Psychiatric Services: Treating Bipolar Disorder

bipolarEvery year, 2.9% of the U.S. population is diagnosed with bipolar disorder, with nearly 83% of all cases being classified as severe. The Integrative Center for Wellness offers patients one-on-one consultations, evaluations, diagnosis, treatment and management of bipolar disorder.

It is common for patients with bipolar disorder to have ongoing mood symptoms of depression, anxiety, and/or obsessional thinking. It is also very common for patients to self-medicate with alcohol and other substances.

Depression, anxiety or other conditions are frequently associated with bipolar disorder, and therefore, bipolar disorder is often misdiagnosed. Due to misdiagnosis, many patients receive inadequate relief from treatment. 

 

Understanding Bipolar Disorder

Bipolar disorder is commonly misunderstood as a mood disorder, as this chronic mental illness causes a patient to experience “highs” (mania) and “lows” (depression) in their mood. However, bipolar disorder affects much more than a patient’s mood. Their energy, thought process, and behavior are also impacted by it. According to The National Alliance on Mental Illness, the average age of onset is 25, although the illness can develop at any age in both men and women. While an exact cause for the illness has not been identified, scientists believe that genetics, stress, and an individual’s brain structure can all contribute to its development.

 

Symptoms of Bipolar Disorder

Bipolar disorder is commonly marked by states of depression and mania.

Depression is frequently the first symptom of bipolar disorder. A bipolar patient experiencing a depressive episode will feel symptoms commonly associated with depression, such as hopelessness and a lack of energy. A patient in a manic state, on the other hand, may experience feelings of euphoria, excessive goal-driven activity, limitless energy and an inability to sleep.

The time between mood shifts depends on the person, as the shifts can take place within a few hours or within a period of days. It is also possible for individuals to experience mixed states with both manic and depressive features (i.e., sad but can’t sleep; hopeless, but going on gambling binges). Some patients even experience brief — minutes to a few hours — episodes of depression during manic episodes.

It’s recommended that people talk to a professional if they experience any of these stand-out signs of trouble:

  • Hopelessness, helplessness, and a chronic inability to function in daily life
  • Suicidal thoughts
  • An inability to concentrate, either due to an elevated or depressed mood
  • A complete loss of energy or a dramatic increase in energy
  • Major shifts in mindset and mood, for example, feeling unusually “high” or extremely irritable; experiencing grandiose beliefs about your abilities; high energy levels despite a lack of sleep
  • Impaired judgement and reckless behavior

In severe cases, a patient may experience hallucinations or delusions during a manic episode.

While the extremes of bipolar disorder are obvious, misdiagnosis is frequent because bipolar disorder can present as a wide range of symptoms and behavior.  There are many subtleties of moods that need to be evaluated for a proper diagnosis.  Though the condition is called bipolar disorder, in reality, there is a spectrum of symptoms and behaviors that vary widely from one mood to the other, in any combination. 

The National Institute of Mental Health and The National Alliance on Mental Illness are good resources for a comprehensive review of bipolar disorder,. A physician with expertise in treating bipolar disorder is recommended for proper diagnosis.

 

Making A Diagnosis

Bipolar disorder can be particularly enigmatic as a diagnosis. Dr. Samoon Ahmad of the Integrative Center for Wellness compares the bipolar spectrum to a chameleon – like a reptile with the capacity to change its skin color. The rapidly shifting symptoms of bipolar patients often cause the disorder to blend in with other illnesses. The depressive state may also precede manic behavior by months or even years, causing a bipolar diagnosis to be overlooked in favor of depression. Detailed history, genetic and neurocognitive testing as well as collateral information from family and friends are all important factors in formulating a correct diagnosis.

 

Treating Bipolar Disorder

There is no one-size-fits-all treatment for bipolar disorder. The Integrative Center for Wellness is committed to working with our patients to help develop a personalized treatment plan that will address their specific needs as a bipolar patient. This means that our support will vary depending on the type of bipolar disorder a patient experiences, as well as based on their medical history, family history, etc. Moreover, as described above, the treatment requires a comprehensive, detailed approach including assessment of other systems in the body.

To help address bipolar disorder, the Integrative Center for Wellness offers local psychiatric services in New York. Our treatments are often a mix of medication (which can include mood stabilizers, antipsychotic medications, and/or antidepressants), psychotherapy, and nutritional therapy. The medication we choose will depend on the phase of the disorder, co-existing symptoms, and personal and family history. Dietary support is often necessary when addressing bipolar disorder due to the correlation between bipolar disorder and metabolic syndrome.

We work with our patients to help them develop personalized stress relief measure, as well as recognize triggers in their lifestyle and routine that can be addressed, ensuring that the risk of an episode is reduced through self-managed behavioral adjustments.

Dr. Ahmad’s clinical and educational expertise provides a strong foundation for treatment, but he also encourages patient education, family integration and social support networks for their ability to dramatically improve a treatment’s effectiveness.

Like any chronic illness, BD requires a long-term approach to successful outcome, and therefore, the treatment plan is formulated based on clinical symptoms, co-morbid conditions, body composition and patient preference. Psychopharmacological treatments are initiated after full discussion of risk and benefits. There are numerous medications that are utilized in the treatment of BD, and Dr. Ahmad takes every opportunity to discuss in detail each aspect of this complex strategy and welcomes an open discussion and engagement in this process.

If you are interested in meeting with Dr. Ahmad to discuss how he may be able to assist you, please contact us for more information or make an initial appointment here.

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