Hello Misha9,
Bipolar Disorder:
====================
?Prevalance of Bipolar disorder: 1.2 percent of the population; 2.3
million adult Americans (NIMH)
Prevalance Rate for Bipolar disorder: approx 1 in 83 or 1.20% or 3.3?
http://www.wrongdiagnosis.com/b/bipolar/stats-country.htm
Dianosing bipolar disorder
----------------------------
?Because bipolar disorder tends to run in families, researchers have
been searching for specific genes?the microscopic "building blocks" of
DNA inside all cells that influence how the body and mind work and
grow?passed down through generations that may increase a person's
chance of developing the illness. But genes are not the whole story.
Studies of identical twins, who share all the same genes, indicate
that both genes and other factors play a role in bipolar disorder. If
bipolar disorder were caused entirely by genes, then the identical
twin of someone with the illness would always develop the illness, and
research has shown that this is not the case.
But if one twin has bipolar disorder, the other twin is more likely to
develop the illness than is another sibling.7
In addition, findings from gene research suggest that bipolar
disorder, like other mental illnesses, does not occur because of a
single gene.8 It appears likely that many different genes act
together, and in combination with other factors of the person or the
person's environment, to cause bipolar disorder. Finding these genes,
each of which contributes only a small amount toward the vulnerability
to bipolar disorder, has been extremely difficult. But scientists
expect that the advanced research tools now being used will lead to
these discoveries and to new and better treatments for bipolar
disorder.?
http://www.athealth.com/Consumer/disorders/Bipolar_1.html
?Q: Testing for Bipolar Disorder
---------------------------------
Hello, I am going to get tested for bipolar disorder on the 21st and I
am curious as to how doctors test for this disorder?-Dorothy
Dear Dorothy --
Unfortunately, we have no "test"; at least no blood test or brain scan
or anything like that (yet). There is a questionnaire that works
reasonably well as an initial screening test -- meaning it could be
wrong, but it's a good general start. You can take that test on my
website, here. Dr. Phelps?
http://www.bipolarworld.net/Phelps/ph_2001/ph354.htm
?The study's lead author Carol Lynn Trippitelli discussed the survey
last week at the annual Mood Disorders Symposium held at Johns
Hopkins. She emphasized that the questions are hypothetical because a
gene test for bipolar disorder does not exist. Many studies have
indicated that genetics plays a role in the onset of bipolar disorder,
also known as manic depression, but no specific genes have been
identified.?
http://www.genomenewsnetwork.org/articles/05_00/bipolar_disorder.shtml
Here is one online test for Bipolar disorders:
http://www.psycheducation.org/depression/MDQ.htm
And the Bipolar Spectrum Diagnostic Scale
http://www.psycheducation.org/depression/BSDS.htm
Treatment:
?In most cases, bipolar disorder is much better controlled if
treatment is continuous than if it is on and off. But even when there
are no breaks in treatment, mood changes can occur and should be
reported immediately to your doctor. The doctor may be able to prevent
a full-blown episode by making adjustments to the treatment plan.
Working closely with the doctor and communicating openly about
treatment concerns and options can make a difference in treatment
effectiveness.
In addition, keeping a chart of daily mood symptoms, treatments, sleep
patterns, and life events may help people with bipolar disorder and
their families to better understand the illness. This chart also can
help the doctor track and treat the illness.?
http://www.nimh.nih.gov/publicat/bipolar.cfm#bp5
Symptoms:
Mania
? Excessive energy, activity, restlessness, racing thoughts and rapid
talking ? Denial that anything is wrong ? Extreme "high" or euphoric
feelings ? a person may feel "on top of the world" and nothing,
including bad news or tragic events, can change this "happiness." ?
Easily irritated or distracted ? Decreased need for sleep ? an
individual may last for days with little or no sleep without feeling
tired. ? Unrealistic beliefs in one?s ability and powers ? a person
may experience feelings of exaggerated confidence or unwarranted
optimism. This can lead to overly ambitious work plans and the belief
that nothing can stop him or her from accomplishing any task... ?
