Bipolar Disorder (cont.)
IN THIS ARTICLE
- Bipolar Disorder Overview
- Bipolar Disorder Causes
- Bipolar Disorder Symptoms
- When to Seek Medical Care
- Exams and Tests
- Bipolar Disorder Treatment
- Medications
- Other Therapy
- Next Steps
- Follow-up
- Prevention
- Outlook
- Support Groups and Counseling
- For More Information
- Web Links
- Synonyms and Keywords
- Authors and Editors
Bipolar Disorder Causes
The exact cause of bipolar disorder has not been discovered, but many experts believe that multiple factors are involved which act together to cause the disease. Bipolar disorder may result from a chemical imbalance within the brain. The brain's functions are controlled by chemicals called neurotransmitters. An imbalance in the levels of one of these neurotransmitters, such as norepinephrine, may cause bipolar disorder. When levels of this chemical are too high, mania occurs. When levels of norepinephrine drop below normal levels, a person may experience depression. Levels of other neurotransmitters, such as serotonin and dopamine, are also believed to play a role.
There is a significant genetic component to bipolar disorder. If a family member has bipolar disorder, other family members may be at risk. The identical twin of a person with bipolar disorder is at the highest risk for developing the condition. However, stress of some kind often is needed to trigger the onset of the disease. The disease does not occur just because of one gene, and the cause of the disease is likely a combination of multiple genetic and environmental factors.
Sometimes a period of emotional stress, drug use, an illness, or another event seems to trigger the onset of the disease. Stresses can also trigger a manic or depressive episode in people who are known to have the condition.
Not everyone with severe mood swings or a change in personality has bipolar disorder. Mood swings can be caused by other medical conditions that need to be diagnosed and treated properly. Medical diseases and medications that may have symptoms similar to bipolar disorder include the following:
- Head trauma (blood clot or
bleeding in the brain)
- Thyroid problem (both underactive and overactive)
- Systemic lupus erythematosus
(a condition that may affect various body organs, including the brain)
- Brain tumor
- Epilepsy (seizures)
- Neurosyphilis (a form of the sexually transmitted disease, syphilis, that has
gone to the brain because it went untreated too long)
- AIDS (acquired immunodeficiency syndrome, the ultimate result of infection with the human immunodeficiency virus or HIV)
- Sodium imbalance
(sodium, one of several elements found in body cells that is necessary for
their proper function)
- Diabetes mellitus (a
disorder of, among other things, sugar processing in the body)
- Certain medications that decrease the amount of serotonin or norepinephrine, such as some antihypertensive drugs and some preparations of steroids and birth control pills
- Attention deficit/hyperactivity disorder (ADHD)
- Anorexia nervosa
- Drug abuse (cocaine,
methamphetamine use)
- Bulimia nervosa
- Panic disorder
- Posttraumatic stress disorder
- Social phobia
- Schizoaffective disorder
- Schizophrenia
- Delusional disorder
Next: Bipolar Disorder Symptoms »
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Cymbalta is approved for the treatment of depression.
Important Safety Information
Cymbalta® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.
What should I talk about with my healthcare provider?
Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.
You should also know that:
- ·Suicide is a known risk of depression and some other psychiatric disorders.
- ·Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
- ·All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
- ·Cymbalta® is not approved for use in patients under age 18.
Who should NOT take Cymbalta?
You should not take Cymbalta if:
- ·You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
- ·You have uncontrolled narrow-angle glaucoma (an eye disease)
- ·You are taking Mellaril® (thioridazine)
What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:
- ·about all of your medical conditions, including kidney problems, glaucoma, or diabetes
- ·about your alcohol use
- ·if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
- ·if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
- ·if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant
While taking Cymbalta, tell your healthcare provider:
- ·if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
- ·if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
- ·before stopping Cymbalta or changing your dose
- ·if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta
If you have any questions, talk to your healthcare provider before taking Cymbalta.
What are the possible side effects of Cymbalta?
The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.
Read What Your Physician is Reading on eMedicine
Bipolar Affective Disorder »
Bipolar disorder, or manic-depressive illness (MDI), is one of the most common, severe, and persistent mental illnesses.
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