Bipolar Disorder: Degrees, Treatment Methods, Risks


In the beginning, everything seemed so easy. he runs away like a crazy marten, frustrated with all sorts of plans and projects, indulges in sports, nights, but does not sleep until morning, walks with friends, reads everything I have, writes notebooks, writes games, writes games, I've been kissing. The world was filled with pleasure and hope; I felt great. (…)

Then my life as if my head rolled into a deep abyss. My thoughts could not lose the crystal glow and they began to fight in the dark rooms. I have been reading a portion of a book several times in a row, but I have noticed that there is nothing else in mind. (…) I can not attend classes, I was looking out the window, not knowing what was happening around me. That was scary durum.

American psychologist Kay Redfield Jamison, who has bipolar disorder, describes her illness in these words in her autobiography, An Unhurried Head.

Bipolar, bipolar disorder with the Turkish name, formerly known as manic-depressive illness, worldwide about 60 million, while in Turkey, where 2 million people had been suffering from a chronic mood disorder. In case of not being treated by high rates of suicide and susceptibility to substance use, according to the severity of the disease, its subtypes and patient-patient; antidepressants, mood stabilizers, antipsychotics, and in some cases are treated by non-drug methods, including electroconvulsive therapy (ECT).

The prevalence of bipolar disorder in Turkey

There are four subtypes of bipolar disorder according to the American Psychiatric Association's DSM-5 reference book: Bipolar I Type, Bipolar II Type, Cyclothymia, and Other Unclassifiable Bipolar Disorder (TBA).

In the first of these, in addition to depression, sometimes psychosis is accompanied by episodes of severe mania that require hospitalization. In Type Bipolar II, the duration and severity of manic attacks are milder, which is called hypomania. According to the DSM-5, there is a prerequisite for the detection of bipolar disorder for at least one week and hypomania for four days. In hypomania, although the symptoms vary from person to person, most patients are characterized by increased energy, increased self-esteem and mood, more than normal speech and sleep below normal. In cyclothymia, mood changes are less noticeable on the outside and less effective in the person's functioning, so it is not easy to diagnose this subtype, as well as the Type Bipolar-II. In cyclothymia where wellness is seen for two months a year, the patient may have difficulty concentrating, sleeping disorders and difficulties to keep work.

In Turkey, according to statistics of five percent prevalence of bipolar disorder in society. For Bipolar Type, this rate is one percent. How does illness affect a person's quality of life? How is she diagnosed? What are the risk factors?

We asked those who experienced the disease personally, their relatives and the specialists in the subject.

Studies show that the average age of onset of the disease in Turkey shows that in the range of 23-28 years. In more than half of bipolar patients, the first episode begins with depression. Depression from the first attack is often a factor that delays the diagnosis. Psychiatric Association of Turkey Istanbul Power Chair and Board Member of the Society of Bipolar Disorders by Tan Age, rapid antidepressive response in cases of depression Bipolar Disorder possibility that should come to mind. Rapid recovery after ECT should also consider this possibility.

Tan says that one of the factors hindering diagnosis and treatment in Type Bipolar II is the fact that the diagnosis is primarily diagnosed as depression because hypomania is not recognized or later recognized: Bipolar I Type is close to people and patients are brought directly by family members. however, in Bipolar-II Type, the patient presents with depression and hypomania (low level of mania) and these people or their environment can observe the disease functionally.

However, according to Tan, the risk of the disease progressing in the bipolar-Iolar type is more frequent in all subtypes of bipolar disorder.

"I loved hypomania attacks"

The fact that the disease is mostly accompanied by other diseases is another factor that hinders differentiation.

According to a study conducted in Turkey to take the diagnosis time of bipolar observation in the range of 2.2 and 11.3 years. The same study estimates the duration of the attack in about three years.

An international study reported a 40.3% error rate in the diagnosis of bipolar disorder. In another study, it was found that the medical room had the correct diagnosis. The most common diagnostic error of bipolar disorder is depression. Referring initially to work in Turkey had been diagnosed with bipolar depression found 65 percent of patients.

Cemal, who asked the psychiatrist six years ago to think he was depressed, received a diagnosis of bipolar disorder three years after starting treatment. She explains the depression with these words: sözcük It is a barrier. At some point you feel you have a disability because you can not do what you think people should do, be simple. For example, wake up at a reasonable hour in the morning, clean the house, go to the market … I can not even take a shower and get up Kalk.

Cemal said he had problems because he could not wake up in the morning and could not go to work, he started working autonomously at home after giving up two consecutive jobs. He says his illness also had a negative impact on his private life: Do you think you are with someone who is not stable? You look normal for a while, then suddenly you fight with ridiculous reasons. You can not do anything for the relationship … No stability. You know, the more you know, the longer you'll get worse, because you're living often.

After diagnosis of Type II bipolar, mood stabilizers and antipsychotics were added to antidepressant treatment, and new drugs did not alter the severity of depression.

In fact, most patients love and miss this period because it is a time when they are more active. There are also articles and research that this disease is entangled with creativity, and that many creative artists have bipolar disorder. In fact, the symptoms of the disease symptoms, that is, mania and depression, are so intense and problematic that they do not allow for any creativity. If there is an occasional connection, this can happen during hypomania, as many researchers have discovered. Experts, only those who are trying to reach this period, themselves, coffee, coke, energy drinks, etc., trying to alert patients who cut or stop their drugs, he says.