Uncharacteristically poor judgment ? a person may make poor decisions
which may lead to unrealistic involvement in activities, meetings and
deadlines, reckless driving, spending sprees and foolish business
ventures. ? Sustained period of behavior that is different from usual
? a person may dress and/or act differently than he or she usually
does, become a collector of various items, become indifferent to
personal grooming, become obsessed with writing, or experience
delusions. ? Unusual sexual drive ? Abuse of drugs, particularly
cocaine, alcohol or sleeping medications ? Provocative, intrusive or
aggressive behavior ? a person may become enraged or paranoid if his
or her grand ideas are stopped or excessive social plans are refused.
Depression
Some people experience periods of normal mood and behavior following a
manic phase; however, the depressive phase will eventually appear.
Symptoms of depression include: ? Persistent sad, anxious or empty
mood ? Sleeping too much or too little, middle-of-the-night or early
morning waking ? Reduced appetite and weight loss or increased
appetite and weight gain ? Loss of interest or pleasure in activities,
including sex ? Irritability or restlessness ? Difficulty
concentrating, remembering or making decisions ? Fatigue or loss of
energy ? Persistent physical symptoms that don?t respond to treatment
(such as chronic pain or digestive disorders) ? Thoughts of death or
suicide, including suicide attempts ? Feeling guilty, hopeless or
worthless
http://www.nmha.org/bipolar/public/signs.cfm
Medications for bipolar:
========================
?In general, people with bipolar disorder continue treatment with
mood stabilizers for extended periods of time (years). Other
medications are added when necessary, typically for shorter periods,
to treat episodes of mania or depression that break through despite
the mood stabilizer.
· Lithium, the first mood-stabilizing medication approved by the U.S.
Food and Drug Administration (FDA) for treatment of mania, is often
very effective in controlling mania and preventing the recurrence of
both manic and depressive episodes.
· Anticonvulsant medications, such as valproate (Depakote®) or
carbamazepine (Tegretol®), also can have mood-stabilizing effects and
may be especially useful for difficult-to-treat bipolar episodes.
Valproate was FDA-approved in 1995 for treatment of mania.
· Newer anticonvulsant medications, including lamotrigine (Lamictal®),
gabapentin (Neurontin®), and topiramate (Topamax®), are being studied
to determine how well they work in stabilizing mood cycles.
· Anticonvulsant medications may be combined with lithium, or with
each other, for maximum effect.
· Children and adolescents with bipolar disorder generally are treated
with lithium, but valproate and carbamazepine also are used.
Researchers are evaluating the safety and efficacy of these and other
psychotropic medications in children and adolescents. There is some
evidence that valproate may lead to adverse hormone changes in teenage
girls and polycystic ovary syndrome in women who began taking the
medication before age 20.14 Therefore, young female patients taking
valproate should be monitored carefully by a physician.
· Women with bipolar disorder who wish to conceive, or who become
pregnant, face special challenges due to the possible harmful effects
of existing mood stabilizing medications on the developing fetus and
the nursing infant.15 Therefore, the benefits and risks of all
available treatment options should be discussed with a clinician
skilled in this area. New treatments with reduced risks during
pregnancy and lactation are under study.?
http://www.nimh.nih.gov/publicat/bipolar.cfm#bp5
Thyroid Disorders and Bipolar Disorder
=======================================
?Prevalance of Hashimoto's Thyroiditis: 1,490,371 adults and 205,159
children in the USA 1996 1
Prevalance Rate for Hashimoto's Thyroiditis: approx 1 in 182 or 0.55%
or 1.5 million people in USA?
http://www.wrongdiagnosis.com/h/hashimotos_thyroiditis/stats-country.htm
Symptoms of Hashimoto?s thyroiditis
===================================
?What are the symptoms of Hashimoto's thyroiditis?
The following are the most common symptoms. However, each individual
may experience symptoms differently:
· goiter (enlarged thyroid gland which may cause a bulge in the neck)
· other endocrine disorders such as diabetes, an underactive adrenal
gland, underactive parathyroid glands, and other autoimmune disorders
· fatigue
· muscle weakness
· weight gain
http://www.umm.edu/endocrin/hashim.htm
?What are the symptoms of Hashimoto's thyroiditis?
Some patients with Hashimoto's thyroiditis have no symptoms. However,
the common symptoms are fatigue, depression, sensitivity to cold,
weight gain, muscle weakness, coarsening of the skin, dry or brittle
hair, constipation, muscle cramps, increased menstrual flow and goiter
(enlargement of the thyroid gland).
