Marbella Bipolar Disorder Hospital

Residential Luxury Bipolar Disorder Rehab in Marbella in Spain

Bipolar Disorder is somewhat an overdiagnosed condition according to many leading experts. The Psychiatric community likes to label people to be able to treat them but we believe in trying to follow the right path so we take every person at face value.

We will cover a few things on this page.

Bipolar (manic-depression) and depression are classified as mood disorders.

Depression is a low, sad state in which life seems dark and its challenges overwhelming. Functioning can be severely imparied, and the depressed individual often loses all interest in activities, becomes hopeless, and may even contemplate or commit suicide.

Mania, the opposite of depression, is a state of breathless euphoria, or at least frenzied energy, in which people may have an exaggerated belief that the world is theirs for the taking. As mania progresses, psychosis becomes more and more likely.

People with bipolar disorder ride an emotional roller coaster, swinging from the heights of elation to the depths of despair without external cause. The first episode may be either manic or depressive.

Manic episodes, typically lasting from a few weeks to several months, are generally shorter in duration and end more abruptly than major depressive episodes. In some cases, episodes of depression and elation may alternate regularly, with months or years of symptom-free normal functioning between the disordered mood states. Sometimes cases involve periods of "rapid cycling" in which the individual experiences two or more full cycles of mania and depression within a year without any intervening normal periods. Rapid cycling is relatively uncommon, but occurs more often among women than men.

Types of Depressive Disorders:

Depression is a horrible illness that can cause a person to suffer emotionally, physically, and socially. Depression is not the same thing as grief, though some symptoms are common to both.

Grief is defined as a self-limiting reaction to a loss that requires no medical treatment. Rarely do people suffering from grief have suicidal thoughts, motor-function problems, or feelings of worthlessness. The symptoms of depression are not only in a person's head - they are physical as well. Constipation, poor appetite, and fatigue are just a few of the physical symptoms people struggling with depression can experience.

A depressed person cannot just "snap out of it" or "cheer up" - they are not "weak" or "wimpy" or "over-dramatic". They are drowning in pain, fighting to get out of bed, to perform normal activities that most people can do with no problem. And sometimes they are fighting just to survive. Depression is not "the blues" or a bad mood.

Everyone has days when they feel unhappy or down, but for those suffering from depression that feeling is constant and much more severe. They have lost all interest in their life and perhaps even their loved ones. They can find no point or interest in anything. They are hopeless and too often suicidal. They need help and support.

• It can include
• Depressed mood most of the day, nearly every day
• Markedly diminished interest or pleasure in almost all activities
  
• Significant weight loss or gain, or decrease or increase in appetite
• Insomnia or hypersomnia nearly every day
• Psychomotor agitation or retardation nearly everyday
  
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness or excessive guilt
• Reduced ability to think or concentrate, or indecisiveness
• Recurrent thoughts of death or suicide

Bipolar mania symptoms can be variable in duration and intensity, and are usually followed by severe depression, sometimes referred to as "crashing." It is often difficult for people to view mania as an illness. Unlike depression, where the patient usually looks miserable and functions poorly, a person in a manic state may feel excessively good and "on top of the world".

Mania can be thought of as the opposite of depression in every way. There is a conviction of power and superhuman ability. Those in the middle of a manic episode may have limitless energy and interest in life. They may feel that they are enjoying life more than ever before, that nothing bad can happen to them, that they are capable of doing everything they have ever wanted to do.

This is where the problems begin as the manic person often behaves impulsively without considering the consequences of his or her actions. Bipolar mania symptoms vary, but the patient may spend money compulsively or do things completely out of the ordinary. He will often take risks he shouldn't or say or do things he will later regret. During a manic episode, the patient may deny there is anything wrong, becoming hostile, irritable, or paranoid when any attempts are made to limit his freedom or persuade him to get help.

Some of the symptoms

• Elevated, expansive, or irritable mood for at least one week
• Inflated self-esteem or grandiosity
• Decreased need for sleep
• More talkative than usual, a pressure to keep talking
• Flight of ideas or sense that your thoughts are racing
• Distractibility
• Increase in activity directed at achieving goals
• Excessive involvement in potentially dangerous activities

When you get a flight of ideas and your throughts are racing it can seem like the noise in your head is just so loud you cannot think.
The noise and electrical activity just keeps on going and it kind of takes over from the outside world. To get a sense of calm and for the noise and racing feeling to go takes a lot of calming down.

Bipolar disorder is a recurring psychiatric illness with often devastating symptoms of depression and mania. The disorder, which has been described in highly accomplished individuals such as Theodore Roosevelt, Robert Schumann, Vincent van Gogh, and Sylvia Plath, is highly treatable, however. Despite the chronicity of the illness, effective drugs such as lithium have enabled persons diagnosed with bipolar illness to lead productive lives.

Diagnostic Criteria

Bipolar illness has two distinct forms. Bipolar I disorder, previously called manic-depressive illness, characterizes patients who experience episodes of mania and depression or mania only. Any single episode can be manic, depressive, or mixed. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) gives specific criteria for both mania and depression. A diagnosis of mania does not require a set duration of illness or impairment. For a diagnosis of depression, however, the symptoms must last at least two weeks.

