00:02
Let's talk a little bit about
bipolar disorder and the statistics.
00:06
For bipolar 1.
00:08
It is usually diagnosed
equally men and women
both equally for bipolar disorder
with a prevalence of 0.4% to 1.6%.
00:21
The onset, the age of onset that we
normally see is about 18 years old.
00:28
This differs from bipolar 2,
where we normally see women
having more bipolar 2 than men.
00:35
And that's in a
prevalence of .5%.
00:39
And we're seeing a little bit
later in life in the mid 20's.
00:44
Cyclothymic disorder, again,
is equal between the genders
and we're seeing it
between 0.4% and 1.0%.
00:53
And that we normally see an
adolescence in early childhood.
00:59
So when we're thinking
about the differences
between bipolar 1 and bipolar 2,
we think about bipolar 1,
which is depression and mania,
that there's at least one manic episode
and at least one depressive episode,
major depressive episode
that we can identify.
01:21
We also want to be able to understand
that the depressive episode
has to have been either occurring right
before or right after the manic episode.
01:34
This gives us a much better
understanding that this person
think about bipolar is experiencing
both depression and mania.
01:45
Also, that manic episode may
have required hospital care.
01:50
And that's important to
understand, it is also may require
because not everyone
requires hospital care
when they are having
a manic experience.
02:02
So let's think again, when we're
thinking about bipolar 1 and bipolar 2.
02:09
The bipolar 1 is
depression and mania
and bipolar 2 is
depression and hypomania.
02:17
Now, manic episodes are
usually characterized by
exceptional energy,
they are restless,
the person has a really hard
time concentrating on one thing,
they are jumping from
one thing to the next.
02:33
They have euphoria all the time.
02:36
And they don't need any sleep.
02:39
They have some risky behaviors,
there's increased sexuality,
increased risk taking.
02:47
Oftentimes, if they are too up, they might
be using drugs to try to self medicate.
02:54
And they also do not sleep.
02:58
They can stay awake
for days on end.
03:02
Now, if we're thinking about bipolar
2 with hypomania, not with mania,
now we have again, a sustained mood
that's elevated, which is our hypomania.
03:15
And also we end up seeing that
there is that grandiosity,
that expansive belief
that they can do anything,
they also are able
to differentiate.
03:32
Because when they're up,
it's not just like happiness.
03:36
It's not like a normal being up.
03:39
When they are up, it is very up.
03:44
And it really is exactly
when they are not depressed.
03:48
There is no period of time in
between the two that we're noticing
where they're up,
and now they have what we call Euthymia,
which means a normal mood.
04:00
They're either very
up or very sad.
04:06
So in mania, that mood is
extremely abnormal, right?
And it is usually so
much activity and energy,
which is also so abnormal.
04:19
But with hypomania,
we don't normally see any of the
psychosis that we will see with mania.
04:25
Mania, they will become paranoid,
after so much not sleeping, not eating.
04:32
There are some real psychotic symptoms
that come along with prolonged mania
that we don't see
with hypomania.
04:44
Now, when you're thinking
about bipolar disorder,
you want to make sure that as these
people are going really up and really down
that we are watching
and trying to help them.
04:59
It is such a disruptive feeling
to be that high and that low
that they cannot continue with
their normal life as it is.
05:10
They also usually have to have this
diagnosis with bipolar disorder
that they've had this manic
episode and a depressive episode.
05:19
And otherwise,
it is not considered bipolar 1.
05:25
Now, with bipolar 2,
we can see that depressive episode.
05:30
And again, that depressive episode
has to be at least 2 weeks long.
05:36
And then they have also
the hypomanic episode.
05:42
Bipolar disease is more
common that we know of
with some of the people
who are extremely famous,
Winston Churchill suffered
from bipolar disease,
Mel Gibson,
and Kurt Vonnegut, the writer,
Ernest Hemingway,
another great writer,
Frank Sinatra, and Demi Moore, all have
had bipolar disease and all have come out
and been able to help other
people with bipolar disease
understand that
it can be treated.
06:23
So this mania, this manic piece,
it has to be greater than a
week to be considered manic.
06:34
And they have high
distractibility.
06:37
Again, this insomnia, they can't sleep,
this grandiose opinion of themselves,
taking amazing risks and not
being able to stop talking.
06:48
Once they start talking with
you, it's amazing.
06:52
If you are taking a history
on a person who is manic,
it's really hard to get them to
answer your questions easily.
06:59
They will give you
a full history.