A person with bipolar disorder will experience changes in mood, energy, and activity levels that can make day-to-day living difficult. Bipolar disorder can cause severe disruption to a person’s life, but the impact varies between individuals. With appropriate treatment and support, many people with this condition live a full and productive life. According to the […]
Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin. It can appear at any age, but it is more likely to occur after the age of 45 years. It affects over 30 million Americans, according to the […]
A person with bipolar disorder will experience changes in mood, energy, and activity levels that can make day-to-day living difficult. Bipolar disorder can cause severe disruption to a person’s life, but the impact varies between individuals. With appropriate treatment and support, many people with this condition live a full and productive life. According to the […]
Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin. It can appear at any age, but it is more likely to occur after the age of 45 years. It affects over 30 million Americans, according to the […]
A person with bipolar disorder will experience changes in mood, energy, and activity levels that can make day-to-day living difficult.
Bipolar disorder can cause severe disruption to a person’s life, but the impact varies between individuals. With appropriate treatment and support, many people with this condition live a full and productive life.
According to the National Alliance on Mental Illness (NAMI), bipolar disorder affects over 10 million people in the United States or around 2.8% of the population.
On average, a person will receive a diagnosis around the age of 25 years, but symptoms can appear during the teenage years or later in life. It affects males and females equally.
What is bipolar disorder?
The National Institute of Mental Health describe the main symptoms of bipolar disorder as alternating episodes of high and low mood. Changes in energy levels, sleep patterns, ability to focus, and other features can dramatically impact a person’s behavior, work, relationships, and other aspects of life.
Most people experience mood changes at some time, but those related to bipolar disorder are more intense than regular mood changes, and other symptoms can occur. Some people experience psychosis, which can include delusions, hallucinations, and paranoia.
Between episodes, the person’s mood may be stable for months or years, especially if they are following a treatment plan.
Treatment enables many people with bipolar disorder to work, study, and live a full and productive life. However, when treatment helps a person feel better, they may stop taking their medication. Then, the symptoms can return.
Some aspects of bipolar disorder can make a person feel good. During an elevated mood, they may find they are more sociable, talkative, and creative.
However, an elevated mood is unlikely to persist. Even if it does, it may be hard to sustain attention or follow through with plans. This can make it difficult to follow a project through to the end.
Symptoms
According to the International Bipolar Association, symptoms vary between individuals. For some people, an episode can last for several months or years. Others may experience “highs” and “lows” at the same time or in quick succession.
In “rapid cycling” bipolar disorder, the person will have four or more episodes within a year.
Mania or hypomania
Hypomania and mania are elevated moods. Mania is more intense than hypomania.
Symptoms can include:
impaired judgment
feeing wired
sleeping little but not feeling tired
a sense of distraction or boredom
missing work or school
underperforming at work or school
feeling able to do anything
being sociable and forthcoming, sometimes aggressively so
engaging in risky behavior
increased libido
feeling exhilarated or euphoric
having high levels of self-confidence, self-esteem, and self-importance
talking a lot and rapidly
jumping from one topic to another in conversation
having “racing” thoughts that come and go quickly, and bizarre ideas that the person may act upon
denying or not realizing that anything is wrong
Some people with bipolar disorder may spend a lot of money, use recreational drugs, consume alcohol, and participate in dangerous and inappropriate activities.
Depressive symptoms
During an episode of bipolar depression, a person may experience:
a feeling of gloom, despair, and hopelessness
extreme sadness
insomnia and sleeping problems
anxiety about minor issues
pain or physical problems that do not respond to treatment
a sense of guilt, which may be misplaced
eating more or eating less
weight loss or weight gain
extreme tiredness, fatigue, and listlessness
an inability to enjoy activities or interests that usually give pleasure
difficulty focusing and remembering
irritability
sensitivity to noises, smells, and other things that others may not notice
an inability to face going to work or school, possibly leading to underperformance
In severe cases, the individual may think about ending their life, and they may act on those thoughts.
Psychosis
If a “high” or “low” episode is very intense, the person may experience psychosis. They may have trouble differentiating between fantasy and reality.
According to the International Bipolar Foundation, psychosis symptoms during a high include hallucinations, which involve hearing or seeing things that are not there and delusions, which are false but strongly felt beliefs. A person who experiences delusions may believe they are famous, have high-ranking social connections, or have special powers.
During a depressive or “low” episode, they may believe they have committed a crime or are ruined and penniless.
It is possible to manage all these symptoms with appropriate treatment.
Types of bipolar disorder
A person may receive a diagnosis of one of three broad types of bipolar disorder. According to NAMI, symptoms occur on a spectrum, and the distinction between the types is not always clear-cut.
Bipolar I disorder
For a diagnosis of bipolar I disorder:
The individual must have experienced at least one manic episode.
The person may have had a previous major depressive episode.
The doctor must rule out other disorders, such as schizophrenia and delusional disorder.
Bipolar II disorder
Bipolar II disorder involves periods of hypomania, but depression is often the dominant state.
