of rheumatoid arthritis patients, which may also be applicable in other populations with chronic disease and limited mobility," Thomsen added.

      As many as 75 adult RA patients with a self-reported daily sitting time greater than five hours and Health Assessment Questionnaire score less than 2.5 underwent a 16-week individually tailored, behavioural intervention that included three individual motivational counselling sessions with a health professional and regular text messages aimed at improving motivation to reduce daily sitting time and replacing it with light intensity physical activity.

     

  • 30 Dec
    eWellness Expert

    Online therapy may better treat depression, anxiety

     online counseling

    Washington, May 14 (PTI)|2016

    • Providing an online therapy may be a more effective treatment for anxiety and depression than usual primary care, scientists have found.

      Researchers at the University of Pittsburgh in the US enrolled 704 depressed and anxious patients who were between 18 to 75 years old.

      They showed that providing an online computerised cognitive behavioural therapy (CCBT) programme both alone and in combination with Internet Support Groups (ISG) provided better outcomes for patients.

      The participants were randomised to one of three groups: care manager-guided access to the eight-session Beating the Blues CCBT programme; care manager-guided access to both the CCBT programme and a password-protected ISG patients could access 24/7 via smartphone or desktop computer; or usual behavioural health care from their primary care physician.

      Over the six-month intervention, 83 per cent of patients randomised to CCBT started the programme, and they completed an average of 5.3 sessions.

      Seventy-seven per cent of patients assigned to the ISG logged into the site at least once, and 46 per cent provided one or more posts or comments.

      Six months later, those patients randomised to CCBT reported significant improvements in their mood and anxiety symptoms and the more CCBT sessions patients completed, the greater the improvement in mood and anxiety symptoms.

      Although patients randomised to both CCBT and ISG had similar overall improvements in mood and anxiety symptoms compared to patients randomised to only CCBT, secondary analysis showed those who engaged more with the ISG tended to experience greater improvements in symptoms.

      ISG that enable individuals with similar conditions to access and exchange self-help information and emotional support have proliferated in recent years, but benefits have yet to be established in randomised trials, researchers said.

      "Our study findings have important implications for transforming the way mental health care is delivered," said Bruce L Rollman, professor at the University of Pittsburgh.

      "Providing depressed and anxious patients with access to these emerging technologies may be an ideal method to deliver effective mental health treatment, especially to those who live in areas with limited access to care resources or who
      have transportation difficulties or work/home obligations that make in-person counselling difficult to obtain," he said.

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  • 30 Dec
    eWellness Expert

    'Parents need lessons for children's mental health'

    parent

    BBC News|15 June 2016|From the sectionUK

    Parents should have lessons provided by the government on how to raise their children, Britain's leading public health expert has said.

    Professor John Ashton, outgoing president of the Faculty of Public Health (FPH), said children were neglected by some schools and parents.

    He said the state should help stop children being crippled by conditions such as anxiety, anorexia and obesity.

    The FPH has released a report calling for mental health improvements.

    It says: "Mental, emotional or psychological problems account for more disability than all physical health problems put together.

    "Although we cannot say yet exactly how much of the burden of mental illness could be prevented, we know prevention is possible."

    Human cost

    One in 10 children aged five to 16 years had a mental health problem that warranted support and treatment, the report said.

    And the quality of the parent-child relationship and parenting more broadly played a primary role.

    Prof Ashton said that, given the huge financial and human cost of mental health problems, more should be done to tackle their causes.

    He said: "We've done well in terms of producing live, healthy babies over the last 60, 70 years, but, by the time children are leaving school, between 10% and 15% of them are in trouble emotionally or mentally, and suffer from things like obesity, eating disorders, anxiety and stress.

    "Having produced healthy babies we then set about neglecting them."

    Prof Ashton suggested parenting advice and support could be provided by investing in existing networks - such as health visitors and schools. And by using social media to reach parents and setting up 24/7 helplines - for example for people raising adolescents.

    Parenting key

    Prof Sarah Stewart-Brown, who produced the report, said diet and activity played a role in mental health but "supporting parenting is key. The first 1,001 days of a child's life are particularly important.