Cemal says he has not tried to give up his medication without consulting his doctors so far. However, although they are often aware of the danger, irregular drug use is common among bipolar patients. One of the possible causes of this may be side effects such as wrong medication selection, and it emphasizes the importance of the client-therapist relationship: The more you cooperate with the patient, the more successful the treatment is Bun.

Ayse, whose brother is a Type II bipolar patient and holds a bachelor's degree in psychology, witnessed firsthand the results of irregular drug use. Saying that her brother spent his first illness at the age of 21 after losing his best friend in a traffic accident, Ayşe told her: her roommate called us on the phone, asking someone to take care of her. We found her in paranoia. Under the government's secret project, he thinks the banks are following him and stealing his personal information, and he's been walking around the house.

After that, his brother was hospitalized for a while, but only after the sudden cessation of drug use, often passed the sick, sometimes three or four days they do not hear about him, he says. Ayse is worried about her brother's life.

Family and environmental support is extremely important.

Founded in 2007, the Bipolar Life Association brings together patients, family, and specialists diagnosed with bipolar disorder. Özlem Sarı, who has been president of the association for 1 year and has Bipolar I himself, explains the association's primary function of informing patients and their families and the community about the disease and being a bridge between health institutions and patients , guiding them D. The Association organizes various activities and meetings to raise public awareness and avoid prejudice and stigmatization.

Yellow states that family and environmental support is extremely important and effective, especially in times of episodes and to accept the patient's disease: olduğun I want to treat all patients: a difficult disease is not an easy disease to accept, but family support, acceptance family, the sick child of the family or the endless love of the wife to wrap up facilitates the process of acceptance. The better and faster the patient accepts the disease, the better the healing process will be.

At age 48, she is married and has a daughter and by the age of fifteen completed the first period of mania: We had the chance to go to the doctor on Sunday. He did not eat within two days, I did not drink, I did not sleep; my mother and father were with me, they could not understand the process. My father took my hand, my mother stroked my hair. Then we went to Özcan Köknel, one of the best psychiatrists of the time, and after a few sessions, I became convinced that my illness was manic depressive that day, then I was hospitalized for about 10 days.

Yellow said that since then there has been no suggestion that the diagnosis may be wrong.

Higher suicide rate in bipolar patients

According to statistics, the suicide rate in bipolar patients is 20-30 times higher than the average; 25 percent of the patients had attempted suicide, 15 percent of which resulted in death. Dr. attention to these rates. Devran Tan points out that the disease can have serious consequences if left untreated: "Bipolar disorder has two extremities, mania (can also appear as hypomania) and depression. If untreated, the likelihood of disease recurrence increases by 60% within two years. The five year recurrence rate is 90%.

Manin knife sharpening

Genetic susceptibility is an important factor in the onset of the disease, however, factors such as stress, insomnia, substance use, time difference can trigger the disease. Among the methods used to prevent them, there are also preventive therapies as well as drugs that are used continuously. Drugs used in the acute period of the disease include antipsychotic needles. So the man who feels that he is about to have a manic episode is able to survive this period without serious problems if he or she visits his doctor as soon as he realizes the initial symptoms of the attack. Yellow, 32 years of experience in the disease because of the symptoms of self-esteem symptoms immediately noticed that it says:

Orum For example, when I walk down the street on a busy street, I suddenly start looking into people's eyes. More than ever … I have a fierce feeling of doing good in myself. Along the street I saw three people open their palms, five pounds not in my hand, what I have in my pocket, fifty pounds, I go to a hundred pounds. I talk about the love of people with all the people I do not know along the street. (Because I see myself as an ambassador who was sent into the world to love one another). This takes half an hour, an hour. When I get home, I immediately call the doctor and say that I am about to go into a cause. He tells me the name of my medicine. I go to the nearest hospital, I'm doing my medicine there and I sleep three days and three nights without getting up. All the thoughts that come back to my brain are stabilized at once and are suppressed so that I do not enter the mania or reach the extreme points of the mania.

So, what happens if it is not pressed? Yellows, three or four days in a row, do not sleep on each other, sleep without drinking, packets of cigarettes consumed, on the fourth day of the hospital, he says and in a certain language says: There is nothing to control the end point of the attack Mania. You're hurting yourself to the extreme. Because you can control hypomania, but there is no manic control. So, if you realize, you will take the precaution, go to the doctor. But if you try to walk around the mania craze, the medication you are going to give is much more.

Mani is not nice at all. Sounds good, but you can not contain the craze. That's why he takes you away, and you're on the road through dusty and terrified roads. Arbitrary Knife Ridge.

Same situation Tan explains: Sometimes they bring mania from the street. Six wounds on her feet. Or they can not prevent themselves, they make impulsive movements. For example, a customer entered a store with his car. Money is growing a lot, they are getting into such debts that sometimes after the attack, "What did I do"? They say. In such cases, hospitalization may be required Böyle.

Yellow, bipolar disorder is similar to driving: If you use controlled, you can get a driver's license and drive, but you will not do too fast too slow because you will cause the accident. Of course it is difficult, but many things are difficult in life.

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