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BIPOLAR DISORDER-
DEMYSTIFYING
Dr Milan Balakrishnan
Bombay Hospital
Mystery of Bipolar
• Syndrome
• Causes
• Co-morbidities
• Inadequate information
• Casual use of the term
• Misconceptions
Bipolar disorder awareness
• Objectives:
• Increase awareness of bipolar disorder (including
both mania and depression)
• ...
Bipolar Disorder-
Major Public Health Issue
• 60 million suffer from BPD with about 9 million in
India
• DALYS 141.7 /1000...
Prevalence Rates and Course
• Bipolar I
• Lifetime: 1 in 100
• = in men and women
• Ave. age onset = 20-25
• Recurrent
What is Bipolar Disorder?
Bipolar disorder is
a serious mental
illness that is
characterized by
extreme mood
swings from m...
Severe mania
Hypomania
Mild depression
Severe depression
Moods Alternate Between “Poles”
High
Lows
Normal Mood
BiologicalApproach
The biological
approach to
bipolar disorder
suggests that
high or low levels
of
neurotransmitters
such ...
Case 1:
• 35 years old male brought forcefully by
family. Since a week had not slept, and
had been busy writing a novel, g...
Case 2:
• 23 year old female presented with crying
spells, no interest in activities, disturbed
sleep, decreased appetite,...
Famous people with bipolar disorder.
Beethoven
Musician.
Abraham Lincoln
U.S President
Catherine Zeta Jones
Hollywood Actr...
Mania
 Persistent
abnormally elevated
irritable mood
 > one week
Symptoms of Mania
 Inflated self-esteem/grandiosity
 Decreased need for sleep
 Racing thoughts or "flight of ideas"
 S...
Depression
• Feeling down
• Loss of interest in
enjoyable things
• > 2 weeks
Symptoms of Depression (Cont.)
 Weight loss/gain
 Insomnia/hypersomnia
 Psychomotor agitation/slow down
 Fatigue/loss ...
 Hypomania
 Mixed state
Between Mania and Depression
Etiological Factors
• Hereditary Factors
• Biochemical Hypothesis
• Stressful Life Events
• Family environment
• Cognitive...
Triggers
Stressful
life
events
Stimulating
internal/external
environment
Excessive
Caffeine/
nicotine
Alcohol/
drug use
Se...
B.D. comorbidities & Differential Diagnosis
• Bipolar vs. unipolar
• ADHD
• Schizophrenia
• Substance abuse
Prognosis
1. Suicidality
2. Presence of a personality disorder
3. Quality of family and social support
4. Substance use
5....
Management
• Seek Help
• Early detection of Individual ‘signature’ signs.
• Ensure the safety of patient and others~
• Sui...
The Warning Signs of Suicide
 Talking about death, self-harm, or suicide
 Feeling hopeless/helpless/worthless
 Withdraw...
Recognize Warning Signs
Offer Support/Help/Listen
Take It Seriously/Get Them
Help
How to Help Someone Who
is Suicidal
Treatment
• Medication-
Mood stabilizers.
• Electroconvulsive
therapy in acute mania
or depression
• Psychoeducation for
p...
Monitoring and prevention
• Continually monitor psychiatric status
• Identify individual’s triggers
• Identify early warni...
Help for care givers
• Burnout
• Take care of own
health- seek
professional help for
own problems
• Family, couples therap...
Self-Help For Bipolar Disorder
 Monitor your moods
 Make healthy choices
 Seek support
 Keep stress in check
 Get edu...
Dr Milan Balakrishnan
Mindcares Clinic
Mumbai
+91 9930160068
dr.milanb@gmail.com
Demystifying Bipolar Disorder
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Demystifying Bipolar Disorder

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Dr Milan Balakrishnan, Psychiatrist & Psychotherapist throws light on a subject that even care givers in a family don't know much about. Bipolar Disorder is a serious Mental Illness which affects 60 Million in the world including over 9 million in India. Yet, awareness about this illness is dismal and Stigma, debilitating.
This presentation was used by Dr Milan during his talk at bipolarindia.com's Event in Mumbai on World Bipolar Day, 2017.
This comprehensive presentation covers the causes, remedies, symptoms and red flags of the dreaded illness that has not spared even renowned World figures.

