Types of bipolar disorder, pathophysiology, causes, risk factors, symptoms, criteria for manic, hypomanic and depressive episodes, mixed episodes; diagnosis and treatments.

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Bipolar disorder, formerly known as manic-depressive disorder, is a very severe and relatively common mental illness characterized by extreme mood swings between episodes of emotional highs and lows, that is, between mania or hypomania and depression.
The episodes can last anywhere from several weeks to several months. Depressive episodes typically last longer than manic or hypomanic episodes. Some patients only have a few episodes during their lifetime, while others experience multiple episodes a year. In between episodes, patients may have residual symptoms, or no symptoms at all.
Bipolar disorder can occur at any age, but it is most often diagnosed in teens and young adults.
The cause likely involves complex interactions of biological and psychological factors. Bipolar disorder is perhaps the most heritable psychiatric disorder. It has a significant genetic component that implicates multiple genes. The condition is associated with neurodegeneration in some brain areas, dysregulation of several neurotransmitters, and hormone imbalances. Stressful life events, as well as substance abuse and certain medications, can trigger episodes or exacerbate symptoms.
There are several types of bipolar disorder:
Bipolar I disorder is defined as having at least one full-blown manic episode, with or without depressive episodes.
Bipolar II disorder is when patients have at least one major depressive episode and at least one hypomanic episode, but never had a full-blown manic episode.
Cyclothymic disorder is when patients have at least two years of both hypomanic and depressive episodes, but never had a major depressive or a full-blown manic episode.
Other types include disorders with clear bipolar pattern but the episodes do not meet the criteria for any specific type.
A manic episode is defined as at least one week of a persistently elevated or irritable mood with at least 3 of the following symptoms:
– Increased energy or irritability
– Decreased need for sleep
– Inflated sense of self-worth or confidence
– Unusual talkativeness, rapid flow of speech
– Racing of thoughts
– Increased distractibility
– and participating in high-risk activities without regard for consequences
In some cases, mania may trigger a complete break from reality, known as psychosis.
A major depressive episode is defined as at least 2 weeks of at least 5 of the following symptoms:
– Depressed mood, feeling sad or hopeless
– Loss of interest in all or almost all activities
– Significant weight gain or loss; or increased or decreased appetite
– Difficulty sleeping or sleeping too much
– Increased restlessness or unusual sluggishness
– Fatigue
– Feeling worthless or guilty, fixating on past failures or mistakes
– Difficulty thinking, concentrating or making decisions
– Having suicidal thoughts or attempts
A small number of patients may have mixed episodes with alternate manic and depressive symptoms. Mixed episodes are considered most severe, as risk of suicide is high, and prognosis is poor.
Diagnosis is based on criteria for bipolar disorders published by the American Psychiatric Association. Physical conditions, such as hyperthyroidism, and substance use, must be ruled out.
Medications typically include mood stabilizers such as lithium, and antipsychotics. Because antidepressants may trigger manic episodes, they are usually prescribed in combination with a mood stabilizer or antipsychotic, and only for severe depression.
It may take some time to establish the right medications and dosage. Patients must be monitored for adverse effects.
Electroconvulsive therapy, in which electrical currents induce a brief seizure, may be a good option for people who do not respond to, or cannot take medications.
Psychotherapy is generally more effective for depressive episodes because manic patients tend to believe they are in their best mental state.
Psychoeducation, together with support systems, are an important part of long-term treatment plan to prevent future episodes.
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For more information about bipolar disorder, please visit https://cle.clinic/3KicmzO

About 5.7 million adults in the U.S. have bipolar disorder. The lifelong mental health condition, which includes four different types, is known for the maniac and depressive episodes someone experiences.

Chapters:
0:00 Intro
0:26 What is bipolar disorder?
0:50 What does a manic episode feel like?
1:18 What does a depressive episode feel like?
2:00 How to manage bipolar disorder

Resources:
Bipolar Disorder (Manic Depression): Symptoms & Treatment – https://cle.clinic/3KicmzO
Bipolar disorder | NAMI: National Alliance on Mental Illness – http://bit.ly/414vyaT
NIMH: Digital Shareables on Bipolar Disorder – http://bit.ly/3GlwIH8

The information in this video was accurate as of 4.7.2023 and is for information purposes only. Consult your local medical authority or your healthcare practitioner for advice.

