Bipolar Disorder

What is Bipolar Disorder?

Bipolar Disorder, or Manic-Depressive illness, refers to a pattern of recurrent mood swings. These mood swings range from hyper arousal and impulsivity to profound loss of motivation.

Behaviors that involve hyper arousal and motivation for acting towards goals that are not well thought out may result in damages to oneself or others, but are driven by a near intoxicating feeling of having to do this. This impulsivity may result in promiscuity, spending sprees, injuries, etc.

In contrast to episodes of hyper arousal are cycles where loss of motivation may be so profound that life feels empty and extended periods are spent in bed, missing work, missing activity with family and friends.

Moods of intense anger or irritability may build up to rages that may ruin marriages and families. Sleep may become impossible with insomnia experienced along with racing thoughts keeping one awake for hours. Alternatively, sleep may become an escape or extensive for more than half the day.

Child-Teen Bipolar Quick Checklist (Answer Yes or No)

• This child's temperament and behavior is very different in a negative way from his siblings.
• This child has mood instability that is not specifically triggered by yes and no from the parent but arise frequently and independently on their own.
• This child has difficulty " letting go " of an upset that may linger for days of weeks unlike other siblings.
• This child has difficulty regulating sleep and on occasion may be awake all or most of the night but not appear fatigued the next day.
• This child has a family history of another member with a mood disorder.

How can Dr. Kohn help you?

Dr. Kohn uses a variety of evaluation forms and both Assessment and Treatment Tools in his Practice. He uses a Holistic view of the patient and the problem. Dr. Kohn uses a Biological-Psychological-Social framework to assess your symptoms because he knows that the proper diagnosis leads to proper treatment.

Some of the Tools used are Quotient Test, IVA, Neurofeedback Therapy, Brain SPECT Scan, Actigraphy, Cognitrace, NEO-5 Factor Test, and Keirsey Temperament Inventory.

The Bipolar diagnosis may not be obtained with a blood test or brain MRI, but is based on factors that include onset of childhood depression, or post partum depression. There may have been an inadequate response to previous treatment with SSRI class or SNRI class of medication. There are associated levels of anxiety or substance abuse (alcohol, marijuana, cocaine), and a history supported by a close partner or family member of a distinct period of elevated mood, or irritable mood. There may be a loss of discretion with finances or social skills leading to poor decision making and perhaps severe impairments in relationships or loss of finances. Also, decrease in sleep without a resulting level of fatigue that may have continued for several days, experiences of increased self grandeur.

This distinct period of symptoms may last a day or several days and then there is a return to either an exhausted depressed state or a return to one's baseline level with period of low to moderate level of depression appearing chronically.

Medication for Bipolar depression is prescribed depending on the state of acute depression or mania or remission of symptoms. Anti-depressant medication used in the chronic or remission phase may include Lithium alone or in combination with Lamotrigene (Lamictal) and an atypical antipsychotic class of medication.