The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 08 Jun 2013 05:42 PM PDT If you are constantly bouncing between feelings of euphoria and depression, affecting your daily activities, it may be a symptom of bipolar disorder. WE all have days when we dread getting out of bed. And when you do, you feel like kicking puppies on the way to work. Then you get into work and someone compliments you on how good you look, and suddenly, the world seems all rosy and cheery again. Sound familiar? Mood swings are normal, varying from subtle changes in temperament, to wild oscillations between jovial expansiveness and extreme irritability. For most people, mood swings remain in the mild to moderate range of emotional ups and downs. However, when mood swings are so strong that they become disruptive to one's daily life, they may be a symptom of bipolar disorder (BD). BD is a form of mental illness. According to the United States National Institute of Mental Health, the disorder is also known as manic-depressive illness. It can cause unusual shifts in mood and energy levels, and impede one's ability to carry out daily tasks. Symptoms of BD are unlike those of a common mood swing, which we can snap out of almost as quickly as we get into it. They are severe and can result in damaged interpersonal relationships, poor job or academic performance, and even suicide. BD often develops during the late teens or early adult years. At least half of all cases start before the age of 25. Some people reportedly experience their first symptoms during childhood, while others may develop symptoms late in life. In 2011, Hollywood actress Catherine Zeta-Jones shook the entertainment world when she revealed that she suffers from Bipolar II, a condition that can cause episodes of depression lasting for days, and occasional intense mood swings. The stunning 43-year-old, who appeared in cinematic hits like The Mask of Zorro (1998), Chicago (2002) and Ocean's Twelve (2004), checked into a healthcare facility in April for maintenance treatment. She completed her therapy in less than a month, and has since returned home. "She's doing a really good job of getting balanced. I'm proud of her," husband and actor Michael Douglas told the media. A multifaceted disorder In general, BD presents itself in symptoms such as mania, hypomania and depression. Hypomania is a less severe form of mania that many do not think of as a problem. A hypomanic episode may actually feel pretty good as it can generate a greater sense of well-being and productivity. People who go through it may feel extremely energetic, talkative, confident and assertive. They may also have a flight of creative ideas. However, many people who experience hypomania may also experience signature hypersexuality. Hypomania can also evolve into mania, or can switch into serious depression – both of which pose potential dangers to a BD patient. Mania is an elevated state of hypomania, characterised by periods of overactiveness and excited behaviour. This symptom varies in intensity, and may present itself in restlessness and less need for sleep, talkativeness and rapid speech, aggression, and reckless behaviours such as lavish spending sprees, drug and alcohol abuse, and sexual indiscretions. These behaviours are usually accompanied by psychotic elements that may include hallucinations, suspiciousness and delusions of grandeur. People with BD generally experience depression as well. This is usually compounded by feelings of severe irritability, guilt or a complete loss of energy. These depressed phases can be dangerous, as a person affected by it may have frequent thoughts of ending their life. The dramatic phases of BD do not follow a specific set pattern. A depressive episode does not always follow mania, and a person with BD may experience the same mood state several times, lasting weeks, months and even years at a time, before suddenly shifting to the opposite mood. The severity of these mood phases also differ from person to person. Between episodes, many people with BD are perfectly fine, but some may have lingering symptoms even while on medication, although these are not as severe as the uncontrolled moods. BD usually lasts a lifetime. "While genetics and stress may contribute to its development, the exact causes of BD are still unknown. Some experts believe that symptoms may arise from a problem with nerve signals in the brain that control emotion, thinking, and behaviour," says Associate Professor Dr Mariani Md Nor from Universiti Malaya's department of educational psychology and counselling. Out of control A person suffering from BD would often appear frenzied and erratic to their family and friends. He or she may start sleeping less, appear to have unlimited energy and is bursting with ideas. They may even be funny and pleasant to hang around at first, but that jovial mood will soon dissipate into bouts of irritation and despair. They may start drinking or using drugs. As bad judgment is common during a hypomanic or full manic episode, a person suffering from BD may spend money recklessly and engage in risky behaviours, including casual (and unprotected) sex and gambling. They may also accuse