For the best experience on htmlWebpackPlugin. This topic discusses bipolar disorder in adults. If you are concerned that your child or teen may have bipolar disorder, see the topic Bipolar Disorder in Children and Teens. Bipolar disorder is an illness that causes extreme mood changes from manic episodes of very high energy to the extreme lows of depression. It is also called manic-depressive disorder. This illness can cause behavior so extreme that you cannot function at work, in family or social situations, or in relationships with others. Some people with bipolar disorder become suicidal.
These include regular activity, getting enough sleep, and learning to recognize early signs of highs and lows. People often stop taking their medicines during a manic phase because they feel good. But this is a mistake. You must take your medicines regularly, even if you are feeling better. The cause of bipolar disorder is not well understood, but evidence suggests that it runs in families. Episodes of depression and mania may be caused by a problem with certain brain chemicals called neurotransmitters.
Antidepressant medicines can trigger a manic episode in a person who has bipolar disorder. But this may occur before the person is diagnosed, while he or she is seeking treatment for an episode of depression. Sleep deprivation or substance abuse, including caffeine, can cause a person with bipolar disorder to have a manic episode.
Bipolar disorder causes extreme mood swings, from feeling overly energetic mania to feeling very sad or having low energy depression. Some people may have bipolar disorder with mixed symptoms. Their highs and lows of mania and depression occur together. This makes the disorder challenging to treat and very frustrating for you and for those around you.
It can also lead to hospitalization if your daily functioning becomes impaired. If you have rapid-cycling bipolar disorderyou may have at least four episodes of depression, mania, or both within a month period.
You may go directly from a low to a high. Or you may have a short time lapse between the two extreme moods. In addition to changes in mood, some people with bipolar disorder also have symptoms of anxietypanic attacksor symptoms of psychosis. With bipolar disorder, you go back and forth between highs and lows of mania and depression. In between, you may return completely to normal or have some remaining symptoms. The extreme mood changes may come on suddenly or appear more slowly. During a manic episode, you may go from feeling abnormally happy and productive to behaving irresponsibly and sleeping very little.
After this manic high, your mood may return to normal. Or it may swing in the opposite direction. You may feel useless and extremely sad. And you may lose interest in things you've enjoyed in the past.
Men tend to have more manic highs, and women tend to have more lows of depression. At first, stress may trigger depression or mania. But as the illness progresses, mood swings may not be caused by any specific event. Without treatment, your bipolar disorder may get worse.
This can cause you to move more often between mania and depression.
Times are tough, and if you're uninsured with bipolar disorder, finding and paying for treatment and medication can seem like an.
People with bipolar disorder-men more often than women-may have substance abuse problems, especially during manic episodes. Other disorders that may occur along with this disorder include: Bipolar disorder can be passed down through families. If anyone in your family has been diagnosed with bipolar disorder, your risk of having it is higher. Some things can increase your risk of a manic episode or depression.
These include:. Alcohol or drug use or abuse puts you at a high risk for having a relapse of mood disturbances.
Callthe national suicide hotline at TALKor other emergency services right away if:. Bipolar disorder is complex and hard to diagnose, because it has many phases and symptoms. Sometimes it is misdiagnosed as only depression, because people are more likely to seek treatment during a period of depression.
After you are diagnosed with bipolar disorder, you'll need to keep a long-term relationship with your doctor or therapist. It can help you make sure that your treatment is consistent and that your medicines can be adjusted as needed. Although other health professionals can diagnose bipolar disorder, you will probably be referred to a psychiatrist who specializes in treating such disorders.
He or she can prescribe medicines and provide counseling. Other health professionals who can diagnose bipolar disorder include:. Counseling can help you deal with mood changes and the impact bipolar disorder can have on your work and family relationships. In addition to psychiatrists, others who can provide counseling include:. To prepare for your appointment, see the topic Making the Most of Your Appointment.
