Not long ago, a patient was admitted to the ward of Peking University Sixth Hospital.
A month ago, the patient had a hypomanic episode, and it took only one week to complete an extremely difficult master's thesis that usually takes two or three months to complete.
However, after the paper was submitted, he fell into depression again while waiting for the results, trying to end his life.
Zhu Yue, an outpatient doctor specializing in bipolar disorder at Peking University Sixth Hospital, told the China Youth Daily and China Youth Daily that the patient's disease was bipolar disorder.
Mood swings, highs and lows, like riding a roller coaster, are the core features of bipolar disorder.
Zhu Yue explained that normal people also have mood swings, but they are generally within a relatively stable range, while bipolar patients have extreme mood swings or mood swings.
Bipolar disorder, also known as bipolar disorder, is a common psychiatric disorder characterized by both manic or hypomanic episodes and depressive episodes.
A "manic episode" refers to a state of excessive pleasure and excitement; a "depressive episode" refers to a state of extreme depression and hopelessness; an episode of both mania and depression is called a "mixed episode".
The mood of patients with bipolar disorder changes back and forth between extreme highs and extreme lows. Sometimes they feel that they are flying to the "top of the world", with too much energy and omnipotence; .
Many patients describe this feeling of traveling between two extremes: half sea water, half fire.
Dangerous and fascinating "genius disease"
Zhu Yue introduced that the American diagnostic criteria divides bipolar disorder into type I and type II.
Type I refers to bipolar disorder in which the patient has had manic or mixed episodes in addition to depressive episodes; type II refers to bipolar disorder with only hypomanic episodes in addition to depressive episodes, but no manic or mixed episodes. Emotional disorders.
Hypomania is a milder form of mania.
Bipolar II disorder is less severe than bipolar I disorder.
During the hypomanic episode, the patient is extremely flexible, thinking extremely quick, energetic, socially active, and working efficiently.
During a hypomanic episode, the patient usually does not think that he has a mental problem, but will enjoy this state very much and hope to maintain this state forever.
Although hypomania does not significantly impair the patient's social functioning, however, this does not mean that it can be left unchecked.
"Without proper treatment, hypomania may also develop into mania," Zhu Yue said. "Manic episodes can cause significant damage to individuals in work, life and relationships, and even encounter legal disputes."
People who are in a manic episode are more agitated and behave more extreme than in a hypomanic episode.
If hypomanic patients are socially active because of high mood, manic patients will keep talking until their throat is hoarse due to excessive excitement. Maniacs will schedule a full day, and sleep time may be shortened to only three or four hours, so that the body and mind are severely exhausted; in addition, manic patients also appear to be impulsive, and will act recklessly, irrationally, and recklessly. During manic episodes, patients may also become irritable, and may appear verbal and physical impulsive aggressive behaviors; manic patients may also be accompanied by delusions, suspicion, Psychotic symptoms such as auditory hallucinations.
Therefore, bipolar disorder, like schizophrenia, is classified as a serious mental illness.
Interestingly, being emotional, indefatigable, impulsive, and adventurous are just the right traits for creativity.
In fact, many outstanding figures in history are bipolar patients, such as artists Van Gogh, Beethoven, writers Hemingway, Pushkin, politicians Napoleon, Churchill, scientists Newton, philosopher Nietzsche, etc., they are inspired and brilliant Both may be subtly linked to episodes of mania or hypomania, which is why bipolar disorder is also known as "genius disease."
Difficulty in early diagnosis
Zhu Yue told reporters that the cause of bipolar disorder is still unclear.
It is generally believed that it may be related to biological factors such as genetics, neurobiological changes, immune system disorders, neuroendocrine abnormalities, as well as psychological and social factors.
About 1%-3% of people worldwide suffer from bipolar disorder.
Epidemiological surveys show that the lifetime prevalence of bipolar disorder in adults in my country is 0.6%, and most of them have their first onset between the ages of 15 and 30.
In patients without systemic treatment, the lifetime recurrence rate is as high as 90%.
Early diagnosis of bipolar disorder is often difficult because of its complex symptoms and many overlapping symptoms with depression and other psychiatric disorders, and a definitive diagnosis may take years after the illness.
It has been reported that as many as 40% of people with bipolar disorder are initially diagnosed with depression, and 35% wait at least 10 years between their first visit and their diagnosis of bipolar disorder.
Zhu Yue explained that those patients with onset of manic episodes can be diagnosed at an early stage, but more patients with onset of depression will be initially diagnosed as depression; some patients have depression-based symptoms, Short duration of hypomanic or manic episodes, insignificant symptoms, or the patient's perception of a hypomanic state as normal can also make identification difficult for clinicians.
As a result, self-identification of bipolar disorder is more difficult.
In addition to the difficulty in recognizing hypomanic state, some patients' manic manifestations may not be extremely high emotions, excessive joy and excitement, but irritability and irritability. A temporary performance caused by the recent stress.
Zhu Yue reminded, "Compared with depressed patients, bipolar patients may be more accompanied by impulsive or hostile behaviors, and may also be accompanied by drinking, drug use, etc. If these symptoms occur, they should seek medical attention in time."
Early identification is very important
Zhu Yue emphasized that although patients with bipolar disorder and depression suffer from depressive episodes the same way, they are treated differently, which is why the diagnosis of bipolar disorder is very important.
"The treatment of bipolar disorder needs to be based on drugs such as mood stabilizers, and depression is mainly antidepressants." Zhu Yue said, "For patients with bipolar disorder who have depressive episodes, it is necessary to use Antidepressants are used on top of mood stabilizers, and without mood stabilizers, patients are at risk of exacerbation."
Zhu Yue believes that to identify whether patients with depression have potential "bipolar", we can start from the following aspects: the age of the first depressive episode in his life is less than 25 years old; there is a family history of bipolar disorder; the depressive episode is accompanied by obvious Restlessness or irritability; at least 3 or more depressive episodes; complete recovery within a short period of time after antidepressant treatment, for example, after two or three weeks of antidepressant use, symptoms disappear completely; depressive symptoms are not typical, such as excessive sleep, eating Many, the limbs are heavy, such as the feeling of being filled with lead.
"These clinical features are more often seen in depressed patients who eventually transition to a bipolar diagnosis."
Medication on time, regular work and rest
The good news is that most people with bipolar disorder can live a normal life with medication.
Zhu Yue said that bipolar disorder is an episodic disease, and most patients can enter the remission period after treatment and can work and study normally. However, because mental illness is a disease that is prone to recurrence, patients must follow the doctor's advice and take medicine on time. Adequate and adequate maintenance treatment can prevent recurrence of the disease.
If the drug is reduced or stopped without authorization, the disease is prone to relapse, and the more the number of attacks, the greater the difficulty of treatment.
Zhu Yue also reminded that patients with bipolar disorder should also pay attention to ensuring regular sleep and work and rest, ensure sleep quality and time, try to avoid night shifts and other behaviors that affect sleep work and rest rhythms, and avoid drinking alcohol or stimulant-containing energy drinks.
Patients who are susceptible to caffeine and tea polyphenols should also avoid stimulant beverages such as coffee and milk tea.
A regular routine and a healthy lifestyle both help maintain long-term stability of the condition.
"Bipolar disorder is not terrible. If you maintain a sense of reverence for the disease, maintain good communication and cooperation with doctors, and develop a regular and good daily routine, you will be able to go further and further on the road to recovery." Zhu Yue said.
China Youth Daily, China Youth Daily reporter Xia Jin Source: China Youth Daily