Conventional medical treatments may help relieve the symptoms of
Hashimoto's thyroiditis but they do not address the root of the
problem. Generally, by undergoing comprehensive natural medicine
testing, the reasons the body is producing antibodies against itself
can be found. Some of these reasons include sensitivities or allergies
to foods, inhalants and chemicals and various infections.?
http://www.caringmedical.com/conditions/Hashimoto's_Thyroiditis.htm
?This disease shows a marked hereditary pattern but it is 20 times
more common in women than in men. It occurs most frequently between 30
and 50 years of age but may arise in young children. The thyroid,
typically enlarged, pale yellow, and lumpy on the surface, shows dense
lymphocytic infiltration, and the remaining thyroid tissue frequently
contains small empty follicles. The goiter (gradual painless
enlargement of the thyroid gland) is usually asymptomatic (no
symptoms), but sometimes patients complain of dysphagia (difficulty in
swallowing) and a feeling of local pressure. Thryroiditis is the
general term used to describe three different disorders in which the
thyroid becomes inflamed. Most commonly, the inflammation takes the
form of a chronic, progressive disease known as chronic lymphocytic
thyroiditis or Hashimoto's disease. This condition may be so mild that
it may go unnoticed for many years, but eventually it may destroy so
much thyroid tissue that hypothroidism develops.?
http://www.wkrn.com/global/story.asp?s=1230585
?Thyroid Function
People with bipolar disorder often have abnormal thyroid gland
function.5 Because too much or too little thyroid hormone alone can
lead to mood and energy changes, it is important that thyroid levels
are carefully monitored by a physician.
People with rapid cycling tend to have co-occurring thyroid problems
and may need to take thyroid pills in addition to their medications
for bipolar disorder. Also, lithium treatment may cause low thyroid
levels in some people, resulting in the need for thyroid
supplementation.?
http://www.nimh.nih.gov/publicat/bipolar.cfm#bp5
?There is an increase in frequency of bipolar disorder (also known as
manic-depressive disorder) among patients with autoimmune thyroid
problems. If you or someone in your family has manic or hypomanic
episodes manifested by days or weeks of feeling hyperactive,
excitable, and euphoric followed by days or weeks of depression with
significant fatigue and sleep or appetite disturbances that may
interfere with your normal activities, your physician may offer you
medication to control your mood swings and treat your bipolar
disorder.?
?But if a psychiatrist starts your Lithium he or she may not know that
you have a thyroid problem. Therefore you should be sure to tell the
doctor that you do have a thyroid disorder and need your thyroid level
checked to be sure there is no effect of the Lithium on thyroid
hormone production.?
?Zoloft is an anti-depressant that has been shown to be effective in
treating different kinds of depression. But if you are taking thyroid
hormone medication for hypothyroidism, you may have to increase your
dose if you start taking Zoloft. Fortunately these effects are mild
and it is likely that your thyroid hormone dosage will not change very
much if at all.
Although not everyone taking thyroid hormone experiences a need for a
different dose of thyroid hormone when they begin taking Zoloft, it?s
common enough that your doctor should order a T4 and TSH test to
evaluate your thyroid levels within a month or two of your starting
Zoloft treatment.?
http://www.allthyroid.org/disorders/specialmeds/bipolar_depression.html
?Conclusion: In treatment resistant courses of disorders, the
thorough clinical and laboratory investigation of our patient revealed
a very efficient treatment strategy. Cases of Hashimoto's
encephalopathy associated with the occurrence of a manic episode and
hence with bipolar disorder are rare; this is the first reported case.
However, clinicians should be alert to this possibility.?
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1399-5618.2005.00196.x?cookieSet=1
If you haven?t already found this page in your own research, please
read it in its entirety-it?s chock full of good information on the
connection between thyroid disorders and bipolar disorder.
?There is a clear connection between the process of thyroid hormone
regulation and bipolar disorder. The problem is, this connection is
only just now beginning to become evident, and how the connection
works is basically a mystery. One study recently showed a strikingly
high rate of autoimmune-caused thyroid problems in people with bipolar
disorder, far more than you would expect to find.Kupka Thyroid
problems are more common in the complex forms of bipolar disorder
(mixed states and rapid cycling) than in classic bipolar manic
patients.Chang Signs of thyroid auto-immunity are much more common in
people with anxiety and depression, particularly the forms of anxiety
which don't easily fit into typical "anxiety disorder" labels.?
