Misconceptions about bipolar disorder

Bipolar disorder, known as “manic depressive illness” and “bipolar temperament disorder”, in individuals; It is seen as mood attacks covering various periods such as “mania-hypomania”, “depression” and “mixed”. Drawing attention to the well-known misconceptions about bipolar disorder, Assist. Assoc. Dr. Emre Tolun Arıcı emphasized that, contrary to what is known, there are no constant mood changes during the disease process, that bipolar disorder patients are healthy except for the attack periods, and that they can get married and become pregnant under the control of a doctor.

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Psychiatrist Assistant from Üsküdar University NP Feneryolu Medical Center. Assoc. Dr. Emre Tolun Arıcı gave important information about bipolar disorder.

Bipolar disorder attacks can be completely healed!

Assist. Assoc. Dr. Emre Tolun Arıcı, his illness “Bipolar disorder; Manic-depressive illness, also known as bipolar disorder, is an important psychiatric disorder. It is characterized by mood attacks covering various periods such as ‘Mania/Hypomania’, ‘Depression’ and ‘Mixed’. attack symptoms

Depression, unhappiness, not enjoying life, thoughts of worthlessness, pessimism, difficulty concentrating, weakness, body aches, sleep, changes in appetite, suicidal thoughts.

Manic/hypomania attack symptoms in bipolar disorder

Exaggeration, exaggerated increase in self-confidence, irritability, increased speech, flight of ideas, distraction, hyperactivity, lots of money spending, inappropriate behavior, easy risk-taking, inability to sleep, decreased need to eat, quarrelsomeness.

Mixed period symptoms in bipolar disorder

The combination of some of the symptoms of depression and mania is called ‘mixed period’. The disease progresses with attacks, the duration and severity of attacks can vary from person to person or over the years. Attacks often heal completely; however, some people may continue to have some symptoms, called residual symptoms.

Common misconceptions in bipolar disorder

Asst. Assoc. Dr. Emre Tolun Arıcı said, “It is useful to correct some well-known misconceptions about Bipolar Disorder,” and said:

“The disease is perceived as a constant mood change or people who experience various behavioral problems are called bipolar. This is completely wrong. Bipolar is not a personality trait or behavioral problems, contrary to popular belief, they are healthy except for the attack periods that need to be treated. Apart from this, there are also stigmatizing false beliefs such as “they cannot marry, have children, cannot work”. People with bipolar disorder can get married like any individual who has reached marriage maturity, work outside of shift work that disrupts sleep patterns (because sleep patterns are important to prevent attacks from triggering), and can become pregnant under the control of a doctor.

Attacks are triggered during stressful times

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Assist. Assoc. Dr. Emre Tolun Arıcı, “Attacks are in certain seasons; It can be triggered especially in the spring months, during stressful periods such as military service, and in special situations such as puerperium. In the formation of the disease; genetic predispositions, changes in biological substances in the brain, stress and traumas can be effective” and continued his words as follows:

“The disease often begins in the 20s. In general, the incidence is around 1-2%. This frequency is similar in men and women.

This rate may increase to about 8-9% in people whose first-degree relatives have the disease. Genetic predisposition is very important in the disease, but we cannot talk about direct genetic transmission.

Genetic predisposition becomes even more prominent in bipolar disorder that starts especially in childhood and adolescence. The age of onset can go down to 7-8 years. It is more difficult to diagnose at this age and it can often be confused with other diseases or conditions.

The disease can start at any age, including those over 60 years old. In these cases, it is necessary to investigate its relationship with other physical diseases, to be followed closely in terms of suicide risk and drug side effects.

Family support is of great importance

Bipolar disorder treatment is divided into two as “attack treatments” and “preventive treatment”.

Treatments for attacks vary according to the depression/mania/mixed episode at that time. Treatment can be either inpatient or outpatient depending on the severity of the attack. There are various drugs used in the treatment, as well as additional methods, these are; They are treatments such as ECT, TMU, Deep TMU.

In preventive treatment, psychotherapy support is important in addition to mood stabilizing drugs. In addition, it is important to follow the polyclinic, to use the recommended drugs, to follow the blood level of preventive drugs, to recognize the antecedent symptoms of the disease, to have regular sleep, and to avoid alcohol. Families are also here; Supporting the patients about treatment, recognizing the disease and the triggering factors, pre-symptoms, drug side effects, stigmatization in the disease, providing psychosocial support etc. tasks fall.

The course of the disease in women differs according to the periods

Although the gender differences in the disease are not very clear, depressive and mixed episodes, seasonal recurrences are more common in women and some other psychiatric disorders such as anxiety disorders are observed. comorbid medical conditions such as thyroid disease or thyroid disease are more common.

The importance of the disease in women differs during pregnancy, puerperium and menopause. Postpartum period and menopause can trigger attacks. Although the pregnancy itself does not pose a risk, stopping drug treatments may trigger attacks again.”

How does the process progress during pregnancy?

“When women with bipolar disorder decide to become pregnant, they should discuss this with their psychiatrist. “The use of drugs during pregnancy is done according to the course of the disease, the severity of the attacks, and the evaluation of the fetus-mother, profit-loss for the patient,” said Assistant Prof. Emre Tolun Arıcı,

“If it is decided to stop the drug treatment completely, discontinuation of pregnancy protection should be after the time deemed appropriate by the physician after the drug is completely stopped. It may be protective for the patient whose drug treatment is discontinued to receive psychotherapy support during pregnancy, to pay attention to sleep patterns, to stay away from stress. and patients from being helpless about treatment. they are usually worried. In this process, it is important to inform the patient. Again, there are treatments that can be applied according to the patient and the severity of the disease. Considering the health of the mother and the fetus, treatment can be applied by choosing the lowest doses and from the drug groups that are considered safer. Pregnant women who are treated with drugs are recommended to undergo more frequent psychiatric examinations and gynecological controls, and to monitor the level of the drug in the blood. Apart from drug treatments, TMS treatment is a safe treatment method that can be applied in suitable patients without affecting the fetus. ECT treatment and clinical hospitalizations are also the treatment methods used during pregnancy, especially in severe attacks. If the patient realizes that she has become pregnant while using drugs, she should consult her doctor as soon as possible, some drugs may need to be stopped immediately, “he said.

Risky period: Postpartum

Expressing that the postpartum puerperium is a special period in treatment like pregnancy, Assist. Assoc. Dr. Emre Tolun Arıcı said, “The postpartum period is a risky period both for the first emergence of the disease in women and for its recurrence” and concluded his words as follows:

“Moreover, since there is a risk of transfer of drugs to the baby through breastfeeding, treatments are evaluated by evaluating the mother-baby health and benefits. is selected. When arranging drug treatments, it is planned in a low dose and in a way that provides the least transition to the baby. The baby and mother are followed up for side effects. When necessary, breastfeeding can be interrupted by communicating with the pediatrician and making a feeding plan for the baby. TMS can be selected in suitable patients with the advantage that it does not affect breastfeeding.

Psychotherapy should be applied during pregnancy and puerperium

Psychotherapy should be recommended both during pregnancy and puerperium. In this period, it is important for the patient to sleep uninterruptedly at night, to undertake the duty of night feeding of the family, and to support the family physically and psychologically. While deciding on treatments during breastfeeding, the mother’s desire to breastfeed and the baby’s need to suck should be considered; However, it should also be considered that the health of the mother is important, the treatment is mandatory and the baby needs a healthy mother for its development.

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