their family and friends of being boring and "ruining their lives". BD in general tends to worsen if left untreated. Over time, a person may suffer increasingly frequent and more severe episodes. Delays in getting the correct diagnosis and treatment also make a person more likely to experience personal, social and work-related problems, and may even threaten the safety and well-being of the person and their loved ones. Proper diagnosis and treatment will allow BD patients to lead a healthy and productive life. In most cases, treatment can help reduce the frequency and severity of BD episodes. Malacca native Kathy Chin, who was diagnosed with Bipolar Type II at 18, recounts her struggles with the illness. "I first experienced the symptoms at age 16. At times, I would feel like I am the best at everything and anything. I would be up all night writing, and I was volunteering for too many tasks in school," the candid 21-year-old shares. "Then, there were moments when I feel that I am useless and hopeless. Once, I even told my mother that I was a waste of oxygen, and that so many people deserved to live rather than me." It was a heated encounter with a disciplinary teacher in Form Six that eventually prompted Chin to seek medical attention. "I was the secretary of my school's prefect board. One day, this teacher humiliated me during a prefect board meeting by calling me incompetent in front of everyone, and that drove me into a manic state," she says. Frenzied and furious, she dashed out of the meeting and headed for the school's gates. "I wanted to run into the streets and get hit by a car. Two fellow prefects stopped me," she recalls. Prior to her diagnosis, Chin says she had heard about the illness on The Oprah Winfrey Show. "I went on to look up its symptoms and answered online questionnaires that all seemed to point that I have BD." The incident at the prefect board meeting was in many ways, a wake-up call for her, she shares. "What transpired after the meeting made me realise that I needed help. This was no way to live. "Later, I re-read my old diary entries and realised that I had felt suicidal so many times." Living with BD Treatment for BD often includes a combination of mood-stabilising drugs and psychotherapy. Although drug treatment is primary, ongoing psychotherapy is important to help patients better cope with their condition. Medication has been helpful, but Chin says she had to stop after the first few months, as she could not cope with its side effects. "I was constantly drowsy and I couldn't wake up in the morning for school. I only got back on my medication during my STPM year," she explains. Some BD patients reportedly stop taking their medication because it dims the feelings of euphoria and excitement (while in a hypomanic state) that can be incredibly addictive. Stopping her medication nearly proved to be a costly choice for Chin. "One day, I skipped school, took a bus and was planning to jump off a building in Kuala Lumpur," she says. Luckily, she regained her senses in time. Despite the initial hurdles, Chin says that learning about her disorder has provided a large sense of relief. "Sometimes, I do wish that I wasn't 'like this', but the diagnosis has given me an answer to all the questions I have been asking myself all these years," she says. Her family and friends were apprehensive about her disorder though. "My mum was skeptical about the heavy medications I had to take at first. She kept insisting that I go for more 'holistic' alternatives, such as taking fish oil supplements to control my depression instead. "I also had an ex-boyfriend who thought that if I 'worked hard enough' to get rid of it, I wouldn't be bipolar anymore." Over time, Chin says she has learned to accept herself as she is, and feels lucky to have friends who have been understanding about her condition. She will soon begin work as a clerical assistant at a legal firm. She is also a part-time model and was previously a fitness trainer. "I left my previous job because the long hours interfered with my medication. Feeling drowsy while travelling late on public transport cannot possibly be safe. "That's why I opted for a nine-to-six job. I also wanted to have more spare time for my hobbies, which include writing and making corsets," she says. Related Stories: |
| Posted: 08 Jun 2013 04:49 PM PDT DOCTORS usually diagnose mental disorders using guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM). According to the DSM, there are four basic types of bipolar disorder: Bipolar I Disorder Bipolar Type I is the most common form of the illness, and is mainly characterised by manic, or mixed manic-and-depressive episodes, that could last up to seven days or more. These manic symptoms are sometimes so severe, the person may need immediate medical care. Usually, the person also has depressive episodes that could last at least two weeks. The symptoms of mania or depression are a major change from the person's normal behaviour. Bipolar II Disorder Bipolar Type II is characterised by a pattern of predominantly major depressive symptoms, with occasional episodes of hypomania. Symptoms usually last for at least four days. However, there are no