What is the affect and what is meant by bipolar disorder?

The name itself can cause some difficulties in understanding this illness. Affect is described in psychology and psychiatry as expression of emotions. Bipolarity relates to the fact that people affected by this illness apart from depressive episodes, experience episodes of mania, which are considerably different to depression. To compare – depressive disorders are sometimes defined as unipolar affective disorder – usually when classic symptoms of depression appear, such as low mood, loss of joy of life or sleep disturbances.

What are the causes of bipolar affective disorder?

Bipolar affective disorder occurs relatively often and affects even 1 in 50 people. Women and Men are diagnosed equally often. Researchers have proven that genetic component plays an important part in the development of the illness. Bipolar affective disorderis considered as one of the most hereditary mental illnesses. Changes in structure of the brain have also been noticed, such as smaller capacity of the frontal cortex,and often occurring decrease of the amygdala. Moreover, this leads to excessive activity of the dopaminergic and noradrenergic systems. It has also been shown that experiencing a very stressful situation, such as death of loved one, job loss or serious illness can lead to affective bi-polar affective disorder emerging. It is worth noting that first symptoms of this illness usually surface before the age of 30.

Two main types of bipolar affective disorder

Specialist literature usually shows two types of the illness:

• type 1 – classic, with occurrence of at least 1 episode of mania,
• type 2 – the patient has more depressive episodes, where usually hypomania occurs.

What is mania?

Mania is a state in which psychomotor agitation occurs. A person in a state of mania usually experiences rapid, multitude of thoughts, andis frequently oversensitive or just the opposite – unnaturally friendly. An important characteristicis also excessive, unnatural talkativeness, reduced need of sleep and noticeable sexual loosening. Risk assessing is not functioning well and people with mania often make irresponsible decisions. Examples of such decisions arelarge, unnecessary purchases connected with borrowing money, resigning from work or even violating the law. A person experiencingan episode of mania has also inflated self-worthand changes plans often and easily.

What kind of depression occurs in bipolar affective disorder?

Depression in bipolar affective disorder resembles ‘ordinary’ depression, however, there are some characteristics, which indicatethe fact, its origin is in bipolar affective disorder. Depression in bipolar affective disorder has more tendency to recur, itis characterised also by increased drowsiness and irritability. Suicide in the family is also animportant diagnostic marker, as well asfastsubsiding of depressive episode.

How to treat bipolar affective disorder?

Bipolar affective disease is popularly regarded as a constant rollercoaster. Moreover, different works of culture depict people affected by this illness as untrustworthy, unpredictable or even dangerous. These are harmful and dangerous prejudices. The patients return to normal life ifdiagnostic processis carried out appropriately, using pharmacotherapy and psychotherapy with psychoeducation. One needs to remember that appropriately used medication and therapy decrease the risk of occurrence of subsequent episodes of mania and depression. If you notice you have symptoms of depressionand you remember the situationwhen you were significantly agitated, or irritated, it is worth consulting with a doctor or psychiatrist. The doctor or psychiatrist will collect a detailed medical history, which will help them to make a correct diagnosis and suggest appropriate treatment. Do not ignore potential symptoms, as bi-polar affective disordergoes hand in hand with significantly increased risk of suicide and death due cardiovascular causes.

The article Bi-polar affective disorder – constant rollercoaster? comes from IN-MED Psychotherapeutic and Psychiatric Centre Paweł Sala.

What is depression exactly?

Depression is, in fact, a group of mental disorders. In international classification we distinguish among others:

• a depressive episode which we diagnose if such episode has happened for the first time and has lasted more than 2 weeks.
• recurring depressive disorders – we talk about them if at least 2 depressive episodes occurred in the patient. However, to diagnose such disorders one must rule out an occurrence of an episode of mania.
• Dysthymia – often occurring, but rarely diagnosed disorder. Its symptoms last at least 2 years. However, they are less severe than in the case ofthose disorders mentioned above.
• Some researchers also indicate that the premenstrual tension syndrome also belongs to the group of depressive disorders.

Depression – afiction or serious illness?

Unfortunately, we often hear the statement that depression is not an illness, but only a figment of the imagination of the sick person. However, that is not the case. Scientists agree with the fact that depression is an illness. Depression affects a dozen per cent or so of the population during their lifetime and adversely affects both quality of life and life span. According to WHO depression will have been the most common illness by 2030. It has also been noticed that it is an independent factor for the occurrence of cardio- vascular diseases.  Older age and female gender are the factors which can increase the risk of depression. Unfortunately, there are reasons to claim that men are significantly less likely to seek medical help despite experiencing depression.