For a diagnosis of bipolar II disorder, a person must have had:
one or more episodes of depression
at least one hypomanic episode
no other diagnosis to explain the mood shifts
A person with hypomania may feel good and function well, but their mood will not be stable, and there is a risk that depression will follow.
People sometimes think of bipolar II disorder as a milder version. For many, however, it is simply different. As NAMI indicate, people with bipolar II disorder may experience more frequent episodes of depression than people with bipolar I disorder.
Cyclothymia
The National Health Service (NHS) in the United Kingdom note that cyclothymia has similar features to bipolar disorder, but the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) classifies it separately. It involves hypomania and depression, but the changes are less intense.
Nevertheless, cyclothymia can impact a person’s daily life, and a doctor can provide treatment.
Diagnosis
A medical professional will diagnose bipolar disorder using criteria set out in the DSM-5.
The National Institue of Mental Health (NIMH) explain that in order to receive a diagnosis of bipolar I disorder, a person must have had symptoms for at least 7 days, or less if symptoms were severe enough to need hospitalization. They may also have had a depressive episode lasting at least 2 weeks.
To receive a diagnosis of bipolar II, a person will have experienced at least one cycle of hypomania and depression.
A doctor may carry out a physical examination and some diagnostic tests, including blood and urine tests, to help rule out other causes.
It can be challenging for a doctor to diagnose bipolar disorder, as people are more likely to seek help with a low mood than a high mood. As a result, it can be hard for them to distinguish it from depression.
If the person has psychosis, a doctor may misdiagnose their condition as schizophrenia.
Other complications that may occur with bipolar disorder are:
use of drugs or alcohol to cope with symptoms
post-traumatic stress disorder (PTSD)
anxiety disorder
attention-deficit hyperactivity disorder (ADHD)
NIMH urge healthcare providers to look for signs of mania in the person’s history, to prevent misdiagnosis. Some antidepressants can trigger mania in susceptible people.
A person who receives a diagnosis of bipolar disorder has a lifelong diagnosis. They may enjoy long periods of stability, but they will always live with the condition.
Modern flat mental illness bipolar disorder prevention prophylaxis concept.Flat style infographic character with psychology problem,text Bipolar Disorder,Symptoms,Keys to Self Help
Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin.
It can appear at any age, but it is more likely to occur after the age of 45 years.
It affects over 30 million Americans, according to the United States Centers for Disease Control and Prevention (CDC), and it accounts for 90–95 percent of diabetes cases.
What is type 2 diabetes?
People with type 2 diabetes do not make or use insulin correctly.
Insulin is a hormone that regulates the movement of blood glucose, or sugar, into cells, which use it as energy.
When sugar cannot enter cells, this means:
too much glucose collects in the blood
the body’s cells cannot use it for energy
A doctor may diagnose diabetes if a person’s blood sugar levels are 126 milligrams per deciliter (mg/dl) or above after fasting for 8 hours.
Symptoms
The symptoms of high blood sugar in type 2 diabetes tend to appear gradually. Not everyone with type 2 diabetes will notice symptoms in the early stages.
If a person does experience symptoms, they may notice the following:
Frequent urination and increased thirst: When excess glucose builds up in the bloodstream, the body will extract fluid from tissues. This can lead to excessive thirst and the need to drink and urinate more.
Increased hunger: In type 2 diabetes, the cells are not able to access glucose for energy. The muscles and organs will be low on energy, and the person may feel more hungry than usual.
Weight loss: When there is too little insulin, the body may start burning fat and muscle for energy. This causes weight loss.
Fatigue: When cells lack glucose, the body becomes tired. Fatigue can interfere with daily life when a person has type 2 diabetes.
Blurred vision: High blood glucose can cause fluid to be pulled from the lenses of the eyes, resulting in swelling, leading to temporarily blurred vision.
Infections and sores: It takes longer to recover from infections and sores because blood circulation is poor and there may be other nutritional deficits.
If people notice these symptoms, they should see a doctor. Diabetes can lead to a number of serious complications. The sooner a person starts to manage their glucose levels, the better chance they have of preventing complications.
Symptoms in children and teens
Type 2 diabetes is more likely to appear after the age of 45 years, but it can affect children and teens who:
have excess weight
do not do much physical activity
have high blood pressure
have a family history of type 2 diabetes
have an African American, Asian American, Hispanic American, or American Indian background
The following symptoms may occur:
weight loss, despite increased appetite and hunger
extreme thirst and dry mouth
frequent urination and urinary tract infections
fatigue
blurred vision
slow healing of cuts or wounds
numbness or tingling in hands and feet
itchy skin
If caregivers notice these symptoms, they should take the child to see a doctor. These are also symptoms of type 1 diabetes. Type 1 is less common but more likely to affect children and teenagers than adults. However, type 2 diabetes is becoming more common in young people than it was in the past.
Symptoms in older adults
At least 25.2 percent of people aged 65 and above have type 2 diabetes in the United States. They may have some or all the classic symptoms of type 2 diabetes.