To find out if you have bipolar disorder, your doctor will ask detailed questions about your symptoms. You will be asked how long your symptoms last and how often you have them. Your doctor will ask about your family history and may do a mental health assessment. Blood and urine tests, such as a test of your thyroid, may be done to make sure another problem isn't causing your symptoms.
A toxicology screen looks at blood, urine, or hair for the presence of drugs. The earlier the disease is confirmed, the sooner you can get treatment, feel better, and improve the quality of your life. This can also reduce your risk of other health problems, such as alcohol and drug abuse. Bipolar disorder is treated with a combination of medicines and counseling. It's important to take your medicines exactly as prescribed, even when you feel well.
Your doctor may have you try different combinations of medicines to find what's right for you. Your family doctor can prescribe medicines to treat bipolar disorder. But you will probably be referred to a psychiatristwho is trained specifically to treat mental disorders. Many people don't get help for bipolar disorder. You may not seek treatment because you think the symptoms aren't bad enough or that you can work things out on your own.
But treatment can help you manage the highs and lows. If you need help deciding whether to see your doctor, see some reasons why people don't get help and how to overcome them. Treatment often starts with helping you through an "acute" phase or manic episode. You may be suicidal or psychotic or using such poor judgment that you are in danger of harming yourself. Your doctor may decide that you should be hospitalized for your own safety, especially if he or she thinks you are suicidal. Medicines that may be used include mood stabilizers and antipsychotics.
Over time, these medicines will be adjusted with the goal of preventing manic and depressive episodes. It may take months for your symptoms to go away and for you to be able to maintain a normal routine of work and activity. To learn more, see Medications. Counseling is also an important part of treatment.
It can help you cope with problems that may come up in your work or relationships because of bipolar disorder. To learn more, see Other Treatment. You can also do some things on your own to help manage your symptoms and maintain a normal routine.
Joining a support group to talk with others who have bipolar disorder can help. To learn more, see Home Treatment. Bipolar disorder cannot be prevented. But often the mood swings can be controlled with medicines. And there are many things you can do for yourself to help manage highs and lows. Home treatment is important in bipolar disorder. There are many things you can do to help control mood swings. You don't have to do them all at once. Try to do one thing, such as eating a healthy diet, then add another when you can.
Try to eat a healthy, balanced diet. A balanced diet includes foods from different food groupssuch as whole grains, dairy, fruits and vegetables, and protein. Eat a variety of foods from each group. For example, eat different fruits from the fruit group instead of only apples. A varied diet helps you get all the nutrients you need.
No single food provides every nutrient.
And if you've lost your job and are wondering how to continue with your bipolar disorder treatment without health insurance, it's even more. Unrecognized burden of bipolar disorder in primary care patients with bipolar disorder incur the most health care costs of any mental illness . for bipolar disorder in primary care is more difficult given the lack of a screening and. As a result, many people struggling with bipolar disorder were either under- or uninsured, so they went without the essential treatment that they needed.
Family members often feel helpless when a loved one is depressed or manic. But you can help. If a loved one has bipolar disorder, it may be helpful for you to get counseling to deal with its impact on your own life. Manic episodes can be particularly hard. Talk with a psychiatrist, a psychologist, a social worker, or a licensed professional counselor for your own therapy.
Counseling can also be helpful for a child who has a bipolar parent. The parent's mood swings may negatively affect the child. This can cause tearfulness, anger, depression, or rebellious behavior. Find out how to help a person during a manic episode. Medicines, when taken as prescribed, can help control bipolar mood swings. Your doctor will vary the amounts and combinations of your medicines according to your symptoms, which type of bipolar disorder you have, and how you respond to the medicines.
About 1 out of 3 people will be completely free of symptoms of bipolar disorder by taking mood stabilizer medicine, such as carbamazepine or lithium, for life.
