Bipolar II Disorder

Bipolar II disorder is typically defined as rapid mood cycling with episodes of hypomania and
depression. Bipolar II disorder does not occur with psychotic or hallucinating symptoms. Additionally, hypomania is defined as a milder form of mania, in which the patient has a period of heightened happiness or elation. Depression with bipolar II patients is often more severe than in patients with bipolar I disorder. Suicide, suicide threats, suicide attempts, and thoughts of suicide are much more common in bipolar II patients than bipolar I patients.A diagnosis of bipolar II disorder is typically made when the patient has had one or more major depressive episodes, at least one hypomania episode, no manic episodes, and when no other reason for symptoms can be found. Symptoms of depression with bipolar II disorder include decreased energy, unexplained weight changes, feelings of despair, increased irritability, and uncontrollable crying. Symptoms of chinese medicine include sleeplessness, racing thoughts, distractibility, excess energy, and rash judgements. These symptoms are similar to mania, but are less severe.

Treatment of bipolar II disorder typically involves a combination of medication and therapy or counselling. Medications typically prescribed for treatment of bipolar include anti-depressants such as Celexa, as well as mood stabilizers such as Topomax. Mood stabilizers are vitally important in treatment of bipolar disorders, because antidepressants alone can cause the patient to enter into a manic or hypomania episode.

Bipolar II disorder is actually often misdiagnosed as clinical depression. This is due to the fact that depression is most often present, and hypomania episodes rarely come to light in therapy sessions due to their upbeat nature. It is typically through treatment by antidepressants that the correct diagnosis because the patient will spin into a hypomania episode almost immediately if the diagnosis should be bipolar II disorder rather than clinical depression.Counselling or therapy treatment options for bipolar II disorder may include traditional counselling methods, discussion of triggers and life style changes that can lessen the of episodes, and cognitive behavioural therapy. Patients with a mild case of bipolar II disorder may benefit from counselling or therapy alone without medication. However, this is less common with bipolar II disorder than with bipolar I disorder, due to the nature of the severity of the depressive states.

NUTRIENTS FOR STRESS

Multivitamins are a good all-round mood and mind enhancer

People who are under excessive stress need to have an increase in the B vitamins, vitamin C, magnesium, zinc, copper, chromium, selenium and vitamin E.

The B Vitamins: Stress Relief Vitamins

- Provide greatest benefit when they are supplemented as a balanced B-complex
- Associated primarily with the nervous system function and brain activities such as good moods, thinking and memory

B1 (Thiamin)
– helps in nervous system function, reverse fuzzy thinking
– release energy from carbohydrates
– symptoms of deficiency include confusion, loss of balance, weakness and heart damage
– food sources include beans, peas, nuts, seeds and whole grains

B2 (Riboflavin)
- converting proteins, fats and carbohydrates into energy
- deficiency lead to adrenal cortex dysfunction
- found in most vegetables, nuts, legumes and leafy greens
- helpful in reducing migraine headaches

B3 (Niacin)
- important for normal mental function
- release of energy from foods
- low levels lead to anxiety, depression, apprehension, emotional instability, hyperirritability and memory impairment
- food sources include bran, nuts, seeds, wild rice, brown rice, whole wheat, almonds and peas

B5 (Pantothenic Acid)
- a vital role in the production of adrenal hormones
- deficiency lead to a decreased resistance to stress
- found in salmon, yeast, vegetables, dairy, eggs, grains and meat

B6
- vital for the utilization of amino acids; the building blocks for proteins
- deficiency is marked by depression, irritability, nervousness, muscle weakness, dermatitis, slow learning, numbness and cramping in the extremities
- required by nervous system
- needed for normal brain function to produce dopamine, serotonin and GABA (gamma amino butyric acid); neurotransmitters for promoting feelings of well-being, relaxation and calmness
- especially important for women experiencing bouts of depression, irritability, moodiness, fatigue and decreased sex drive
- food sources include lentils, lima beans, soybeans, sunflower seeds, bananas, avocados, buckwheat and brewer’s yeast

B12
- deficiency associated with depression, dementia, heart disease, low energy, poor memory, problems in thinking, low stomach acid and elevated homocysteine levels
- found in liver, trout, salmon and beef

