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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by jrbecker on May 11, 2007, at 19:49:58
1 in 20 American adults? Well, I guess we shouldn't feel so marginalized anymore.
http://www.medicalnewstoday.com/medicalnews.php?newsid=70208
Approximately 4.4 percent of U.S. adults may have some form of bipolar disorder during some point in their lifetime, including about 2.4 percent with a "sub-threshold" condition, according to an article in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Individuals with bipolar disorder tend to fluctuate between periods of mania - an inappropriately elevated mood, characterized by impulsive behavior and an increased activity level - and periods of depression. They are at increased risk of suicide and other medical problems, such as cardiovascular disease, according to background information in the article. Previously, researchers estimated that about 1 percent of adults had bipolar disorder. But evidence indicates that current diagnostic criteria may be too narrow to effectively detect bipolar disorder in the general population, and that a broader definition of bipolar spectrum disorder would identify many more individuals with bipolar symptoms, the authors note.
Kathleen R. Merikangas, Ph.D., National Institute of Mental Health, Bethesda, Md., and colleagues estimated the national prevalence of bipolar disorder using data from 9,282 individuals chosen to represent the general population. The researchers conducted interviews between February 2001 and April 2003 to assess the presence of bipolar disorder and other psychiatric conditions. Participants were classified as having bipolar disorder I, characterized by at least one episode of mania and one of depression; bipolar disorder II, requiring an episode of depression plus hypomania, a milder form of mania that does not require hospitalization; and a milder, sub-threshold bipolar disorder that involves hypomania with or without depression, otherwise classified as bipolar disorder "not otherwise specified" in the current diagnostic nomenclature of the American Psychiatric Association.
The study found that:
* A total of 1.0 percent of participants had bipolar disorder I and 1.1 percent had bipolar disorder II in their lifetimes; in the previous 12 months, 0.6 percent had bipolar disorder I, 0.8 percent bipolar disorder II and 1.4 percent sub-threshold manifestations of bipolar disorder.
* Symptoms began at age 18.2 years for bipolar disorder I, 20.3 years for bipolar disorder II and 22.2 years for sub-threshold bipolar disorder
* 95.8 to 97.7 percent of those with bipolar disorder and 88.4 percent of those with sub-threshold bipolar disorder also had another psychiatric condition, such as an anxiety disorder or substance use disorder, which is a frequent complication of bipolar illness.
* The majority of those with lifetime bipolar disorder (80.1 percent) received treatment, including 69.3 percent of those with sub-threshold bipolar disorder; most of those people sought treatment for the depression rather than for the manic symptoms of bipolar disorder.
* However, over the previous 12 months, only 25 percent of those with bipolar disorder I, 15.4 percent with bipolar disorder II and 8.1 percent with sub-threshold bipolar disorder received appropriate medication
"The present results reinforce the argument of other researchers that clinically significant sub-threshold bipolar disorder is as least as common as threshold bipolar disorder," the authors write. "Although most individuals with bipolar disorder receive treatment owing to co-morbid disorders, the lack of recognition of their underlying bipolarity leads to only a few receiving appropriate treatment." The findings suggest that a substantial proportion of those diagnosed with major depression may actually have a form of bipolar disorder.
More individuals with other psychiatric disorders should also be screened for bipolar disorder, the authors conclude. "Additional research is needed to resolve uncertainty regarding the most appropriate threshold and boundary distinctions for bipolar disorder. This uncertainty remains a major impediment to advancing the understanding of the bipolar disorder spectrum in the population."
###
(Arch Gen Psychiatry. 2007;64:543-552.)