For a diagnosis of mania, the patient’s mood can be either elated or irritable. The most common symptoms are grandiosity, racing thoughts, and pressured speech. The patient is also distractible. These symptoms lead to inattention, impatience, inflated self-confidence, grand schemes, excessive spending, impulsive traveling, and reckless driving.

Bipolar I illness occurs in about 1% of the population and is equally prevalent in men and women. Women, however, are more likely to have depressive episodes.

A patient who has mainly depressions and a few hypomanic episodes (the same symptoms as for mania but without social impairment) would receive a diagnosis of bipolar II, a form much more common in women. These illnesses typically start with a depressive episode.

Thirty percent of patients who have bipolar I illness first experience symptoms as teenagers. In the usual course, episodes of illness are followed by periods of wellness (euthymia), at first punctuated by years but later settling into a pattern that’s often seasonal. The depression can become very chronic and unremitting; suicide is the most serious potential consequence. Despite new and successful treatments, about 12% of manic-depressives commit suicide, almost always during the depressive stage of the illness.

Other symptoms of bipolar disorder are delusions and hallucinations. These symptoms are often overlooked, even by psychiatrists. In patients who have mania, the delusions are consistent with their grandiose ideas and schemes but may also be paranoid. In patients with bipolar depression, delusions occur about 20% of the time (consistent with their inappropriate sense of low self-worth, low productivity, feeling of being a burden, and pessimism, e.g., the family is sinking into poverty).

Research has shown that genetic factors play a significant role in the etiology of bipolar disorder. Biochemical, neurophysiologic, and sleep abnormalities also have been reported, but none seems specific to bipolar disorder. It is not known how recurrent unipolar depression, bipolar I disorder, and bipolar II disorder are related. In addition, many studies identify bipolar patients but do not specify whether the patient is in the depressive, manic, or mixed state, much less whether the patient is manic or hypomanic when studied.

Bipolar disorder is a recurring illness. A few people are lucky enough to have only two or three episodes, but the average patient has more than 10. Studies have found that the depressive episodes in bipolar disorder are shorter than the depressive episodes in unipolar illness. Unfortunately, however, some bipolar patients have chronic depressions. Between 15% and 20% of bipolar patients experience rapid cycling, defined as four or more episodes of depression, mania, or hypomania in a year.

Related to these two distinct illnesses is cyclothymia, a condition in which patients have mood swings, but the swings are not as extreme as those in mania and depression. Another related condition is hyperthymic temperament, seen in patients who have recurrent depression. Such patients have baseline personalities that are cheerful and exuberant. They are extroverted, highly energetic, and short sleepers. Unlike the other conditions, which demand treatment, hyperthymia is associated with desirable traits and should not be treated.

Drug Treatment

Bipolar illness is underdiagnosed and undertreated. A 1999 hospital study from a university center confirmed that 40% of the bipolar patients in the study were previously diagnosed as unipolar. Only 38% were taking mood stabilizers on admission to the hospital (96% on discharge). Psychological autopsies on persons who have committed suicide show that the majority of patients who are diagnosed as bipolar are not taking any mood stabilizers.

Psychological treatment cannot be accomplished when a patient with bipolar illness is in a manic state. The patient will be highly talkative, irritating, sexually aroused, overconfident, expansive, and completely lacking in insight and good judgment. Because of the uplifted mood, the patient will feel no need for treatment and will vehemently refuse assistance. This is particularly evident with respect to a spouse. If in your practice you see a spouse who suddenly becomes extremely derogatory and accusatory toward the partner, consider the possibility of mania. A history of depressive episodes will help you make the diagnosis. Treatment, usually on an inpatient basis, is imperative for a patient with mania.

Psychotherapy

Bipolar illness frequently has its onset in the teenage years, when much of life is unfolding: completing high school, choosing a college, developing personal relationships, and separating from the family. Because of these often stressful life events, psychotherapy is probably indicated for the adolescent. No specific psychotherapy has been tested on teenagers, although all evidence indicates that behavioral therapies are effective in mild and moderate depression.

For older patients, supportive psychotherapy is indicated. It is important to give patients feedback about current symptoms, identify early symptoms of an episode, help solve problems, and repair relationships damaged by the illness. It is also important to teach patients how to control their symptoms better. For instance, because lack of sleep can precipitate an episode of mania, patients should take additional medication to stabilize their sleep when they are under stress and sleeping less. Changing the dose of a mood stabilizer during periods of stress is not as important as ensuring a good night’s sleep.

Patients can also help themselves through self-help groups. The National Depressive and Manic Depressive Association, for example, meets regularly in cities throughout the country and teaches patients how to live with their illness.

Substance Abuse and Bipolar Illness

Substance abuse is a problem in bipolar illness. About 60% of patients with this diagnosis have superimposed substance abuse at some point in their life. Therefore, the use of alcohol and illicit drugs needs to be examined and monitored. When a patient is not doing well or not responding to treatment, the physician should suspect substance abuse.

Most patients with bipolar illness (about 80%) are able to stabilize their mood and be highly productive. The others, especially those with chronic depression, are severely disabled. Still, they can live outside the hospital for long periods, especially with the help of family, friends, and a knowledgeable, sympathetic physician.