Folic acid
- needed for DNA synthesis
- low folate levels were more likely to have melancholic depression
- symptoms of deficiency include irritability, weakness, forgetfulness, megaloblastic, anemia, weight loss, apathy, hostility, paranoid behaviour, palpitations, headaches, gastrointestinal disturbances and diarrhea
- good sources are dark green leafy vegetables, oranges, most fruits, brown rice, beans, asparagus, soybeans and brewer’s yeast

Vitamin C
- to ease irritability and fatigue
- brain levels are significantly higher than levels in the blood
- needed to make certain neurotransmitters
- take the non-acidic form if you have stomach upset

Magnesium
- involved in the activation of more than three hundred different enzymes
- vital to health
- symptoms of deficiency include muscle cramps, muscle spasms, hyperventilation and weakness
- low levels increase a risk for developing high blood pressure, heart disease, insomnia, kidney stones, multiple sclerosis, headaches and menstrual cramps
- sources include wheat bran, wheat germ, nuts, blackstrap molasses, legumes and whole grains
- necessary for sustaining bone density and cellular metabolism related to digestion, adrenal function and liver function

KEMURUNGAN

Bagaimana menyedari episod kemurungan

Jika anda atau seseorang yang anda kenali mempunyai kemurungan unipolar/bipolar, anda perlu menyedari tanda-tandanya dan hubungi doktor jika ianya berterusan atau menjadi lebih serius.

1. Jika anda mula mengalami masalah tidur samada sukar tidur atau asyik mahu tidur – simpan rekod dan lihat tanda-tanda lain.

2. Berhati-hati dengan seseorang yang tidur berlebihan. Kemurungan yang serius boleh menyebabkan seseorang tidur hingga 20 jam sehari.

3. Beri perhatian jika seseorang mula membatalkan aktiviti-aktiviti social dan merenung jauh pada program TV yang kebiasaannya tidak ditontonnya.

4. Perhatikan jika surat-surat tidak dibuka dan bil-bil dibiarkan bertimbun-timbun. Tugas-tugas mudah seperti membasuh pakaian dan membuang sampah tidak dilakukan.

5. Kenalpasti perubahan selera makan; berkurang atau bertambah mahupun kehilangan atau pertambahan berat badan yang ketara.

6. Ikuti perkembangan tangisan-tangisan yang tidak dikawal dan tidak dapat dijelaskan.

7. Catitkan perasaan sedih, bersalah, tidak berharga atau putus asa yang berpanjangan (beberapa hari).

8. Berjaga-jaga jika anda atau orang yang disayangi menunjukkan tanda-tanda kerisauan dan keberangan yang luar biasa, bersikap negative, tidak berdaya atau putus asa.

9. Beri perhatian jika anda atau orang yang disayangi mula menunjukkan kesukaran untuk membuat keputusan walaupun ianya mudah. Contohnya tidak tahu nak makan apa, teragak-agak untuk membeli coklat yang mana satu. Ini merupakan tanda-tanda yang biasanya ada pada kemurungan.

10. Sentiasa peka dengan perubahan tingkah laku seperti ketidakaturan (disorganization), kesukaran untuk menumpukan perhatian atau perbezaan pada keperluan tugas-tugas harian.

11. Perhatikan jika pergerakan dan fikirannya semakin perlahan (kerencatan psikomotor) atau semakin pantas (rangsangan psikomotor).

12. Lihat tanda-tanda fizikal seperti postur yang membongkok, dahi berkerut, mengurangkan bertentangan mata, kerap mengeluh, tidak memberikan tumpuan pada pertuturan atau nafsu seksual yang berkurangan.

13. Hubungi doktor segera jika anda mengalami atau seseorang kerap menyatakan tentang mati atau bunuh diri.

14. Jika tanda-tanda kemurungan muncul selepas pertukaran ubat-ubatan, hubungi doctor berkenaan segera.

Tip:

1. Kemurungan boleh menyusur secara perlahan mahupun diwarisi dengan cepat. Jika perlahan-lahan ianya sukar untuk dikesan terutama pada diri sendiri. Jadikan tabiat memerhatikan diri sendiri jika anda mempunyai episode-episod kemurungan.

2. Bantulah kawan atau orang tersayang jika anda melihat tanda-tanda yang merbahaya. Ambil tindakan yang sewajarnya. Begitu juga jika ianya terjadi pada anda: Bantulah diri anda!

SELAMATKAN DIRI ANDA DAN YANG TERSAYANG

Diterjemah dari Your Guide to Bipolar Disorder oleh Kimberley Read & Marcia Purse.