Why is it difficult to treat bipolar disease?

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Bipolar disease is also known as manic depression or bipolar affective disorder. The condition is extremely difficult to treat on account of the waxing and waning of mood from euphoria to episodes of severe depression.

The causes of bipolar disorder are multiple. Most commonly it is the result of a broken interpersonal relationship or loss of a loved one. One may suppress the emotion of being hurt but a genetic predisposition leads to precipitation of bipolar disease in such individuals. In certain people, some neurological conditions or an injury to the brain may lead to altered and deviated behavior. Altered levels of certain enzymes which control the moods may lead to bipolar disease.

The signs and symptoms of bipolar disease are constantly fluctuating between an elevated mood called as mania and feelings of worthlessness called as depression; hence the alternative name of manic depressive disorder. These two states occur alternately lasting for weeks together. While in the state of mania and hypomania, the person feels extremely energetic. The person can perform all the functions accurately and is highly alert mentally. There is great capacity to talk, lift heavy weights, tendency of jumping from one topic to another in a conversation, illusions of grandeur, extreme ambitiousness, sexual over activity and person is happy and content. This stage lasts for weeks and then is followed by the depressive episode. In the depressive state, the person might have feelings of guilt, sadness,worthlessness and anger. The person might feel that he is completely isolated from the world and that there is no one for him. The patients could also start feeling lonely and harbor a constant thought of hopelessness in their minds. There is lack of motivation and hence, the person does not feel like working, doesn’t take interest in things which he loved to do earlier. The patients lose touch with surroundings and this is combined with vague aches and fatigue. Person tends to fall sick without any reason.

The diagnosis of bipolar disorder is due to the peculiar behavioral changes noticed by the person or by family members and friends. The person suffering rarely admits to the complaint. Management of bipolar disease is multiplanar and difficult as a lot of support is needed from friends and the patient himself too. Cognitive psychotherapy is the most important treatment as it aids the patient by changing the train of thoughts from negative to positive. It is done by an experienced therapist and thus it modifies the outlook of the person. Lastly, medication is given along with all the above therapies. Lithium is the choice of drug as it not only reduces depression but also reduces the manic attacks. All this combined together will reduce the bipolar disorder but generally people resort back to the negative thoughts in spite of thorough support from others. The person must voluntarily opt for treatment and then only can one change. Most of the patients suffering feel they are normal and they are the chosen ones with super natural powers. Hence, treating bipolar disorder is like handling a double edged sword. Too much sedation to calm the manic episode might produce drowsiness while too little might be inadequate to calm the person down. Too little of anti-depressant medication might not be enough to lift the mood while too much might precipitate a manic episode.

Summary: Bipolar disease due to its varied symptoms and alternating behavior makes it difficult to be diagnosed and treated.

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