They may also experience one or more of the following:
flu-like fatigue, which includes feeling lethargic and chronically weak
urinary tract infections
numbness and tingling in the hands, arms, legs, and feet due to circulation and nerve damage
dental problems, including infections of the mouth and red, inflamed gums
Early signs
Most people do not experience symptoms in the early stages, and they may not have symptoms for many years.
A possible early sign of type 2 diabetes is darkened skin on certain areas of the body, including:
the neck
the elbows
the knees
the knuckles
This is known as acanthosis nigricans.
Other early symptoms include:
frequent bladder, kidney, or skin infections
cuts that take longer to heal
fatigue
extreme hunger
increased thirst
urinary frequency
blurred vision
A person may have mild or subtle symptoms for many years, but these can become in time. Further health problems can develop.
Prediabetes and diabetes prevention
A person with blood sugar levels of 100–125 mg/dl will receive a diagnosis of prediabetes. This means that their blood sugar levels are high, but they do not have diabetes. Taking action at this stage can prevent diabetes from developing.
According to a 2016 report published in The Journal of the American Board of Family Medicine, 33.6 percent of people aged 45 years and older had prediabetes in 2012.
The CDC estimate that around 84 million American adults have prediabetes, but most do not know they have it.
Complications
Diabetes may cause a number of health complications if people do not manage it properly. Many of these are chronic, or long-term, but they can become life-threatening. Others need immediate medical attention as soon as they appear.
Emergency complications
Complications can arise quickly if blood sugar rises or falls too far.
Hypoglycemia
If blood glucose dips below 70 mg/dl, this is hypoglycemia, or low blood sugar.
This can happen if a person who uses insulin takes more than they need for a particular time.
A home blood glucose test can check for hypoglycemia.
It is vital to know the early signs of hypoglycemia, as it can progress quickly, resulting in seizures and a coma. In the early stages, however, it is easy to treat.
Symptoms of hypoglycemia include:
confusion
dizziness
feeling faint
heart palpitations
rapid heartbeat
mood changes
loss of consciousness
sweating
clamminess
If symptoms are mild, a person can often resolve low blood sugar levels by consuming:
a few pieces of hard candy
a cup of orange juice
a teaspoon of honey
a glucose tablet
The person should then wait 15 minutes, test their blood sugar, and if it is still low, they should take another glucose tablet or sweet.
When levels return to above 70 mg/dl, the person should eat a meal, to stabilize their glucose levels.
If they remain low for 1 hour or longer, or if symptoms worsen, someone should take the person to the emergency room.
Anyone who has frequent or severe hypoglycemic episodes should speak to their doctor, as they may need to adjust their treatment plan.
Hyperglycemia and diabetic ketoacidosis (DKA)
If blood sugar levels rise too far, hyperglycemia can result. If a person notices increased thirst and urination, they should check their blood sugar levels.
It the level is above the target level that their doctor recomends, they take appropriate action.
Without treatment, high a person with hyperglycemia can develop diabetic ketoacidosis (DKA), which happens when high levels of ketones collect in the blood, making it too acidic. For this reason, the person should also test their ketone levels.
Ketoacidosis can lead to:
difficulty breathing
a fruity smell on the breath
a dry mouth
nausea and vomiting
coma
It can be life-threatening. A person with these signs and symptoms should seek immediate medical attention.
People who regularly experience high blood sugar should speak to their doctor about adjusting their treatment plan.
People should check with their doctor how often they need to test.
Long-term complications
Keeping blood glucose within target levels can prevent complications that can become life-threatening and disabling over time.
Some possible complications of diabetes are:
heart and blood vessel diseases
high blood pressure
nerve damage (neuropathy)
foot damage
eye damage and blindness
kidney disease
hearing problems
skin problems
Effective management of blood glucose levels can reduce the risk of complications.
Diagnosis and treatment
A doctor can diagnose type 2 diabetes with blood tests that measure blood glucose levels. Many people discover they have high blood sugar during a routine screening test, but anyone who experiences symptoms should see a doctor.
Treatment aims to keep blood glucose levels stable at a healthy level and prevent complications. The main ways to do this are through lifestyle measures.
These include:
following a healthful diet
reaching and maintaining a healthy weight and body mass index (BMI)
doing physical activity
getting enough sleep
avoiding or quitting smoking
taking medications or insulin as the doctor recommends
Outlook
There is currently no cure for diabetes, but most people with the condition can lead a healthful life by managing their condition properly.
People who maintain a healthy weight, follow a healthful diet, and do regular exercise may not need medication. Taking these steps can help manage blood sugar levels.
Routine screening can alert a person to high blood sugar levels in the early stages, when there is still time to slow, stop, or reverse the progress of diabetes.
Current guidelines recommend regular screening from the age of 45 years, or younger if an individual has other risk factors, such as obesity. A doctor can advise on individual needs.
It is important to have support from people who understand what it is like to receive a diagnosis and live with type 2 diabetes.