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Your body’s immune system protects you from disease and infection. But if you have an autoimmune disease, your immune system attacks healthy cells in your body by mistake. Autoimmune diseases can affect many parts of the body.

No one is sure what causes autoimmune diseases. They do tend to run in families. Women – particularly African-American, Hispanic-American, and Native-American women – have a higher risk for some autoimmune diseases.

There are more than 80 types of autoimmune diseases, and some have similar symptoms. This makes it hard for your health care provider to know if you really have one of these diseases, and if so, which one. Getting a diagnosis can be frustrating and stressful. Often, the first symptoms are fatigue, muscle aches and a low fever. The classic sign of an autoimmune disease is inflammation, which can cause redness, heat, pain and swelling.

The diseases may also have flare-ups, when they get worse, and remissions, when symptoms get better or disappear. Treatment depends on the disease, but in most cases one important goal is to reduce inflammation. Sometimes doctors prescribe corticosteroids or other drugs that reduce your immune response.
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Anxiety – Causes, Symptoms and Treatments and More

What is anxiety?

Anxiety is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress. For example, you might feel anxious when faced with a difficult problem at work, before taking a test, or before making an important decision. It can help you to cope. The anxiety may give you a boost of energy or help you focus. But for people with anxiety disorders, the fear is not temporary and can be overwhelming.
What are anxiety disorders?

Anxiety disorders are conditions in which you have anxiety that does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships.
What are the types of anxiety disorders?

There are several types of anxiety disorders, including:

Generalized anxiety disorder (GAD).People with GAD worry about ordinary issues such as health, money, work, and family. But their worries are excessive, and they have them almost every day for at least 6 months.
Panic disorder. People with panic disorder have panic attacks. These are sudden, repeated periods of intense fear when there is no danger. The attacks come on quickly and can last several minutes or more.
Phobias. People with phobias have an intense fear of something that poses little or no actual danger. Their fear may be about spiders, flying, going to crowded places, or being in social situations (known as social anxiety).

What causes anxiety disorders?

The cause of anxiety is unknown. Factors such as genetics, brain biology and chemistry, stress, and your environment may play a role.
Who is at risk for anxiety disorders?

The risk factors for the different types of anxiety disorders can vary. For example, GAD and phobias are more common in women, but social anxiety affects men and women equally. There are some general risk factors for all types of anxiety disorders, including:

Certain personality traits, such as being shy or withdrawn when you are in new situations or meeting new people
Traumatic events in early childhood or adulthood
Family history of anxiety or other mental disorders
Some physical health conditions, such as thyroid problems or arrhythmia

What are the symptoms of anxiety disorders?

The different types of anxiety disorders can have different symptoms. But they all have a combination of:

Anxious thoughts or beliefs that are hard to control. They make you feel restless and tense and interfere with your daily life. They do not go away and can get worse over time.
Physical symptoms, such as a pounding or rapid heartbeat, unexplained aches and pains, dizziness, and shortness of breath
Changes in behavior, such as avoiding everyday activities you used to do

Using caffeine, other substances, and certain medicines can make your symptoms worse.
How are anxiety disorders diagnosed?

To diagnose anxiety disorders, your health care provider will ask about your symptoms and medical history. You may also have a physical exam and lab tests to make sure that a different health problem is not the cause of your symptoms.

If you don’t have another health problem, you will get a psychological evaluation. Your provider may do it, or you may be referred to a mental health professional to get one.
What are the treatments for anxiety disorders?

The main treatments for anxiety disorders are psychotherapy (talk therapy), medicines, or both:

Cognitive behavioral therapy (CBT) is a type of psychotherapy that is often used to treat anxiety disorders. CBT teaches you different ways of thinking and behaving. It can help you change how you react to the things that cause you to feel fear and anxiety. It may include exposure therapy. This focuses on having you confront your fears so that you will be able to do the things that you had been avoiding.
Medicines to treat anxiety disorders include anti-anxiety medicines and certain antidepressants. Some types of medicines may work better for specific types of anxiety disorders. You should work closely with your health care provider to identify which medicine is best for you. You may need to try more than one medicine before you can find the right one.