Taking medicines during pregnancy for bipolar disorder may increase the risk of birth defects. If you are pregnant or thinking of becoming pregnant, talk to your doctor. You may need to keep taking medicine if your bipolar disorder is severe. Your doctor can help weigh the risks of treatment against the risk of harm to your pregnancy. Several medicines are used to treat bipolar disorder. It may take time to find the treatment that works best for you.
The most common medicines used are:. When you and your doctor are discussing your medicines, think about whether your lifestyle allows you to take medicines on time every day. A medicine you only take once a day may work best for you if you have a hard time remembering to take your medicines. If you are prescribed carbamazepine, lithium, or valproate, you will need regular blood tests to monitor the amount of medicine in your blood.
Too much lithium in your bloodstream may lead to serious side effects. Blood tests can also help show how medicines are affecting your liver, kidneys, and thyroid gland or to measure the number of blood cells in your body. The use of antidepressants alone has been linked to an increase in manic episodes. Antidepressant treatment needs to be monitored closely to avoid causing a manic episode.I AM LOSING MY HEALTH INSURANCE: BIPOLAR DISORDER
The U. Food and Drug Administration FDA has issued an advisory on antidepressant and anticonvulsant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicidesuch as threatening to harm himself or herself and being preoccupied with death or suicide. This is especially important at the beginning of treatment or when doses are changed.
Bipolar disorder without health insurance
Almost all people who have bipolar disorder need medicine. But counseling is also important to help you cope with work and relationship struggles related to your illness. No matter which type of counseling you choose, establish a long-term relationship with a counselor you like.
The counselor will help you recognize personality changes that show when you are moving into a mood swing.
Bipolar Disorder with no Health Care Insurance: What are my options? resources for local organizations that help those without insurance. Thinking you can do a lot of things at once without getting tired, Unable to do even To diagnose bipolar disorder, a doctor or other health care provider may. Objectives. High rates of misdiagnosis, delayed diagnosis, and lack of recognition and treatment of comorbid conditions often lead patients with bipolar illness to.
Getting early treatment can reduce the length of the high or low. See some tips for finding a counselor or therapist. In some cases, electroconvulsive therapy ECT may be an option. In this procedure, brief electrical stimulation to the brain is given through electrodes placed on the head.
The stimulation produces a short seizure that is thought to balance brain chemicals. A few studies suggest that adding omega-3 fatty acids to medicine such as lithium can help reduce the depressive symptoms of bipolar disorder in some people. Omega-3 fatty acids don't seem to have an effect on the manic symptoms of bipolar disorder. And omega-3 fatty acids alone are not a good treatment for bipolar disorder.
They are not a replacement for medicine or other therapy used to treat bipolar disorder. Maldonado, PhD - Behavioral Health.
Current as of: June 5, Healthwise Staff. Medical Review: This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.
Therefore, aripiprazole may offer an economic advantage over other atypical antipsychotics in patients with bipolar disorder. Bipolar disorder is a chronic, recurring disorder associated with frequent episodes of mania and depression. Overall costs for the treatment of bipolar disorder are comprised of direct costs of professional services, medication, and hospitalization costs; indirect costs associated with caring for patients; as well as costs associated with the loss of productivity.
Patients with bipolar disorder have been found to utilize nearly 3 to 4 times more healthcare resources 6 and to incur more than 4 times greater healthcare costs than patients without bipolar disorder.
Effective pharmacotherapy and psychosocial interventions are an essential part of the successful treatment of bipolar disorder. Atypical antipsychotics, either as monotherapy or as adjunctive treatment to mood stabilizers, are an increasingly common treatment option for patients with bipolar disorder.
There may be an association between antipsychotic medication half-life and hospitalization. It has been shown that patients using longer-acting antipsychotics experienced a lower rate of hospital admissions and emergency department visits than patients treated with short half-life antipsychotic agents.