The NCS-R is supported by a grant from the National Institute of Mental Health, with supplemental support from the National Institute of Drug Abuse, the Substance Abuse and Mental Health Services Administration, a grant from the Robert Wood Johnson Foundation and the John W. Alden Trust. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Colleen Labbe
JAMA and Archives Journals
Posted by Squiggles on May 11, 2007, at 20:47:57
In reply to Approx 4% of US Adults Have Some Form of Bipolar D, posted by jrbecker on May 11, 2007, at 19:49:58
I've noticed that for a number of reasons,
depression often comes along with anxiety or
agitation. That may be mistaken for bipolar
disorder. On the other hand it may actually
be the preliminary phase of bipolar to come.The real thing is unmistakeable once it hits--
because the depression is severe and the mania
is very strange. Both these unusual mental states are also physical (like the kind you get after a stroke).I've often wondered if the mania is not a reaction to the deep depression or if these cyclical turns have a life of their own, as part of the disease. An analogy would be when you are run out of breath exercising, and you stop to slow down the breathing-- similar physical refractory things-- when you look at a bright light, and then you get after effects when you go into a dark room;
Then, there is the drugs you take-- it is possible to get bipolar-like symptoms;Then there is thyroid disease-- again, the same.
You have to study the case over some time to make sure that what you have is true-blue bipolar disorder, and not something else. That might mean removing the bipolar drug to see how the person does. Then again, you have to wait so as not to get a withdrawal effect mimicking bipolar.
Honestly, I don't know how drs. do it.
Squiggles
Posted by Phillipa on May 11, 2007, at 22:38:19
In reply to Re: Approx 4% of US Adults Have Some Form of Bipol, posted by Squiggles on May 11, 2007, at 20:47:57
Squiggles why do you keep referring to thyroid disease? I need to know as I have hasimostos. Thanks Love Phillipa
Posted by Squiggles on May 12, 2007, at 7:02:59
In reply to Re: Approx 4% of US Adults Have Some Form of Bipol » Squiggles, posted by Phillipa on May 11, 2007, at 22:38:19
> Squiggles why do you keep referring to thyroid disease? I need to know as I have hasimostos. Thanks Love Phillipa
Because thyroid disease can mimic bipolar disorder:
e.g.
http://www.mhsanctuary.com/bipolar/bipolardr/206.HTM
bipolar disorder, Dr. Paul Markovitz
"Q. I am a woman in my forties with a bipolar disorder. I've been on Depakote for four years, and combined Depakote (750 mg) and lithium (450 mg) for two years. This month my blood work showed a thyroid imbalance (hypothyroid), and I'm being treated with Levoxyl. This was probably caused by the lithium. Shortly after beginning the Levoxyl I began having "pressured thinking," irritability, anxiety, and heart palpitations. I also had occasional bouts of euphoria for the first time in six months, and I didn't mind that at all! Although I've made an appointment to see my doctor, I have a question. How can I tell the difference between hypomania and hyperthyroid? Do I have to get a new blood test every time I feel high?
A. A very good question. Hyperthyroidism can mimic or induce mania in folks like yourself. The best thing you can do is call your psychiatric doctor if you feel hyper. The mania has some fairly severe consequences, whereas the hyperthyroidism (which would be mild at most) has a lot less. By assuming the worst case scenario (mania) you will be protecting yourself. There is no good way for you to tell which is which.
Chances are you will get better shortly with the thyroid addition, and not have the highs once your level of thyroid hormone is stabilized in your body. You will not need to get thyroid levels but once or twice yearly once your daily dose of thyroid is stabilized."
Posted by linkadge on May 12, 2007, at 8:13:10
In reply to Re: Approx 4% of US Adults Have Some Form of Bipol, posted by Squiggles on May 12, 2007, at 7:02:59
Posted by Phillipa on May 12, 2007, at 20:01:11
In reply to Re: Approx 4% of US Adults Have Some Form of Bipol, posted by Squiggles on May 12, 2007, at 7:02:59
Squiggles funny but when my thyroid went hyper I was not manic at all didn't even notice the difference. I know that lithium can destroy the thyroid but mania? Not for me. Love Phillipa ps did feel better when hyper but could still sit still.
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