Bipolar4LifeSupport

What is Bipolar Disorder?

Bipolar Disorder is a mood disorder that is characterised by alternating periods of mania and depression. It was formerly known as manic depression. People with Bipolar Disorder can swing from extreme highs to extreme lows, sometimes very quickly. This can often feel confusing or even frightening for the sufferer and their loved ones.

The good news is that effective treatments are available for people with Bipolar Disorder.

At the London Psychiatry Centre, we have a wealth of knowledge and experience with the condition and can help you take the right steps to move forward in improving your quality of life. The first is recognising there is a problem, and seeking an accurate diagnosis.

Types of Bipolar Disorders

The various types of Bipolar Disorders and their symptoms are described below:

Bipolar I
This applies to patients who have one or more manic or mixed episodes, often combined with depression. Patients with Bipolar I Disorder typically have severe manic (high) episodes along with shorter depressive episodes. In other words, they are ‘high’ more often than they are low – which can make this condition hard to recognise.

Bipolar II
Patients with Bipolar II Disorder tend to have longer periods of depression that alternate with shorter manic episodes. In other words, depression is the dominant factor.

Cyclothymia
This is Bipolar Disorder with less obvious highs and lows. Although a comparatively milder condition, it can still have a serious impact on quality of life.

Bipolar Disorder Not Otherwise Specified (BD-NOS)
When a person doesn’t follow all the patterns of other known forms of the condition, they are said to have BD-NOS, and/or sometimes when bipolar occurs as part of other coexisting mental health conditions.

Causes of Bipolar Disorder

Bipolar Disorder is thought to be caused by a combination of biochemical, genetic and environmental factors. It may be due to a lack of serotonin (the ‘happy’ hormone) or an irregular release of dopamine (which helps control a person’s relationship to pleasure and reward) in the brain.

Bipolar Disorder tends to run in families and may lie dormant for years, only to be triggered by a traumatic event such as a relationship break-up, divorce, job loss, change of home, bereavement, etc.

Symptoms of Manic Phase (Mania)

The so-called ‘manic’ stage of the condition means a person is likely to be bursting with energy and ideas, intense and prone to seemingly bizarre behaviour such as excessive spending, heavy drinking or wild sexual behaviour.

Symptoms include:

• Exaggerated euphoria
• Insomnia
• Grandiosity
• Racing ideas
• Rapid speech
• Reckless behaviour

Symptoms of Depressed Phase (Depression)

While a person battling depression may not realise they have the condition, fortunately it tends to be fairly straightforward for us to identify here at the London Psychiatry Centre.

The patient may feel disproportionately angry or sad, seemingly about nothing. They may have frequent crying bouts and fantasise about dying. Patients often say their lives have become unmanageable, they feel overwhelmed and their confidence is at rock bottom.

Symptoms include:

• Frequent crying or sad mood
• Lethargy (e.g. not wanting to get up in the morning)
• Insomnia or excessive sleeping
• Obsessive thought patterns
• Feelings of guilt, pessimism and low self-esteem
• Thoughts about/attempts at suicide

Bipolar Disorder Test

Many factors are involved in diagnosing Bipolar Disorder. Factors that we will consider before making a bipolar diagnosis include:

• A patient’s family medical history, such as whether anyone has or have had bipolar disorder/depression
• Any pronounced mood swings – and for how long they have been occurring

We may also suggest a thorough examination to look for illnesses that may be causing the symptoms, such as thyroid problems or possible drug use.

Note: Drug use may cause some bipolar symptoms. But this doesn’t mean the patient doesn’t have bipolar disorder. In fact, they may be ‘self medicating’ their symptoms.

Bipolar Disorder Treatment

Bipolar Disorder can be effectively treated, but there is always a chance it will re-occur. That is why at the London Psychiatry Centre we encourage our patients to practice ongoing awareness, and we are always available should they need any further help. The major goals of treatment are to:

• Treat and reduce the severity of acute episodes of mania or depression when they occur
• Reduce the frequency of episodes
• Avoid the cycling from one phase to another
• Improve the patient’s overall quality of life

An important aspect of treatment is to determine what might have triggered a bipolar episode and work at minimising its negative impact. At the Centre, we work with the patient to identify key emotional triggers and anything that might interfere with the treatments prescribed.

Drugs Used in Bipolar Disorder

• Lithium – Lithium has been used for years for Bipolar Disorder. It remains the most common drug for people with pure mania characterised by euphoria and pure depression
• Anti-seizure Drugs – such as Valproate (valproic acid) carbamazepine (Tegretol, Carbatrol, Equetro), oxcarbazepine (Trileptal), and lamotrigine (Lamictal). These drugs might be an alternative for people who do not respond well to lithium, particularly those with substance abuse problems
• Atypical Anti-psychotics – Drugs known as atypical anti-psychotics are used to treat schizophrenia and also have mood stabilising properties that help treat Bipolar Disorder. They may be used either alone or in combination with lithium or valproate
• Anti-depressants – Anti-depressant drugs (SSRIs) like fluoxetine (Prozac) and Effexor are not typically used in treating bipolar disorder as they can trigger manic or mixed episodes. Recent studies have shown that exposure to anti-depressants in bipolar patients produces worse long-term outcomes than no treatment. This is known as mood destabilisation.