Recent claims database analyses have shown that treatment with aripiprazole was associated with a lower risk of and longer time to hospitalization, as well as with lower psychiatric treatment costs and lower total healthcare costs compared with other adjunctive antipsychotic medications. The aim of the current analysis was to evaluate hospitalization and medical care costs for patients during the time they were receiving treatment with aripiprazole compared with patients receiving other atypical antipsychotics ie, olanzapine, quetiapine, risperidone, or ziprasidone.
The analysis presented here is an extension of a previous article covering medical claims from to14 with additional important changes in the methodologic approach. This retrospective cohort analysis was conducted using the PharMetrics Patient-Centric Database, which includes medical and pharmacy claims from January 1,through September 30, The PharMetrics database encompasses a composite of 85 health plans across the United States, and it includes information on approximately 47 million patients.
The database includes inpatient and outpatient medical claims, diagnosis and procedure codes, as well as pharmacy claims. The PharMetrics database is geographically representative of the US population, and includes a variety of demographic measures.
The sample for this study was restricted to health plans providing comprehensive healthcare data, including mental health—related services. The general approach of the analysis was to use baseline measures of health and disease severity, such as baseline comorbidity indices, demographics, drug utilization patterns, and hospitalization rates. Lagged costs as predictors in cost models were not used because of issues with serial correlation.
The healthcare system in the United States is abysmal, especially where mental Without insurance, a bipolar disorder patient can pay at least. Patients with bipolar disorder use close to 3- to 4-fold more healthcare resources and incur more than 4-fold greater healthcare costs than patients without the. This topic discusses bipolar disorder in adults. If you are concerned that your child or teen may have bipolar disorder, see the topic Bipolar Disorder in Children.
In particular, because healthcare data are extremely skewed, the use of a highly variable predictor may lead to an unstable model. The study included patients aged 18 to 64 years who had 1 or more outpatient or inpatient claims with an International Classification of Diseases, Ninth Revision code for bipolar disorder ie, manic, mixed, or hypomanic [ A patient's new start index date was defined as the date of the first prescription claim for an atypical antipsychotic medication in the claims database between January 1,and September 30, Patients were excluded from the study if they were prescribed an atypical antipsychotic in the day preindex period, or if they had prescriptions for more than 1 atypical antipsychotic agent at the index date.
Eligible patients were required to have at least days of continuous enrollment before and after 90 days of continuous enrollment after the index prescription date. In addition, patients were excluded from the analysis if they resided in a nursing home, hospice facility, or another type of long-term care facility, or if they received prescriptions via mail order.
Patients with a diagnosis of schizophrenia spectrum disorder XXor those who were hospitalized at the time of the index prescription or within 7 days after the index prescription, were excluded from the study. In the analysis evaluating the impact of atypical antipsychotics on hospitalizations, patients were followed for up to 1 year or until the occurrence of hospitalization, loss of continuous eligibility, or until switching or discontinuation of the index medication occurred allowing for a gap of 15 days.
In this study, the inpatient and emergency department visit costs and medical costs were also evaluated for patients during their time receiving the index treatment. For this analysis, patients were followed from treatment initiation to the time of switching or discontinuation of the index medication allowing for a gap of 15 daysloss of continuous eligibility, or the end of the study period after 1 year.
Costs were reported as costs per treated patient per month PPPM. Both all-cause and mental health—related outcomes were evaluated. Mental health—related outcomes were identified based on claims with a primary or a secondary diagnosis code ranging from XX to The primary analysis of time to hospitalization was addressed using a Cox proportional hazards model, which controlled for baseline factors, such as age, sex, year of index prescription, Charlson comorbidity index, diabetes, hyperlipidemia, glucose and lipid testing, baseline hospitalization rate, and use of mood stabilizers.
These control variables were computed using data from the 6-month period before the index date. The models for medical costs were implemented using a generalized linear framework with a log link and gamma distribution.
