In You Are Not Alone: The NAMI Guide to Navigating Mental Health, Dr. Duckworth shares inspiring first-person stories from 130 people across the country, weaves in advice from prominent clinical experts, and offers an essential road map to mental health care, including the newest treatment research. He also brings the empathy of peer perspective as someone with bipolar disorder in his family.
Written by bipolar disorder researcher Julie A. Fast, who was diagnosed at age 31, and specialist John Preston, PsyD, Take Charge of Bipolar Disorder: A 4-Step Plan for You and Your Loved Ones to Manage the Illness and Create Lasting Stability, is a practical guide for those who live with bipolar disorder and their loved ones. The book promotes a holistic approach to treatment: the importance of medication adherence, lifestyle changes that can help manage symptoms naturally, and how to establish a strong support system.
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In Enough: A Memoir of Mistakes, Mania, and Motherhood, Malaysia-born writer Amelia Zachry chronicles her route to resilience. As a bicultural child of Malay and Indian heritage, Zachry struggled to fit in; her PTSD and bipolar 2 disorder further complicated matters but ultimately shaped her life as an individual, wife, and mother. In Enough, she shares her trauma and healing, through culture shock, new beginnings, and later triumph.
Research psychologist Rachel A. Pruchno, PhD, whose mother and daughter were both diagnosed with bipolar, delivers a part-memoir, part-supportive guide in Beyond Madness: The Pain and Possibilities of Serious Mental Illness.
Pruchno struggled in the face of misinformation, intolerance, and ignorance surrounding bipolar treatment when seeking treatment for her daughter, and she eventually found answers in scientific literature. Understanding that those without the background and experience necessary to unravel highly technical medical writing and conflicting data would be overwhelmed, she sought to provide solutions and guidance for everyone in Beyond Madness.
Renowned author and clinical psychologist Kay Redfield Jamison has released a new book on the topic of bipolar disorder, which she has lived with since early adulthood. Fires in the Dark: Healing the Unquiet Mind delves into the culture and history of treatment of mental illnesses and how, when done correctly, psychotherapy can be a life-saving tool. Jamison also touches on the history of using physical treatments for mental disorders, as well as the role of ritual and religion in healing.
In a candid memoir, Ann E. Jeffers, PhD, details the complexities of bipolar disorder and psychosis, and her systematic path to reclaim her trusted intellect. Ann E. Jeffers, PhD, had a longtime partner, 3-year-old daughter, and tenure-track position at a top-ranked college engineering program when she was diagnosed with bipolar 1 disorder. In her newly...
I am not sure that reading memoirs of persons who had bipolar disorder is the most helpful strategy for patients and families. The books above would be a much better way to go. But, if one is looking for a memoir, here is one that is very popular.
Bipolar disorder, also known as bipolar affective disorder, is one of the top 10 leading causes of disability worldwide. Bipolar disorder is characterized by chronically occurring episodes of mania or hypomania alternating with depression and is often misdiagnosed initially. Treatment involves pharmacotherapy and psychosocial interventions, but mood relapse and incomplete response occur, particularly with depression. Continual reevaluation and treatment modification are commonly required during the long-term care of patients with bipolar disorder. Management of comorbid psychiatric and chronic medical conditions may also be necessary. This activity reviews the etiology, classification, evaluation, management, and prognosis of bipolar affective disorder, and it also highlights the role of the interprofessional team in managing and improving care for patients with this condition.
Objectives:Recognize patterns of symptoms suggestive of bipolar disorder, its various subtypes, and related disorders.Implement evidence-based management of bipolar disorder based on current published guidelines.Select individualized pharmacotherapy plans and adjunct therapies for bipolar disorder and comorbidities.Describe the necessity of an interprofessional holistic team approach that integrates psychiatric and medical healthcare in caring for patients with bipolar disorder to help achieve the best possible outcomes.Access free multiple choice questions on this topic.