Non-Medical Treatments

In addition to medical treatments, psychotherapy and sleep management are also parts of Bipolar Disorder treatment. They can help reduce symptoms and prevent relapse.
If you think you or a loved one may be suffering from Bipolar Disorder, please contact us. The London Psychiatry Centre is home to the UK’s leading affective disorder experts who can correctly diagnose bipolar disorders and offer suitable treatment programmes.

Trying to cope amidst a chronic feeling of low mood, physical tiredness or extreme anxiety. Persistent bad feelings about oneself and life in general are draining, unhelpful and most importantly, not your fault.

If you have been struggling with Depression, know that there is something that can be done about it. At the London Psychiatry Centre, we are experts in tackling this condition. With the right help, you can feel better.

What is Depression?

Major Depressive Disorder, often referred to as ‘Clinical Depression’ is a type of mood disorder. It can vary in its severity and precise patterns from person to person but there are common symptoms that psychiatrists have identified.

Depression is sometimes an overused term. People may say they ‘feel depressed’ when referring to a passing low mood; at the end of a holiday or after Christmas for instance. However, actually being depressed in the clinical sense is something quite different.

Clinical Depression (Major Depressive Disorder) can be incredibly disorientating and debilitating. It can affect a person physically, mentally and emotionally. It can drain your energy, making it literally difficult to get out of bed. It can get in the way of your ability to work, sleep, and enjoy close relationships. It is real, and quite complex. It is not something you ‘choose’ to have, nor something you can simply ‘snap out of’.

Depression Symptoms: Am I Depressed?

It can be difficult to identify when you are suffering with Depression because the condition lowers self-esteem and feelings of confidence in your own judgment. Ironically, you may be more likely to think you’re ‘making a fuss about nothing’ at a time when you most need help.

To assist you, we’ve listed some of the common symptoms of Depression here. Though remember, Depression affects different people in different ways. You most probably won’t have experienced all of these symptoms. On the other hand, you may have suffered other symptoms not included on the list.

If you are suffering from Depression, you may be likely to:

• Experience a low mood for extended periods of time
• Lose your ability to enjoy life – even activities you used to love, such as hobbies
• Feel difficulty in connecting and enjoying spending time with people, even those closest to you. Sometimes Depression sufferers can even lose their ability to feel love for family and friends.
• Suffer with anxiety. This can be extremely troubling, sometimes even more so than the low mood. It can at times make everyday activities almost impossible.
• Have problems with your appetite. Many people struggle to eat enough when they are depressed. Or others may comfort eat to try to counteract negative emotions.
• Experience disturbed sleep patterns. Some people sleep more when they are depressed. Others suffer with problems getting to sleep at night, followed by a tendency to wake very early.
• Be preoccupied with the past, often with a sense of regret or guilt
• Find it difficult or even impossible to concentrate
• Be irritable
• Suffer with poor short-term memory or a sense of absent-mindedness
• Avoid socialising
• Experience a sense of dread or hopelessness about the future

Depression is also bad for physical health. We know, for example, that the risk of suffering a heart attack, or some other serious medical problem, is significantly increased by the presence of Depression.

To make matters even more challenging, Depression is a condition which is often misunderstood. Sometimes even the people who love you the most don’t understand why you’re feeling so bad. They may wonder why you don’t seem to want to socialise, or you may be slow to get in touch. They may even become frustrated. Sadly, this can leave a sufferer feeling even more alone, and with a heightened sense of guilt.

What causes Depression?

The roots of depression are complex. It is often a combination of problems and stresses in life, along with particular traits in an individual’s personality (for example a tendency to be overly self-critical). Traumas and life changes can be contributing factors – a marital breakdown or a difficult boss for example. At times loss can trigger Depression; loss of a child, spouse, or a role in life perhaps. Sometimes a genetic predisposition is also responsible for Depression.

How common is Depression?

Depression is the third most common reason for a visit to the GP in Britain. It is the most common psychiatric disorder by far. At any given point, it is estimated that 1 in every 10 people is living with depression or anxiety. Almost 1 in every 5 people will suffer an episode of Depression in the course of their lifetime, and around two thirds of adults will experience a depressed mood significant enough to interfere with their normal life. Women are around twice as likely as men to be depressed.

What are the treatments for Depression?

There are a number of different treatments available for Clinical Depression. Since Depression can be such a complex condition, different interventions may work for different people, and often, a combination is appropriate.

