NEUROSCIENCE

Bipolar Disorder

Bipolar Disorder also called manic-depressive disorder, is a neurological illness characterized by period of abnormally elevated mood (Mania) followed by periods of extremely low mood (Depression).

While we all experience changes in mood from time to time, the extreme mood swings seen in patients with bipolar disorder are very different. During the manic phase of the illness, people with bipolar disorder can experience feelings of euphoria, extreme optimism or exaggerated self- esteem, racing thoughts and irritability. They may have little need for sleep and act impulsively and even behave recklessly. During the depressive phase, the same person may then feel sad, worthless or hopeless, have little energy, show changes in sleep patterns and show other signs of clinical depression.

The symptoms of bipolar disorder can cause significant distress and result in damaged relationships, poor job performance and even suicide. However, there is a reason for hope; while there is no cure for bipolar disorder the illness can be effectively managed and controlled.

Bipolar disorder is treated today with a combination of medication and psychotherapy; medication helps to stabilize moods, while therapy help individuals understand their moods and behaviors, detect patterns and triggers and develops strategies for managing their mood swings and related symptoms.

Other signs and symptoms of bipolar disorder

Signs and symptoms of bipolar I and bipolar II disorders may include additional features.

  • Anxious distress — having anxiety, such as feeling keyed up, tense or restless, having trouble concentrating because of worry, fearing something awful may happen, or feeling you may not be able to control yourself
  • Mixed features — meeting the criteria for a manic or hypomanic episode, but also having some or all symptoms of major depressive episode at the same time
  • Melancholic features — having a loss of pleasure in all or most activities and not feeling significantly better, even when something good happens
  • Atypical features — experiencing symptoms that are not typical of a major depressive episode, such as having a significantly improved mood when something good happens
  • Catatonia — not reacting to your environment, holding your body in an unusual position, not speaking, or mimicking another person's speech or movement
  • Peripartum onset — bipolar disorder symptoms that occur during pregnancy or in the four weeks after delivery
  • Seasonal pattern — a lifetime pattern of manic, hypomanic or major depressive episodes that change with the seasons
  • Rapid cycling — having four or more mood swing episodes within a single year, with full or partial remission of symptoms in between manic, hypomanic or major depressive episodes
  • Psychosis — severe episode of either mania or depression (but not hypomania) that results in a detachment from reality and includes symptoms of false but strongly held beliefs (delusions) and hearing or seeing things that aren't there (hallucinations)

For more information on bipolar disorder, speak to your doctor about it.

References:
  1. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 54th ed. Lange; 2015.

 

Depression

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness, nor is it something that you can simply "snap out" of. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychological counseling or both. Other treatments also may help.

Although depression may occur only one time during your life, usually people have multiple episodes of depression. During these episodes, symptoms occur most of the day, nearly every day and may include:

  • Feelings of sadness, emptiness or unhappiness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in normal activities, such as sex
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so that even small tasks take extra effort
  • Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  • Anxiety, agitation or restlessness — for example, excessive worrying, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

For more information on Depression, a mental health specialist can provide additional answers.

References:
  1. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 54th ed. Lange; 2015.

 

Diabetic Peripheral Neuropathic Pain

Nerve allows your body to feel temperature, pain and other sensations.

The damaged nerves can become overly sensitive, to the point where the slightest movement or light touch of the skin can trigger intense pain. Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet.

Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal.

Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control.

Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.

A health care professional can provide information on the treatment options available.

References:
  1. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 54th ed. Lange; 2015.

 

Fibromyalgia

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

For unknown reasons, between 80 to 90 percent of those diagnosed with Fibromyalgia are women; however, men and children can also be affected. It also tends to run in families. Fibromyalgia is most often diagnosed in middle age, but it can affect all age groups.

Other symptoms of Fibromyalgia may include:

  • Irritable bowel syndrome
  • Painful menstrual periods
  • Numbness or tingling of extremities
  • Restless leg syndrome
  • Temperature sensitivity
  • Cognitive and Memory problems

Fibromyalgia can be difficult to diagnose and treat. There are a number of medications available that can help in the management of the condition.

A health care professional can provide information on the treatment option available as well as an exercise and lifestyle plan to minimize the impact of fibromyalgia.

References:
  1. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 54th ed. Lange; 2015.

 

Generalized Anxiety Disoder (GAD)

Worry and anxiety are a natural part of life, and in fact, anxious emotions can serve a purpose by helping us prepare to deal with difficult or stressful circumstances.

People with Generalized Anxiety Disorder (GAD) cannot seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They cannot relax, they startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include:

  • Fatigue
  • Headaches
  • Muscle tension
  • Muscle aches
  • Difficulty swallowing
  • Trembling
  • Twitching
  • Irritability
  • Sweating
  • Nausea
  • Lightheadedness
  • Having to go to the bathroom frequently
  • Feeling out of breath
  • Hot flashes.

