Bipolar disorder in Nepal,Disease of grandiosity and over familiarity

Rama, 16 year girl started to talk more for last 10 days. She is irretible, restless, do arguementive behavior and appear over confident. She started to tell “ I am a female leader, I am a actress”. She move here and there bought 10 pieces of umbrella from market for use. She likes red and yellow dress and appears more smart than past. Now she is busy watching movie, hindi dance programme in tv. She sleeps only 2-3 hours at night. She tells her family member everyone should follow her rule. Sometime she became violent and start to beat her father, mother, brother. Frequently she demanded delicious food. Day by day she appeared out of control. Finally she was brought to hospital. She was known that she has suffering from mania (mental illness).Now she is under treatment and getting Clinical features of mania Signs and symptoms of the manic include:  Euphoria  Extreme optimism  Inflated self-esteem  Poor judgment  Rapid speech  Racing thoughts  Aggressive behavior  Agitation or irritation  Increased physical activity  Risky behavior  Spending sprees or unwise financial choices  Increased drive to perform or achieve goals  Increased sex drive  Decreased need for sleep  Inability to concentrate  Careless or dangerous use of drugs or alcohol  Frequent absences from work or school  Delusions or a break from reality (psychosis)  Poor performance at work or school Bipolar disorder — sometimes called manic-depressive disorder — causes mood swings that range from of the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may only occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time. Although bipolar disorder is a disruptive, long-term condition, you can keep your moods in check by following a treatment plan. In most cases, bipolar disorder can be controlled with medications and psychological counseling (psychotherapy). Symptoms Depressive phase of bipolar disorder Signs and symptoms of the depressive phase of bipolar disorder can include:  Sadness  Hopelessness  Suicidal thoughts or behavior  Anxiety  Guilt  Sleep problems  Low appetite or increased appetite  Fatigue  Loss of interest in daily activities  Problems concentrating  Irritability  Chronic pain without a known cause  Frequent absences from work or school  Poor performance at work or school Other signs and symptoms of bipolar disorder Signs and symptoms of bipolar disorder can also include:  Seasonal changes in mood. As with seasonal affective disorder (SAD), some people with bipolar disorder have moods that change with the seasons. Some people become manic or hypomanic in the spring or summer and then become depressed in the fall or winter. For other people, this cycle is reversed — they become depressed in the spring or summer and manic or hypomanic in the fall or winter. Causes Several factors seem to be involved in causing and triggering bipolar episodes:  Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.  Neurotransmitters. An imbalance in naturally occurring brain chemicals called neurotransmitters seems to play a significant role in bipolar disorder and other mood disorders.  Hormones. Imbalanced hormones may be involved in causing or triggering bipolar disorder.  Inherited traits. Bipolar disorder is more common in people who have a blood relative (such as a sibling or parent) with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.  Environment. Stress, abuse, significant loss or other traumatic experiences may play a role in bipolar disorder. Risk factors Factors that may increase the risk of developing bipolar disorder include:  Having blood relatives such as a parent or sibling with bipolar disorder  Periods of high stress  Drug or alcohol abuse  Major life changes, such as the death of a loved one  Being between the ages of 15 and 30 Complications Left untreated, bipolar disorder can result in serious problems that affect every area of your life. These can include:  Problems related to substance and alcohol abuse  Legal problems  Financial problems  Relationship troubles  Isolation and loneliness  Poor work or school performance  Frequent absences from work or school  Suicide diagnosis When doctors suspect someone has bipolar disorder, they typically do a number of tests and exams. These can help rule out other problems, pinpoint a diagnosis and also check for any related complications. These can include:  Physical exam. This may involve measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen.  Lab tests. These may include blood and urine tests. These tests can help identify any physical problems that could be causing your symptoms.  Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. You may also fill out a psychological self-assessment or questionnaire. With your permission, family members or close friends may be asked to provide information about your symptoms and possible episodes of mania or depression.  Mood charting. To identify exactly what's going on, your doctor may have you keep a daily record of your moods, sleep patterns or other factors that could help with diagnosis and finding the right treatment. Treatments Bipolar disorder requires lifelong treatment, even during periods when you feel better. Treatment is usually guided by a psychiatrist skilled in treating the condition. You may have a treatment team that also includes psychologists, social workers and psychiatric nurses. The primary treatments for bipolar disorder include medications; individual, group or family psychological counseling (psychotherapy); or education and support groups.  Hospitalization may be needed if you are behaving dangerously, you feel suicidal or you become detached from reality (psychotic).  Initial treatment generally involves taking medications to balance your moods right away. Once your symptoms are under control, you'll work with your doctor to find the best long-term treatment.  Continued treatment (maintenance treatment) is used to manage bipolar disorder on a long-term basis. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.  Substance abuse treatment may be necessary if you have problems with alcohol or drugs. Otherwise, it can be very difficult to manage bipolar disorder. Lifestyle and home remedies You'll probably need to make lifestyle changes to stop cycles of behavior that worsen your bipolar disorder, and to make sure you get the support you need from people in your life. Here are some steps to take:  Quit drinking or using illicit drugs. One of the biggest concerns with bipolar disorder is the negative consequences of risk-taking behavior and drug or alcohol abuse. Get help if you have trouble quitting on your own.  Steer clear of unhealthy relationships. Surround yourself with people who are a positive influence and won't encourage unhealthy behavior or attitudes that can worsen your bipolar disorder.  Get regular exercise. Moderate, regular exercise can help steady your mood. Working out releases brain chemicals that make you feel good (endorphins), can help you sleep and has a number of other benefits.  Get plenty of sleep. Sleeping enough is an important part of managing your mood. If you have trouble sleeping, talk to your doctor or mental health provider about what you can do. Coping and support Coping with bipolar disorder can be challenging. Here are some things that can help:  Learn about bipolar disorder. Education about your condition can empower you and motivate you to stick to your treatment plan. Likewise, help educate your family and friends about what you're going through.  Join a support group. Support groups for people with bipolar disorder can help you connect to others facing similar challenges and share experiences.  Stay focused on your goals. Recovery from bipolar disorder can take time. Stay motivated by keeping your recovery goals in mind and reminding yourself that you can work to repair damaged relationships and other problems caused by your mood swings.  Find healthy outlets. Explore healthy ways to channel your energy, such as hobbies, exercise and recreational activities.  Learn ways to relax and manage stress. Yoga, tai chi, meditation, or other relaxation techniques can be helpful.