Bipolar and related disorders include bipolar I disorder (BD-I), bipolar II disorder (BD-II), cyclothymic disorder, other specified bipolar and related disorders, and bipolar or related disorders, unspecified. The diagnostic label of "bipolar affective disorders" in the International Classification of Diseases 10th Revision (ICD-10) was changed to "bipolar disorders" in the ICD-11. The section on bipolar disorders in the ICD-11 is labeled "bipolar and related disorders," which is consistent with the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).[1]
A World Health Organization study showed "remarkably similar" international prevalence rates, severity, impact, and comorbidities of bipolar spectrum disorder, defined as BD-I, BD-II, and subthreshold bipolar. The aggregate lifetime prevalence of the bipolar spectrum was 2.4%.[2]
BD is often difficult to recognize because symptoms overlap with other psychiatric disorders, psychiatric and somatic comorbidity is common, and patients may lack insight into their conditions, particularly hypomania. Treatment involves pharmacotherapy and psychosocial interventions, but mood relapse and incomplete response occur, particularly with depression. Continual reevaluation and treatment modification are commonly required during the long-term care of these patients. Management of comorbid psychiatric and chronic medical conditions may also be necessary. This activity provides an overview of the etiology, classification, evaluation, and management of bipolar affective disorder.
In a recent neuroimaging review article, the ENIGMA Bipolar Disorder Working Group stated, "Overall, these studies point to a diffuse pattern of brain alterations including smaller subcortical volumes, lower cortical thickness and altered white matter integrity in groups of individuals with bipolar disorder compared to healthy controls."[9] Neuroimaging studies have also shown evidence of changes in functional connectivity.[10][11]
Because bipolar disorder is a clinical diagnosis, making the correct diagnosis requires a comprehensive clinical assessment, including the directed patient interview, preferably supplemented by interviews of their relatives and the longitudinal course of their condition. Currently, there is no biomarker or neuroimaging study to aid in making the diagnosis.
Most patients with bipolar disorder are not correctly diagnosed until approximately 6 to 10 years after first contact with a healthcare provider, despite the presence of clinical characteristics of the condition.[17] Notably, misdiagnosing BD after first contact differs from not recognizing the transition from major depressive disorder (MDD), the most common index presentation, to BD. Estimates of patients transitioning to BD within three years of an MDD diagnosis range from 20-30%; therefore, clinicians must maintain an awareness of the potential for this transition when caring for patients with MDD who initially screened negative for BD.[18] Also, subthreshold hypomanic symptoms can occur in as many as 40% of patients with MDD.[19]
Although not highly sensitive and specific, self-report screening tools for BD may aid clinicians in making an accurate diagnosis. The most studied screening tools are the Mood Disorders Questionnaire (sensitivity 80%, specificity 70%) and the Hypomania Checklist 32 (sensitivity 82%, specificity 57%).[20] Positive results should motivate the clinician to conduct a thorough clinical assessment for bipolar disorder.
Specified bipolar and related disorders: Bipolar-like phenomena that do not meet the criteria for BD-I, BD-II, or cyclothymic disorder due to insufficient duration or severity, ie, 1) short-duration hypomanic episodes and major depressive disorder, 2) hypomanic episodes with insufficient symptoms and major depressive episode, 3) hypomanic episode without a prior major depressive episode, and 4) short-duration cyclothymia.
Unspecified bipolar and related disorders: Characteristic symptoms of bipolar and related disorders that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning but do not meet the full criteria for any category previously mentioned.
The following characteristics may heighten the clinical suspicion for a possible secondary cause in patients with signs and symptoms associated with bipolar disorder: older than 50 at the first onset of symptoms, abnormal vital signs or neurological examination, a recent change in health status or medications temporally associated with symptom onset, unusual response or unresponsiveness to appropriate treatments, and no personal or family history of a psychiatric disorder.
Suicidal and self-harm risk has priority in managing patients with bipolar disorder who present with an acute depressive episode because most suicide deaths in patients with BD occur during this phase. Patients may or may not require hospitalization.
For patients not already taking long-term medication for BD, first-line monotherapy includes quetiapine, olanzapine, or lurasidone (has not been studied in acute bipolar mania). Combination treatment with olanzapine-fluoxetine, lithium plus lamotrigine, and lurasidone plus lithium or valproate may also be considered.
Consider cognitive behavioral therapy (CBT) as an add-on to pharmacotherapy. However, never consider CBT as monotherapy because there is minimal evidence to support psychological treatments without pharmacotherapy in treating acute bipolar depression. 006ab0faaa
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