Depression is not just sadness

Usually, we associate depression with sadness. This is not a wrong impression; however, it is a little incomplete. People suffering from depression also lose interest in things they used to enjoy. Moreover, they lose the joy of life and become indifferent to activities they used to find pleasurable. Such an example can be a loss of interest in a hobby or work that used to bring joy. Suicidal thoughts occur frequently. Person affected by depression has also lower appetite and suffers weight loss. Fatigue is also a dominant feeling, often accompanied by a sense of guilt or even delusions about the illness. A neglected but important symptom of depression is concentration problem.

Sleep disorders are an inherent part of depression

A significant but often omitted aspect of depression is a sleep disorder. A person who suffers from depression finds it more difficult to fall asleep or sleep through the night until the morning. It means that a person wakes up early and is not able to fall back to sleep, and therefore feels sleepy and tired. So called atypical depression features excessive sleepiness and the affected person is constantly tired despite sleeping a lot. Sometimes it happens that sleep disorders lead to misuse of alcohol as a help to sleep. People suffering from insomnia frequently reach for various sedatives such as benzodiazepines or so-called Z-drugs – e.g., zolpidem and zopiclone. It complicates the diagnostic process and method of treatment.

Going for a walk won’t cure depression

People suffering from depression are often misunderstood and get a lot of good advice from those around them. ‘Go for a run’ or ‘go shopping’ are the most common forms of advice which result from a lack of knowledge, as well as underestimating the problem of depression. Even though exercise is important in the process of healing and maintaining health, it cannot substitute pharmacotherapy and/or psychotherapy. Psychiatrist will conduct a full interview with you, which will help them to select the right medication and direct you towards the most appropriate therapeutic treatment. The problem of depression should not be ignored, and one should not be ashamed of it. This condition is quite frequent, severe but curable by an appropriate therapy.

The article Depression – something more than constant sadness comes from IN-MED Psychotherapeutic and Psychiatric Centre Paweł Sala.

A psychiatrist is a medical doctor. Thus, he is a specialist who graduated from medical school and then, in the course of further training, obtained specialization in psychiatry.

A psychiatrist deals with the diagnosis and treatment of mental disorders. As a doctor, he can administer treatment using an array of modern and selective psychotropic drugs, for which he prescribes appropriate prescriptions. Depending on the medical indications, a psychiatrist can issue various types of certificates, including sick leave.

The treatment offered by a psychiatrist provides relief from a variety of mental ailments.

The principle of confidentiality of a psychiatrist

A psychiatrist is bound by strict medical confidentiality and the rules of the code of medical ethics

What does a psychiatrist do and when can you go to a psychiatrist?

Most often, the decision to go to a psychiatrist for help comes after many attempts to cope with the crisis – when a person realizes that he can’t overcome it on his own. When should one seek help?

The deciding factors are: the type of symptoms, how the ailments affect daily functioning, and the severity of the symptoms. It seems that such a key factor is long-term psychological suffering. This suffering can manifest itself in very different ways and under different forms. Consider contacting a psychiatrist or psychotherapist when they persist:

• constant feelings of uncertainty, sadness, anxiety, danger
• recurrent feelings of helplessness and confusion
• crises in family, marriage, at work, swollen situations that cause a constant desire to withdraw and hide
• eating disorders (anorexia and bulimia nervosa)
• neurotic and anxiety disorders
• stress-related somatic complaints
• personality disorders
• sleep disorders
• sexual dysfunctions
• depression

The article Psychiatrist comes from IN-MED Psychotherapeutic and Psychiatric Centre Paweł Sala.

This destructive opinion is shared particularly by many men. It is associated with the often-found belief that a man who admits having problems, gives a signal that he is weak.

To maintain the imperative of being a strong man, men have denial strategies such as workaholism, alcoholism, sex addiction, gambling, drugs, etc. Showing weakness is associated with risk of being exposed to ridicule and rejection. Expressing and sharing one’s emotions can be considered a weakness. As a result of this, suppressing and denial of emotions in daily functioning often takes place and resorting to more and more desperate and less effective attempts to deal with problems rationally and intellectually.

Family factors can play important role here, in which seeking help and support was associated with experiencing constant disappointment and rejection and sometimes even shaming and humiliation.

A visit to a psychiatrist is admitting my life’s failure

Such a belief has many destructive meanings. It may result from the assumption that all problems should be dealt with completely independently. Reaching out for help can be viewed as a general failure. On the other hand, life can bring many things that often cause feelings of helplessness and being lost. Mental suffering can be kept inside, hidden and pretending to the outside world there is nothing wrong. However, the costs associated with this over time increasingly affects our functioning. Unresolved problems will remain, and they will be likely to torment us more and more.

Obviously, there is a difference between a trivial problem, which will disappear if you ignore it, and one that requires attention and resolution. Most people do not have difficulty telling the difference, but a lot of people make light of them and dismiss them, ignoring of them which can be detrimental. Seeking help for oneself may be delayed and put off, which in some situations cause the exacerbation of the condition or the other way round – more chronic nature, the risk of complications and even life-threatening conditions, (such as depression, psychosis and mental anorexia.)