Published in: Health & Medicine
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Demystifying Bipolar Disorder

  1. 1. BIPOLAR DISORDER- DEMYSTIFYING Dr Milan Balakrishnan Bombay Hospital
  2. 2. Mystery of Bipolar • Syndrome • Causes • Co-morbidities • Inadequate information • Casual use of the term • Misconceptions
  3. 3. Bipolar disorder awareness • Objectives: • Increase awareness of bipolar disorder (including both mania and depression) • Promote early detection and accurate diagnosis • Reduce Stigma • Minimize the Impact on those who live with this medical illness.
  4. 4. Bipolar Disorder- Major Public Health Issue • 60 million suffer from BPD with about 9 million in India • DALYS 141.7 /100000 • 1 in 3 get diagnosed • 1 in 3 people with bipolar disorder fail to comply with treatment • Non-adherence to treatment often results in hospitalization and suicide
  5. 5. Prevalence Rates and Course • Bipolar I • Lifetime: 1 in 100 • = in men and women • Ave. age onset = 20-25 • Recurrent
  6. 6. What is Bipolar Disorder? Bipolar disorder is a serious mental illness that is characterized by extreme mood swings from mania to depression. Mania is an abnormally elevated mood, while depression is an abnormally low mood.
  7. 7. Severe mania Hypomania Mild depression Severe depression Moods Alternate Between “Poles” High Lows Normal Mood
  8. 8. BiologicalApproach The biological approach to bipolar disorder suggests that high or low levels of neurotransmitters such as dopamine, serotonin, or norepinephrine is the cause.
  9. 9. Case 1: • 35 years old male brought forcefully by family. Since a week had not slept, and had been busy writing a novel, getting banners published and building huge projects. His children were afraid of his aggressive behavior and he had recently started using recreational drugs too. He was usually flirting and acting inappropriately with women. He was fired from his job but he said that he didn’t need it as he was going to launch his own company soon.
  10. 10. Case 2: • 23 year old female presented with crying spells, no interest in activities, disturbed sleep, decreased appetite, social withdrawal and a suicidal attempt of over- dosing of sleeping pills. • Her mother often suffered from the same symptoms and was diagnosed with bipolar disorder.
  11. 11. Famous people with bipolar disorder. Beethoven Musician. Abraham Lincoln U.S President Catherine Zeta Jones Hollywood Actress • Winston Churchill- • British Prime Minister. • Isaac Newton- • Scientist • Vincent Van Gogh- • Artist
  12. 12. Mania  Persistent abnormally elevated irritable mood  > one week
  13. 13. Symptoms of Mania  Inflated self-esteem/grandiosity  Decreased need for sleep  Racing thoughts or "flight of ideas"  Spending sprees  Increased physical/mental energy  Irritability/aggressive behavior  Impulsive/risk taking  Increased sexual drive
  14. 14. Depression • Feeling down • Loss of interest in enjoyable things • > 2 weeks
  15. 15. Symptoms of Depression (Cont.)  Weight loss/gain  Insomnia/hypersomnia  Psychomotor agitation/slow down  Fatigue/loss of energy  Decreased ability to concentrate/make decisions  Recurrent thoughts of death/suicide
  16. 16.  Hypomania  Mixed state Between Mania and Depression
  17. 17. Etiological Factors • Hereditary Factors • Biochemical Hypothesis • Stressful Life Events • Family environment • Cognitive Styles as Vulnerabilities
  18. 18. Triggers Stressful life events Stimulating internal/external environment Excessive Caffeine/ nicotine Alcohol/ drug use Seasonal change Non- compliance with medication Changes in routine Stressful relationships Prolonged untreated or poorly managed illness.
  19. 19. B.D. comorbidities & Differential Diagnosis • Bipolar vs. unipolar • ADHD • Schizophrenia • Substance abuse
  20. 20. Prognosis 1. Suicidality 2. Presence of a personality disorder 3. Quality of family and social support 4. Substance use 5. History of severity of prior episodes 6. Bipolar I type is most severe 7. Treatment onset-the sooner the better 8. Age of onset-the younger the more severe
  21. 21. Management • Seek Help • Early detection of Individual ‘signature’ signs. • Ensure the safety of patient and others~ • Suicidal behavior • Homicidal behavior • Risk taking behavior ( financial, sexual, driving etc.) • Exhaustion
  22. 22. The Warning Signs of Suicide  Talking about death, self-harm, or suicide  Feeling hopeless/helpless/worthless  Withdraw from friends/family  Acting recklessly  Putting affairs in order or saying goodbye  Seeking out weapons or pills
  23. 23. Recognize Warning Signs Offer Support/Help/Listen Take It Seriously/Get Them Help How to Help Someone Who is Suicidal
  24. 24. Treatment • Medication- Mood stabilizers. • Electroconvulsive therapy in acute mania or depression • Psychoeducation for patient and family • Psychological therapy (Interpersonal and social rhythm therapy, CBT & others)
  25. 25. Monitoring and prevention • Continually monitor psychiatric status • Identify individual’s triggers • Identify early warnings and seek help • Prevent relapse and encourage adherence to treatment.
  26. 26. Help for care givers • Burnout • Take care of own health- seek professional help for own problems • Family, couples therapy, Group therapy • Join a Support group.
  27. 27. Self-Help For Bipolar Disorder  Monitor your moods  Make healthy choices  Seek support  Keep stress in check  Get educated
  28. 28. Dr Milan Balakrishnan Mindcares Clinic Mumbai +91 9930160068 dr.milanb@gmail.com

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