Bipolar Disorder

Bipolar disorder or manic–depressive illness is characterized by the serial occurrence
of repeated episodes of depressed and elevated mood. There are two main forms
of Bipolar Disorder. In Bipolar I disorder elevated mood episodes are severe
(referred to as “mania”) in Bipolar II disorder elevated mood is less severe (called
“hypomania”) and there are frequent depressions. Bipolar I disorder is the best
characterized and its treatments are the best studied. Less is known about how best
to treat bipolar II disorder. A range of psychotropic medicines are available that can
effectively treat manic/hypomanic episodes and/or depression. In addition
medications are available to help prevent episodes of illness. The BAP bipolar
guideline
, revised in 2009, provide a detailed review of evidence?based supporting
these treatment options along with recommendations for their use.

Antidepressants Do Work

There has been a great deal of misinformation in the press in recent years about the
value of antidepressants. Some publications and newspaper articles have claimed
that they don’t work any better than placebo and even then only in more severely
depressed patients. This is a highly misleading interpretation of the evidence which
is extensive and shows clearly that antidepressants do work, even in the less
severely depressed people.

Anxiety symptoms and anxiety disorders

Anxiety is part of the normal response to stress and is usually short-lived and controllable. It
probably allows someone to respond better to a perceived threat or danger (and is
sometimes called the ‘fight-or-flight’ response). Anxiety symptoms are important when they
are particularly severe, last longer than expected, occur in the absence of stress and impair
everyday life. Anxiety symptoms can be physical (or ‘somatic’) and due to over-arousal (such
as shortness of breath, a racing heart and excessive sweating), or psychological, such as
feeling frightened, troublesome worrying or being irritable.

Doctors can diagnose anxiety disorders when a patient has had a certain number of
symptoms for more than a specified time, providing these symptoms cause much distress
and impair everyday life. There are several different anxiety disorders, which share many
psychological and physical symptoms but each disorder has its own characteristic features.
For example, recurrent unexpected ‘panic attacks’ occur in panic disorder, whilst recurring
troublesome ruminations and repeated checking habits occur in obsessive-compulsive
disorder.