Contacting a psychiatrist can be a simple way to look after one’s own health and better life quality, an attempt to improve your own functioning in the face of irritating and unpleasant mental ailments. It can be a kind of new opening in life and sign of modern thinking to take advantage of different resources which are available to us.

Meeting with a psychiatrist is complete giving up on your own affairs

For many people, coming to terms with the fact that they cannot deal with something remains very difficult.

Difficulties in realizing their plans and tasks cause feelings of threat, fear, hurt, feeling of guilt or anger. The feelings experienced are, on the one hand a source of suffering, they are a sign that life is not working out. On the other hand, these feelings are source of energy to remove obstacles we meet on our way. The feeling of discomfort associated with failures causes a sense of anguish, but simultaneously it is also a stimulus to remove this discomfort. It motivates to different than former activities, which may help more in overcoming the problem.

In other words, sense of helplessness could be such a stage in life, which may release new energy to deal with problems. In this context, contact with a specialist could be useful temporary support for his expertise and experience.

My depression is just a whim and temporary breakdown

This belief may result from lack of knowledge or understanding or downplaying the problems. Colloquially, depression is often defined as brief, fleeting state of sadness or low spirits. In medical terms, depression includes a set of symptoms, including low mood, low activity, sleep disorder, anxiety, depressive assessment of the past and future; losing the will to live, decreased interests and withdrawing from life. These symptoms cannot be treated lightly, especially if they are accompanied by suicidal thoughts and attempts, which can be life-threatening.

It is worth knowing that approximately 10% of adults within a year experience longer lasting depressive mood disorder. Even though some of those people can deal with depression on their own, it does not change the fact that depressive disorders belong to the most common health problems. If we consider the consequences of depression, the rank of depression can be compared to other diseases which are dealt with by modern medicine (cardiovascular diseases, inflammatory and degenerative diseases of muscle- skeletal system, cancers.)

For several years, almost all developed European countries, have seen significant increase in the number of people treated for depression.

If someone has anorexia it is enough to get a grip and start eating normally

Anorexia nervosa is a serious disorder which requires intensive and long-term treatment with the help of various specialists. One of the symptoms of anorexia nervosa is a strong fear of gaining weight. This fear has sometimes paralysing force when trying to eat meals. Dealing with the problem of anorexia is complex and goes far beyond a simple advice concerning eating meals.

The destructive meaning of this myth, often present in the families of the people affected or those surrounding them it is that it influences the decision to stop treatment and subsequently end up suffering and dealing with the illness on their own. The family sometimes only after a few years admits they are not able to help a sick person. This sometimes happens when the symptoms are already advanced and well established.

With neurosis you go to a neurologist

Neuroses are mental disorders, in which a standard treatment is psychotherapy that provides a lasting and effective cure. The use of drugs is supplementary and supports the basic treatment. On the other hand, a neurologist is a specialist in the diagnosis and treatment of illnesses of the nervous system (for instance facial neuritis, sciatic nerve damage, vascular diseases of the brain, infectious diseases of nervous system, etc.) A neurologist, as specialist in his field, may not possess adequate knowledge concerning the diagnosis and treatment of neurotic disorders, the principles concerning using psychotropic drugs, the ability to use qualified psychotherapy. Many patients use the help of doctors of other specialities before they reach a psychiatrist. They get superficial, symptomatic help which can be often ineffective. Sometimes it can happen that a person with anxiety or depressive ailments is prescribed the wrong medication or incorrect dosage. The excessively frequent use of benzodiazepine drugs is a problem among neurologists and GPs and in the long run can cause addiction and difficulties in coming off them.

Are psychotropic drugs addictive?

There are various groups of psychotropic drugs. Some of them belonging to the group of benzodiazepines or to the group of hypnotic drugs are indeed likely to cause addiction if taken for too long. Hypnotics belonging to the benzodiazepine group, can be used relatively safely for a period of 4 weeks. Practice shows that after approximately 2 weeks of taking, some of the sleeping pills become less effective. In anxiety ailments, treatment with benzodiazepine drugs lasts on average 4-6 weeks, only in completely exceptional cases more than over 8 weeks.

In relation to other drugs – such as antidepressants, neuroleptic drugs or normothymic drugs – there are no such restrictions. They can be taken for any length of time without the risk of addiction. That is, at any time, after agreeing with the doctor, the drug can be gradually withdrawn. Sudden, too fast withdrawal can sometimes cause unpleasant symptoms, but it doesn’t mean constant obligation to take such drugs.

The article Myths surrounding the psychiatrist and psychiatry comes from IN-MED Psychotherapeutic and Psychiatric Centre Paweł Sala.