What is bipolar disorder?
William Lawson: Bipolar disorder is probably a group of disorders but we like to look at it as one disorder that's characterized by mood swings and the mood swings can vary from going from a mania being so impulsive and out of control that you have a stress puerility but again a mood swing all the way down to severe depression. Bipolar disorder is characterized by mania or hypomania. When it's hypomania, then it has to be associated with severe depression, so it's what we used to call manic depressive illness.
What are the symptoms of bipolar disorder?
William Lawson: It also has a loss of pretty pervasive, the highest can vary from adaptability that can, in terms of the mood state all the way to extreme euphoria. The person feels king of the universe. And the manic phase may also be characterize by racing thoughts, by just shifting from one idea to another very quickly, by easily distract it, but targeted thoughts of trying to solve problems in a way that the casual observer doesn't make sense.
And the person may be involved in high-risk behavior and the higher-risk behavior can be all the way from going on shopping spree, driving to prison sometimes for bankruptcy, to multiple sexual liaisons, multiple short and quick marriages and divorces, to giving in frequent altercations, and fights.
What advice would you give to someone who has recently been diagnosed with bipolar disorder?
William Lawson: The advice is to quick treatment by a qualified mental health professional as quickly as possible. This is not a disorder to be treated by amateurs. It's not a disorder to be treated by people who have very little experience with it. It's a complex, disorder, that the results of people who quite familiar with a different medications that are used in a cycle for imputing interventions
Is there a genetic risk factor?
William Lawson: Yeah, we believe that bipolar disorder is that acts as one disorder that has the strongest genetic influence and because we find that it's all from the family history. Not necessarily a bipolar disorder but frequently a mood disorder and so we called it heritability when we look at identical twins, it's extremely high if you include all mood disorder in the family. It is not Mendelian that is you don't -- it's not a single gene that you can look at, person has a certain gene in one family, characteristics go on to the next generation.
It's much more complex than it is, it's more like the inheritance of bad beats or hypertension and that occurs frequently in families but could skip generations like remodel in one generation and appear differently in other.
Does an environmental factor affect a person's risk for bipolar disorder?
William Lawson: What we suspect is that the onset of it, by people at risk may be triggered by environmental factors. One that is – study is role about all the sums of these, which may be associated with early onset. But the others, is the increase risk of abuse and trauma, I mean we realize the lives of these individuals, which is the secondary act that we can say at this point.
Why is bipolar disorder frequently misdiagnosed?
William Lawson: Many times the folks maybe in a depressive phase and other times, maybe manic – when people see them they're just in a depressive phase and so the misdiagnosis depression. Many times the depressive symptoms can overlap the manic symptoms. The person may feel like they have, they're just sad, tearful but still working like crazy, shopping like crazy, spending like crazy. We also find high with it in various severe cases. Folks may actually feel like they can heal forces, have thoughts that delusions that are frankly out of this world and then it can be diagnosed as schizophrenia.
What are the different types of bipolar disorder?
William Lawson: Yeah, that relates to how we diagnose using the Diagnostic Statistical Manual which is a diagnostic system. The psychiatry developed in order to bring consistency before it and – what we called Diagnostic Statistical Manual three went out in four. Psychiatry would disagree about 50% of the time, on seeing the same patient. Now the disagreement is four, four less and we divide in four Axis. One Axis, Axis I is the actual illness of symptom, Axis II is the underlying personality. Chronic state of disorder. Axis III. This one had a contributor general medical condition. Axis IV is one of when that the person is face himself sort of stressed in their life and Axis V is what is when what is the functioning of the person.
So in bipolar disorder, folks of Axis I disorder, would be between bipolar I which a person has a manic phase. They may or may not have a depressive phase but they must have a manic face. In bipolar II, the person now never has a manic phase but they must hypomanic phase. Hypomanic means nice obvious so that the person cannot do anything. Person's do can carry out their role functioning but in a defective way. But they must have had a major depressive episode and major depression which is carried out persisting symptoms of impaired mood, impaired functioning, steroids of sleeping, eating, distortion in concentration that last for at least two weeks, most of the time.
Then there are some people that have just hypomania and we call that cyclothymia by the same term so one may never mania and may have a mild depression, what we called that dysthymia.
What about bipolar disorder in children?
William Lawson: We used to think of the bipolar disorder was a disorder that occurred late in life. In recent years, however, we have now discovered that bipolar disorder can occur early in life and there are some people who think that there maybe symptoms or the disorder even in early childhood and perhaps at birth. What we do know is that we can get diagnose bipolar disorder in childhood. It's a major problem because often kids don't have the verbal skills to express the moods and we have to distinguish it from a additional defects disorder, which kind of adverse similar symptoms except that you don't have the all the change in mood states. The treatment is little more difficult, I mean that the medications have more side effects in children and also children are much more difficult to get them to adhere to a medication regime.
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