?However, a few things are clear. People who have symptoms that look
like "bipolar disorder" as explained on this website, have thyroid
problems and have family members with thyroid problems at a greater
rate than would be expected. Is that because the thyroid problems
somehow actually cause "bipolar"-like symptoms? Could it be that some
of what looks like "bipolar" is actually a thyroid problem? There may
be some such folks. In addition, there are clearly cases which seem
to be "bipolar disorder" for sure, that get better with thyroid
hormones as part of the treatment. In many of these cases it is clear
that thyroid hormone was not enough, by itself, to make mood "normal".
So, for now I think it is safe to say that bipolar disorder has
something to do with thyroid regulation in many cases, though not the
majority; and that treating with thyroid alone is only rarely going to
lead to full remission of symptoms.?
?Thyroid hormone is sometimes used as a treatment for bipolar
disorder, even if your thyroid is "normal" (by lab tests, anyway).
4.And finally, lithium commonly interferes with the thyroid system, so
you'll need to understand a bit about thyroid if you're going to take
lithium.?
http://www.psycheducation.org/thyroid/introduction.htm
A more scientific explanation of the above can be found here:
http://home.comcast.net/~pmbrig/BP_pharm.html#thyroxine
?Kupka RW, Nolen WA, Post RM, McElroy SL, Altshuler LL, Denicoff KD,
Frye MA, Keck PE Jr, Leverich GS, Rush AJ, Suppes T, Pollio C,
Drexhage HA.
High rate of autoimmune thyroiditis in bipolar disorder: lack of
association with lithium exposure.
Biol Psychiatry 2002 Feb 15;51(4):305-11
"BACKGROUND: We assessed the prevalence of thyroperoxidase antibodies
(TPO-Abs) and thyroid failure in outpatients with bipolar disorder
compared with two control groups. METHODS: The TPO-Abs of outpatients
with DSM-IV bipolar disorder (n = 226), a population control group (n
= 252), and psychiatric inpatients of any diagnosis (n = 3190) were
measured. Thyroid failure was defined as a raised thyroid stimulating
hormone level, previously diagnosed hypothyroidism, or both. Subjects
were compared with attention to age, gender, and exposure to lithium.
RESULTS: The TPO-Abs were more prevalent in bipolar patients (28%)
than population and psychiatric controls (3-18%). The presence of
TPO-Abs in bipolar patients was associated with thyroid failure, but
not with age, gender, mood state, rapid cycling, or lithium exposure.
Thyroid failure was present in 17% of bipolar patients and more
prevalent in women. It was associated with lithium exposure,
especially in the presence of TPO-Abs, but not with current rapid
cycling, although an association may have been masked by thyroid
hormone replacement. CONCLUSIONS: Thyroid autoimmunity was highly
prevalent in this sample of outpatients with bipolar disorder and not
associated with lithium treatment. These variables appear to be
independent risk factors for the development of hypothyroidism,
especially in women with bipolar disorder."
http://neurotransmitter.net/bipolaranatomy.html
?Some mental health practitioners are also examining giving
combination treatments for hypothyroid patients with resistant
depression or bipolar disorder. However, these products have not been
rigorously tested in different patient groups, and more work is needed
before this combination is recommended widely.?
http://adam.about.com/reports/000038_6.htm
?Lithium. This drug, used in bipolar disorders, has multiple effects
on thyroid hormone synthesis and secretion.
Amiodarone (Cordarone). This drug, used to treat abnormal heart
rhythms, contains iodine and can induce hyper- or hypothyroidism,
particularly in patients with an existing thyroid problem.?
http://adam.about.com/reports/000038_6.htm
Wolff-Parkinson-White Syndrome
===============================
?One paper suggested the incidence of preexcitation in first-degree
relatives could be as high as 5.5 per 1,000 persons. About 7 to 20
percent of patients with WPW also have congenital defects within the
heart.?
http://www.clevelandclinic.org/heartcenter/pub/guide/disease/electric/wpw.htm
?What is the Wolff-Parkinson-White syndrome?
If there's an extra conduction pathway, the electrical signal may
arrive at the ventricles too soon. This condition is called
Wolff-Parkinson-White syndrome (WPW). It's in a category of electrical
abnormalities called "pre-excitation syndromes."
