User:Arpgurp/sandbox
From Wikipedia, the free encyclopedia
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression as well as periods of abnormally elevated moods.[1][2][3] If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe, it is called hypomania.[1] During mania, an individual behaves or feels abnormally energetic, happy, or irritable.[1] Individuals often make impulsive decisions during manic episodes, with little regard for the consequences.[2] There is usually a reduced need for sleep during manic phases.[2] During periods of depression, individuals may experience crying, a negative outlook on life, and poor eye contact with others.[1] The risk of suicide among those with this condition is high; over a period of 20 years, one study found that 6% of people with bipolar disorder died by suicide, while 30-40% engaged in self-harm behaviors.[1] Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder.[1]
While the causes are not clearly understood, both environmental and genetic factors are thought to play a role.[1] Many genes, each with small effects, contribute to the disorder.[1][4] Genetic factors account for about 60-90% of the risk of developing bipolar disorder.[5][6][7] Environmental risk factors include a history of childhood abuse and long-term stress.[1] The condition is classified as bipolar I disorder if there has been at least one manic episode, with or without depressive episodes, and as bipolar II disorder if there has been at least one hypomanic episode (but no full manic episodes) and one major depressive episode.[2] If the symptoms are due to drugs or medical problems, they are not diagnosed as bipolar disorder.[2] Other conditions that may present similarly include attention deficit hyperactivity disorder, personality disorders, schizophrenia, and substance use disorder as well as many other medical conditions.[1] Medical testing is not required for a diagnosis, though blood tests or medical imaging can rule out other problems.[8]
Mood stabilizers—lithium and certain anticonvulsants such as valproate and carbamazepine—are the mainstay drugs prescribed for the treatment of bipolar disorder and long-term relapse prevention.[9] Antipsychotics are prescribed during acute manic episodes, as well as in cases where mood stabilizers are poorly tolerated or ineffective, or if compliance is poor.[9] There is some evidence that psychotherapy improves the course of this disorder.[10] The use of antidepressants in depressive episodes is controversial—they can be effective but have been implicated in triggering manic episodes.[11] However, the treatment of depressive episodes is often difficult.[9] Electroconvulsive therapy (ECT) is effective in acute manic and depressed episodes, especially with psychosis or catatonia.[lower-alpha 1][9] Admission to a psychiatric hospital may be required if a person is a risk to themselves or others; involuntary treatment is sometimes necessary if the affected person refuses treatment.[1]
Bipolar disorder occurs in approximately 1% of the global population.[9] In the United States, about 3% of the population are estimated to be affected at some point in their life; rates appear to be similar in men and women.[13][14] The most common age at which symptoms begin is 25.[1] Around a quarter to a third of people with bipolar disorder have financial, social, or work-related problems due to this condition.[1] Bipolar disorder is among the top 10 causes of disability worldwide and leads to substantial costs for society.[15] Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as coronary heart disease in people with bipolar is twice that of the general population.[1]