NIH: National Institute of Mental Health

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Call 281-633-8600 or visit http://orthopedicsportsdoctor.com. In this video, Houston and Sugar Land Orthopedic Surgeon Dr. J. Michael Bennett describes the anatomy and causes of stress fractures and he talks about how stress fractures can become broken bones if left untreated. Dr. Bennett also talks about how flat feet can contribute to stress fractures. He covers how to prevent stress fractures and a broken tibia. A compound or open fracture of the tibia is the injury that University of Louisville Cardinal basketball player Kevin Ware suffered.

Here’s our contact information:
J. Michael Bennett, MD, PA
4690 Sweetwater Blvd., Suite 240
Sugar Land TX 77479
281-633-8600
http:orthopedicsportsdoctor.com

Dr. J. Michael Bennett
4543 Post Oak Place, Suite 105
Houston TX 77027
713-234-3152
http://jmichaelbennett.com

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How long does it take a stress fracture to heal? At what point should a patient worry that the bone isn’t healing like it should? In this Ask Dr. Geier video, I discuss healing of a stress fracture in the tibia and how you can adjust activities to help it heal.

http://challenge.drdavidgeier.com/ds/906ca4c8
I want to help you! Please take a few seconds to share the biggest challenge or struggle you’re facing with your injury! Click here!

How long does it take a stress fracture to heal?

Click the link above for more information about a stress fracture and other resources for your sports or exercise injury.

Get The Serious Injury Checklist FREE!
How can you know if your injury should get better in a few days or if it’s more serious? This checklist can help you plan your next step to recover quickly and safely.
http://www.sportsmedicinesimplified.com

Please note: I don’t respond to questions and requests for specific medical advice left in the comments to my videos. I receive too many to keep up (several hundred per week), and legally I can’t offer specific medical advice to people who aren’t my patients (see below). If you want to ask a question about a specific injury you have, leave it in the comments below, and I might answer it in an upcoming Ask Dr. Geier video. If you need more detailed information on your injury, go to my Resources page: https://www.drdavidgeier.com/resources/

The content of this YouTube Channel, https://www.youtube.com/user/drdavidgeier (“Channel”) is for INFORMATIONAL PURPOSES ONLY. The Channel may offer health, fitness, nutritional and other such information, but such information is intended for educational and informational purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. The content does not and is not intended to convey medical advice and does not constitute the practice of medicine. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. You should consult with your healthcare professional before doing anything contained on this Channel. You agree that Dr. Geier is not responsible for any actions or inaction on your part based on the information that is presented on the Channel. Dr. David Geier Enterprises, LLC makes no representations about the accuracy or suitability of the content. USE OF THE CONTENT IS AT YOUR OWN RISK.

Heidi in Davidson, NC asks:
I am a runner and was diagnosed with a proximal (close to the knee) tibial stress fracture by MRI. I have had symptoms for over a year. I stopped running because it hurt. I have followed all precautions. I don’t bend past 90, no kneeling, and obviously no running, jumping, etc. That pain has improved somewhat, but it is still there with specific activities. 10 weeks after diagnosis, I’m concerned that it isn’t healing. Is there a time limit on this kind of healing? After this long should I just consider surgery? I feel like my current doctor is being too conservative, and I just want to get healed and back to normal routine.

The tibial plateau is the top of the tibia (shin bone) just below the knee. Stress fractures can occur in this area in running athletes and active people. Usually rest or modifying activities is enough to get this bone to heal.

Most stress fractures heal in 6 to 12 weeks, but every patient is different. Some stress fractures, although not generally tibial plateau stress fractures, are prone to poor healing. For those stress fractures, completely avoidance of weight on the leg and even surgery can be needed.

In this video, I discuss the treatment and time frames for healing for different stress fractures.

Have you suffered a stress fracture? How did you get it to heal? I would love to hear your experience below

Please remember, while I appreciate your questions, I cannot and will not offer specific medical advice by email, online, on my show, or in the comments at the end of these posts. My responses are meant to provide general medical information and education. Please consult your physician or health care provider for your specific medical concerns.
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— video script below —
Angina is chest pain or discomfort you feel when there is not enough blood flow to your heart muscle. Your heart muscle needs the oxygen that the blood carries. Angina may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw, or back.
Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.
There are three types of angina:
• Stable angina is the most common type. It happens when the heart is working harder than usual. Stable angina has a regular pattern. Rest and medicines usually help.
• Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It does not go away with rest or medicine. It is a sign that you could have a heart attack soon.
• Variant angina is rare. It happens when you are resting. Medicines can help.
Not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.
NIH: National Heart, Lung, and Blood Institute

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