It's recognized by certain changes on the electrocardiogram, which is
a graphical record of the heart's electrical activity. The ECG will
show that an extra pathway or shortcut exists from the atria to the
ventricles.
Many people with this syndrome who have symptoms or episodes of
tachycardia (rapid heart rhythm) may have dizziness, chest
palpitations, fainting or, rarely, cardiac arrest. Other people with
WPW never have tachycardia or other symptoms. About 80 percent of
people with symptoms first have them between the ages of 11 and 50.?
http://www.americanheart.org/presenter.jhtml?identifier=4785
?Frequency:
· Internationally: WPW affects approximately 0.15-0.2% of the general
population. Of these individuals, 60-70% have no other evidence of
heart disease.
Mortality/Morbidity: Death from WPW occurs secondary to the associated
arrhythmias or from mistreatment of these arrhythmias with
inappropriate medications. Little data are available regarding the
mortality rate of such arrhythmias, but most studies report the
incidence of sudden death in the 0-4% range.
Sex: Men are affected more often (60-70%) than women. Typically, those
affected are young, otherwise healthy individuals.
Age: Although this disease affects people of all ages, it most
commonly is recognized in children and young adults presenting to the
ED with an arrhythmia. Conduction speed in the accessory pathway
appears to attenuate with age.?
http://www.emedicine.com/emerg/topic644.htm
?The incidence of paroxysmal tachycardias in the young adult
population with WPW is approximately 10% and increases with age up to
30%. Episodes of atrial fibrillation occur in as many as 2030% of
patients with the syndrome. The exact risk for developing ventricular
fibrillation during atrial fibrillation with fast ventricular rates is
not known?
http://www.clinicalcardiology.org/briefs/200108briefs/cc24-531.editorsnote.html
?Symptoms of WPW may include one or more of the following:
· heart palpitations ? a sudden pounding, fluttering or
· racing feeling in your chest
· dizziness ? feeling lightheaded or faint
· shortness of breath (dyspnea)
· anxiety
· rarely, cardiac arrest (sudden death)
Some people have WPW without any symptoms at all.
How is WPW diagnosed?
WPW is diagnosed by reviewing the results of several tests:
· ECG (electrocardiogram)
· Holter monitor
· Exercise testing
· Electrophysiology testing?
http://www.clevelandclinic.org/heartcenter/pub/guide/disease/electric/wpw.htm
?Patients with WPW syndrome are potentially at an increased risk of
dangerous ventricular arrhythmias due to extremely fast conduction
across the bypass tract if they develop atrial flutter or
fibrillation. Certain patients with WPW syndrome are at risk for
sudden death. In these patients, cardiac electrophysiologic (EP)
studies and radiofrequency (RF) catheter ablation may be curative.
Other patients have symptomatic SVT, which can also be cured by
catheter ablation. Asymptomatic patients may merely need periodic
observation.?
?Patients with WPW syndrome have a very small risk of sudden
arrhythmic death. Medical therapy with agents such as digoxin may
increase this risk. The risk in asymptomatic patients is extremely
low.
Overall, sudden death occurs rarely, with an estimated frequency rate of 0.1%.
Other factors that appear to influence risk are the presence of
multiple bypass tracts and a family history of premature sudden death.
Sudden cardiac death is unusual without preceding symptoms. Digoxin is
contraindicated in patients with WPW syndrome, although it may play
some role in children only. Most deaths from WPW syndrome have been
associated with digoxin use.?
?Laboratory evaluation and correction of electrolyte and metabolic
abnormalities that may have acted as triggers?
http://www.rjmatthewsmd.com/Definitions/wolff_parkinson_white_syndrome.htm
Additional Information:
=======================
One person?s story of thyroiditis and bipolar disorder
http://bipolar.about.com/cs/experience/a/queenie.htm
I can find no connection between WPW and your other disorders.
Bipolar disorder and Hashimoto?s do seem to share some symptoms, and
thyroiditis does have a connection to bipolar disorder. I also found
no information on the numbers of people who have all three disorders.
I hope this answer has been informative to you. If I have duplicated
information you already had, please request an Answer Clarification,
before rating. This will allow me to assist you further, if possible.
Sincerely, Crabakes
Search Terms
============
Hashimoto?s thyroiditis
Hashimoto?s + bipolar
Diagnosing bipolar
Thyroid + bipolar
WPW
WPW + bipolar disorder
WPW + thyroid disorders |