Generalized Anxiety Disorder develops slowly. It often starts during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress.

When their anxiety level is mild, people with G.A.D can function socially and hold down a job. Although they don’t avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe.

While the specific cause of G.A.D is unknown, doctors have identified a variety of biological and psychological factors. Research shows that G.A.D tends to run in families, but anxiety and worry can also be learned.

The treatment for G.A.D can involve medication therapy as well as psychological counselling, or a combination of both. A mental health specialist can provide additional answers.

References:
  1. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 54th ed. Lange; 2015.

 

Schizophrenia

Schizophrenia is a complex neurobiological disorder, believed to be caused by a biochemical imbalance in the brain. Its symptoms which usually appear in adolescence or early adulthood- include delusions, hallucinations, disturbances in thinking and communication, and withdrawal from social activity.

If left untreated, schizophrenia can take a financial and emotional toll on its patients and their families, in addition to placing an economic and social burden on society as a whole. Sadly, because of the nature of the illness schizophrenia can also lead to incarceration, homelessness and even suicide for those who are ill.

Although there is no cure for Schizophrenia, the illness is treatable, and many people with Schizophrenia go on to lead fulfilling lives in recovery. Psychiatrist agree that today, the best way to manage Schizophrenia is through a combination of medication therapy and psychosocial interventions, a term which describes a range of treatments such as psychological counselling, patient education programs and other support services.

There are a number of medications currently available in the Philippines that treat Schizophrenia. Since each person’s illness is unique, their medication plan will also be unique and the type of medication and dosage required will vary for each individual. Regardless of which medication are used, regular and ongoing monitoring is important to ensure that patients are taking their medications as prescribed, to identify when patients respond well (and when they don’t) and to monitor any side effects.

With early intervention and proper treatment, many individuals living with Schizophrenia are able to manage their disease and live a full productive life.

Signs and Symptoms of Schizophrenia:

  • Delusions.These are false beliefs that are not based in reality. For example, you're being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; a major catastrophe is about to occur; or your body is not functioning properly. Delusions occur in as many as 4 out of 5 people with schizophrenia.
  • Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.
  • Disorganized thinking (speech).Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad.
  • Extremely disorganized or abnormal motor behavior. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation. Behavior is not focused on a goal, which makes it hard to perform tasks. Abnormal motor behavior can include resistance to instructions, inappropriate and bizarre posture, a complete lack of response, or useless and excessive movement.
  • Negative symptoms. This refers to reduced ability or lack of ability to function normally. For example, the person appears to lack emotion, such as not making eye contact, not changing facial expressions, speaking without inflection or monotone, or not adding hand or head movements that normally provide the emotional emphasis in speech. Also, the person may have a reduced ability to plan or carry out activities, such as decreased talking and neglect of personal hygiene, or have a loss of interest in everyday activities, social withdrawal or a lack of ability to experience pleasure.

For more information on Schizophrenia, ask your doctor about it.

References:
  1. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 54th ed. Lange; 2015.

 

Chronic Pain

Chronic pain is often defined as any pain lasting more than 12 weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different. Chronic pain persists—often for months or even longer.

Chronic pain may arise from an initial injury, such as a back sprain, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair.

Osteoarthritis:

According to the American College of Rheumatology (ACR), Osteoarthritis is a Heterogeneous group of conditions leading to joint symptoms and signs associated with defective integrity of articular cartilage, in addition to related changes in underlying bone at the joint margins. It is the most common form of arthritis, and a leading cause of disability and is usually progressive. It most frequently occurs in hands, knees, hips, and spine.

Chronic Lower Back Pain:

Pain, muscle tension, or stiffness localized below costal margin and above inferior gluteal folds, with or without leg pain. Its diagnosis is based on focused history and physical exam, location and duration of pain, risk factors for other serious conditions, symptoms of radiculopathy or stenosis, presence and severity of neurological deficits, Psychosocial factors, Imaging and other diagnostic tests not generally recommended unless severe neurologic deficits / other serious condition suspected.

For any further specific healthcare related inquiries, please consult your healthcare professional.

References:
  1. Altman R, et al. Arthr Rheum 1986;29(8):1039-1049.
  2. Issa SN, et al. Current Rheum Reports 2006;8:7-15.
  3. Felson D, et al. Ann Intern Med 2000;133:635-646.
  4. Sarzi-Puttini P, et al. Semin Arthritis Rheum 2005;35(1):1-10.
  5. Williams FMK, et al. Medicine 2006;34(9):364-368.
  6. Koes BW, et al. BMJ 2006;332:1430-1434.
  7. Chou R, et al. Ann Intern Med. 2007;147(7):478-491.
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