Integrative Psychiatry and TMS

This disorder is usually characterized by instability of mood, energy and/or sleep. People suffering from Bipolar Disorder may experience significant changes in mood and behavior over periods of time. The disorder may first occur as a depressed, hypo-manic, manic or mixed episode.

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A depressed episode can be characterized by five or more of the following symptoms during the same 2-week period:

1. Depressed mood most of the day, nearly every day

2. Markedly diminished interest or pleasure in all, or almost all, activities

3. Significant decrease or increase in appetite and weight loss or gain (more than 5% a month)

4. Loss of sleep, or too much sleep

5. Agitation and restlessness, or markedly slowed mental and motor activity

6. Fatigue or loss of energy almost every day

7. Feeling of worthlessness or excessive/ inappropriate guilt almost every day

8. Diminished ability to think or concentrate, or indecisiveness, nearly every day

9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideations with or without plans

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Manic and Hypo-manic episodes differ in duration and severity. They are characterized by a distinct period of abnormal and persistently elevated, expansive, or irritable mood.

During that period some of the following symptoms can be present:

1. Inflated self-esteem or grandiosity

2. Decreased need for sleep (feel rested after only 3 hours of sleep)

3. More talkative than usual or pressure to keep talking

4. Racking thoughts

5. Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli)

6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

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Mixed episode can include the symptoms characteristic for both depressed and manic episodes at the same time.

The exact cause why some people develop Bipolar-Affective Disorder is not yet known. The studies have repeatedly demonstrated a significant genetic predisposition.
The contemporary model of therapy is a combination of lifestyle modifications, psychotherapy and psychotropic medications. The medications usually consist of mood stabilizers, and the most commonly used drugs are Lithium, Lamictal, Depakote, Zyprexa, Abilify, Geodon, Seroquel, and Tegretol.