This is why, at The London Psychiatry Centre, we take an integrated approach to your recovery, assessing every patient as a complex individual in their own right. Our approach can encompass Cognitive Behavioural Therapy, Counselling and Psychotherapy, Personal Training, Medication and Nutrition. Furthermore, we are now the first clinic in the UK able to offer patients the new world-leading, evidence-based treatment for Depression; Repetitive Transcranial Magnetic Stimulation (rTMS).

Here we’ll discuss each intervention briefly in turn, in order to give you more of an idea of how they work.

Antidepressant medications

There are different ‘families’ of antidepressants. In recent years, ‘selective serotonin reuptake inhibitors’ (SSRIs) have become widely used. These drugs work to help keep serotonin in your system for longer, regulating the ‘feel good’ chemicals in the brain. Many patients report favourable results with these medications, but a significant proportion show no significant response. Still others are unable to tolerate the side effects that often accompany
them, such as sexual dysfunction, stomach problems, disturbed sleep and so on. In any case, antidepressant medications are shown to work better long-term in conjunction with psychotherapy than as a sole solution.

Psychotherapy (including Cognitive Behavioural Therapy)

There are a number of different approaches to ‘talking therapies’ and here at The London Psychiatry we cover a variety of approaches to address the individual needs of our patients. As one of the leading centres in the UK, we particularly favour approaches with strong evidences bases, such as Cognitive Behavioural Therapy; but we do also work with a number of other disciplines as appropriate. Our specialists are experts in their fields, and when you come to us for assessment we will talk with you in depth, to help determine which approach is best for you.

In any case, all talking therapies are concerned with uncovering and identifying unhelpful thought and behaviour patterns, releasing negative feelings, and developing new, positive strategies for dealing with life’s challenges. Other approaches to tackling Depression, such as treatment with medication, tend to fare better when combined with some element of talking therapy. Conversely, talking therapies often tend to have higher rates of recovery when combined with medication.

However, there are still a significant proportion of sufferers who do not respond to either medication or psychotherapy. For those persons, and people who choose not to take those routes, The London Psychiatry Centre is now able to offer rTMS. A highly effective, leading-edge treatment for Depression, rTMS offers a solution without the side effects associated with medications.

Repetitive Transcranial Magnetic Stimulation (rTMS)

rTMS is a pioneering treatment, proven in extensive research and many thousands of patient cases to be a safe and highly effective intervention to beat Depression. It works with your body’s own natural resources through the use of magnetic energy to stimulate the brain, improving brain chemistry and helping you to feel more balanced and positive.

Depression treatment with rTMS is non-invasive, highly-effective and provides long-lasting results. It comes without the many side effects often linked to medication, such as stomach problems, disturbed sleep, exhaustion or even heart problems. For many patients who have found antidepressants to offer insufficient relief, rTMS has made the difference.

On par with the world-famous Mayo Clinic, John Hopkins and Harvard’s McLean Hospital in the US, The London Psychiatry Centre is the only centre in Britain able to offer the treatment. To find out more about this leading-edge solution for Depression, visit our rTMS page.

Important complementary components: Exercise and Nutrition

Studies on both sides of the Atlantic have shown the value of regular exercise and smart nutrition in helping to tackle Depression.

When we exercise, our bodies release endorphins, helping to stabilise energy levels, relieve anxiety and improve mood. In a similar vein, science has shown certain foods to be good for the brain; sometimes informally referred to as ‘brain foods’. Other foods contain a lot of synthetic chemicals or sugars, causing spikes in glucose levels, which can have a negative effect on energy levels and our brain’s ability to regulate mood. Combining the right foods, at the right times of the day, can help to create balance.

Here at The London Psychiatry Centre, our wide variety of in-house experts enables us as a clinic to take an integrated approach to your treatment. Along with medication, psychotherapy or rTMS, we can also provide personal training and nutritional planning wherever appropriate. No two people are the same, so here at The London Psychiatry Centre, no two treatment plans are exactly the same. Tailored care that fits you – that is our philosophy.

Milder and less frequent forms of Depression

Dysthymia

Dysthymia is a mood disorder consisting of chronic depression but with less severity than Major Depressive Disorder. Chronic depression is diagnosed when a person has a prolonged period of repeated mild depression.

If you are battling this condition, it is possible you may have become used to feeling significantly low, and be reticent about seeking medical help. But the truth is, you do deserve to be enjoying life and reaching your potential. We can help you to achieve recovery with therapy and medication.

Depressive Disorder Not Otherwise Specified

This is a common phrase for other types of mild depression with some similar symptoms to the above mentioned categories, but that don’t fall into them fully.

Depressive disorders can affect people of all ages and from all walks of life and circumstances. If you or someone you know is suffering from a depressive disorder, book an appointment with one of our experts. Our skilled practitioners treat all kinds of depressive illnesses. We will do everything possible to help you recover and enjoy the best life has to offer.