For the analysis of costs of hospitalization and emergency department visits, a 2-stage multivariate modeling approach was used combining logistic regression, generalized linear models, and bootstrapping with repetitions, to account for the fact that many patients had no hospitalizations and emergency department visits and therefore incurred no inpatient or emergency department costs.
All models controlled for the same set of baseline factors used in the Cox proportional hazards model that was stated above. Aripiprazole therapy was used as the reference group for all of the comparisons, with an a priori level of significance set at 0. A total ofpatients were identified with a prescription for an atypical antipsychotic in the study database; 19, patients had been diagnosed with bipolar disorder, met the study selection criteria, and were therefore included in this analysis. A schematic diagram of patient disposition is shown in the Figure page Of the total number of patients, were prescribed aripiprazole; received olanzapine; quetiapine; risperidone; and received ziprasidone Table 1.
Baseline patient characteristics for the 5 atypical antipsychotics are displayed in Table 1. Patients who were treated with aripiprazole were statistically younger, more likely to be female, and had lower rates of preindex hospitalization and emergency department rates than the comparator atypical antipsychotics.
On-Treatment Sample. Results of the Cox proportional hazards model, controlling for differences in baseline patient characteristics, demonstrated a significantly lower hazard ratio HR for all-cause and for mental health—related hospitalization for patients who received aripiprazole compared with those receiving any of the other atypical antipsychotics Table 2.
Everyone goes through normal ups and downs, but bipolar disorder is different. The range of mood changes can be extreme. In depressive episodes, someone might feel sad, indifferent, or hopeless, in combination with a very low activity level.
Some people have hypomanic episodes, which are like manic episodes, but less severe and troublesome.
Most of the time, bipolar disorder develops or starts during late adolescence teen years or early adulthood. Occasionally, bipolar symptoms can appear in children. Although the symptoms come and go, bipolar disorder usually requires lifetime treatment and does not go away on its own. Bipolar disorder can be an important factor in suicide, job loss, and family discord, but proper treatment leads to better outcomes.
The symptoms of bipolar disorder can vary. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer.
Paying for Bipolar Disorder Care
During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are intense and happen along with changes in behavior, energy levels, or activity levels that are noticeable to others. Some people with bipolar disorder may have milder symptoms than others with the disorder. For example, hypomanic episodes may make the individual feel very good and be very productive; they may not feel like anything is wrong.
However, family and friends may notice the mood swings and changes in activity levels as behavior that is different from usual, and severe depression may follow mild hypomanic episodes.
There are three basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. People with bipolar disorder also may have a normal euthymic mood alternating with depression. Many people with bipolar disorder also may have other mental health disorders or conditions such as:.
Some bipolar disorder symptoms are like those of other illnesses, which can lead to misdiagnosis. For example, some people with bipolar disorder who also have psychotic symptoms can be misdiagnosed with schizophrenia. Some physical health conditions, such as thyroid disease, can mimic the moods and other symptoms of bipolar disorder. Street drugs sometimes can mimic, provoke, or worsen mood symptoms.
The exact cause of bipolar disorder is unknown. However, research suggests that there is no single cause. Instead, a combination of factors may contribute to bipolar disorder. Bipolar disorder often runs in families, and research suggests that this is mostly explained by heredity—people with certain genes are more likely to develop bipolar disorder than others. Many genes are involved, and no one gene can cause the disorder.
But genes are not the only factor. Some studies of identical twins have found that even when one twin develops bipolar disorder, the other twin may not. Although people with a parent or sibling with bipolar disorder are more likely to develop the disorder themselves, most people with a family history of bipolar disorder will not develop the illness.
Researchers are learning that the brain structure and function of people with bipolar disorder may be different from the brain structure and function of people who do not have bipolar disorder or other psychiatric disorders. Learning about the nature of these brain changes helps doctors better understand bipolar disorder and may in the future help predict which types of treatment will work best for a person with bipolar disorder.
At this time, diagnosis is based on symptoms rather than brain imaging or other diagnostic tests.