    "Over three-quarters of all mental health problems emerge in childhood and adolescence."

    Programmes based in schools, workplaces, doctors' surgeries, and in the community could help, she said.

    The Faculty of Public Health sets standards for public health specialists in the UK and covers 3,300 professionals.

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  • 30 Dec
    eWellness Expert

    At any skill level, making art reduces stress hormones

    art work reduce stress

    Cortisol lowers significantly after just 45 minutes of art creation

    Whether you're Van Gogh or a stick-figure sketcher, a new Drexel University study found that making art can significantly reduce stress-related hormones in your body.

    Although the researchers from Drexel's College of Nursing and Health Professions believed that past experience in creating art might amplify the activity's stress-reducing effects, their study found that everyone seems to benefit equally.

    "It was surprising and it also wasn't," said Girija Kaimal, EdD, assistant professor of creative arts therapies. "It wasn't surprising because that's the core idea in art therapy: Everyone is creative and can be expressive in the visual arts when working in a supportive setting. That said, I did expect that perhaps the effects would be stronger for those with prior experience."

    The results of the study were published in Art Therapy under the title "Reduction of Cortisol Levels and Participants' Responses Following Art Making." Kendra Ray, a doctoral student under Kaimal, and Juan Muniz, PhD, an assistant teaching professor in the Department of Nutrition Sciences, served as co-authors.

    "Biomarkers" are biological indicators (like hormones) that can be used to measure conditions in the body, such as stress. Cortisol was one such the hormone measured in the study through saliva samples. The higher a person's cortisol level, the more stressed a person is likely to be.

    For Kaimal's study, 39 adults, ranging from 18 to 59 years old, were invited to participate in 45 minutes of art-making. Cortisol levels were taken before and after the art-making period.

    Materials available to the participants included markers and paper, modeling clay and collage materials. There were no directions given and every participant could use any of the materials they chose to create any work of art they desired. An art therapist was present during the activity to help if the participant requested any.

    Of those who took part in the study, just under half reported that they had limited experience in making art.

    The researchers found that 75 percent of the participants' cortisol levels lowered during their 45 minutes of making art. And while there was some variation in how much cortisol levels lowered, there was no correlation between past art experiences and lower levels.

    Written testimonies of their experiences afterward revealed how the participants felt about the creating art.

    "It was very relaxing," one wrote. "After about five minutes, I felt less anxious. I was able to obsess less about things that I had not done or need [ed] to get done. Doing art allowed me to put things into perspective."

    However, roughly 25 percent of the participants actually registered higher levels of cortisol -- though that wasn't necessarily a bad thing.

    "Some amount of cortisol is essential for functioning," Kaimal explained. "For example, our cortisol levels vary throughout the day -- levels are highest in the morning because that gives us an energy boost to us going at the start of the day. It could've been that the art-making resulted in a state of arousal and/or engagement in the study's participants."

    Kaimal and her team believed, going into the study, that the type of art materials used by participants might affect cortisol levels. They thought that the less-structured mediums -- using clay or drawing with markers -- would result in lower cortisol levels than the structured -- collaging. That, however, wasn't supported by the results, as no significant correlation was found.

    The study did find a weak correlation between age and lower cortisol levels. Younger participants exhibited consistently lower cortisol levels after they'd created art.

    Those results made Kaimal wonder about how young college students and high school students deal with the stress that comes from academia -- and how creative arts can help.

    "I think one reason might be that younger people are developmentally still figuring out ways to deal with stress and challenges, while older individuals -- just from having lived life and being older -- might have more strategies to problem-solve and manage stress more effectively," Kaimal said.

    In light of that, Kaimal plans to extend the study to explore whether "creative self- expression in a therapeutic environment can help reduce stress." In that study, other biomarkers like alpha amylase and oxytocin will also be measured to give a more comprehensive picture.

    Additionally, Kaimal also plans to study how visual arts-based expression affects end-of-life patients and their caregivers.

    "We want to ultimately examine how creative pursuits could help with psychological well-being and, therefore, physiological health, as well," she said.

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