full-blown manic or mixed manic-and-depressive episodes. Bipolar Disorder Not Otherwise Specified (BP-NOS) BP-NOS is diagnosed when a person has symptoms of bipolar disorder that do not meet the diagnostic criteria for either Bipolar I or II. These symptoms may not last long enough, or a person may have too few symptoms to be diagnosed with Bipolar I or II. However, the person exhibits symptoms that are clearly out of the normal range of his or her usual behaviour. Cyclothymic Disorder, or Cyclothymia This is a mild form of bipolar disorder. People who are diagnosed with cyclothymia experience episodes of hypomania that shift back and forth between these episodes and mild depression, lasting at least two years. However, these symptoms do not meet the diagnostic requirements for any other type of bipolar disorder listed above. Additionally, some people may be diagnosed with rapid-cycling bipolar disorder. This occurs when a person experiences four or more episodes of major depression, mania, hypomania or mixed symptoms within a 12-month period. A person with rapid-cycling bipolar disorder may experience more than one episode in a week, or even within a day. This form of bipolar disorder typically affects more women than men, and there has been evidence that it may be more common in people who experience their first episode at a younger age. Related Stories: |
| Posted: 08 Jun 2013 04:51 PM PDT The World Health Organisation urges action against obesity as poor nations get fatter. ALARMED at expanding waistlines around the world, the United Nation's health agency has urged countries to get serious about reining in a ballooning obesity crisis, proposing an action plan that includes taxing unhealthy snacks and rules against marketing junk food to children. Once considered only a problem in high-income countries like the United States, where nearly 70% of the adult population is overweight, obesity is now growing fastest in developing nations in Africa and Latin America, according to the World Health Organisation (WHO). As the urgency to tackle the crisis grows, member countries of the UN body late on Monday adopted a 2013-2020 action plan to fight against diseases like cardiovascular illness, cancer and chronic diabetes. "The cost of inaction far outweighs the cost of taking action," the body said. The plan, which targets risky lifestyle choices such as smoking, alcohol consumption and an unhealthy diet, includes a goal to halt the rise in global obesity levels by 2020. "The fight against obesity is... one of the most important factors in fighting non-communicable diseases," Francesco Branca, WHO's head of nutrition for health and development, told reporters in Geneva, Switzerland. Obesity levels nearly doubled between 1980 and 2008, when at least one in three adults worldwide was overweight and around one in 10 was considered obese, according to the WHO. At least 2.8 million adults die each year as a result of being overweight or obese, not counting the large percentages of diabetes, heart disease and cancer cases attributable to overweight, according to the UN agency's numbers. The world's fattest country is the tiny South Pacific island nation of Nauru, where 71% of the population is considered obese, WHO figures show. Targeting the young The newly adopted plan "is extremely important in addressing one of the most devastating health crises of our time", said John Stewart of the watchdog Corporate Accountability International, describing obesity as "an epidemic". Since foods high in fat, sugar and salt are often cheaper than healthier alternatives, the battle against the bulge is increasingly spreading to poorer nations, observers say. "In many high-income countries the problem is levelling off, but the worst problems we see are in low- and middle-income countries where the rate of obesity... is increasing at a very fast pace," Godfrey Xuereb, a WHO expert on the issue, said. The new WHO plan calls for a range of measures to stymie obesity's upward trend, including urging food and beverage companies to cut levels of salt and sugar in their products, replace saturated and trans-fats with unsaturated fats, and reduce portion sizes. And in a world where more than 40 million children under the age of five are overweight, it also calls on countries to strictly control the marketing of unhealthy foods and drinks to children. Taking on marketing aimed at youngsters is "incredibly important", Stewart said, insisting that food and beverage corporations for too long have been "taking advantage of children's inherent vulnerabilities by marketing them unhealthy food that makes them sick". The industry itself has welcomed most of the WHO proposals, claiming it had already made strides both in "reformulating" existing products to make them healthier and in voluntarily reining in the advertising of unhealthy foods and drinks to youngsters. The recommended actions "are ones we support and have been implementing on a voluntary basis since 2004", said Jane Reid of the International Food and Beverage Alliance, which represents the world's largest food and drink corporations, including Coca-Cola, McDonald's and Nestlé. The organisation, which maintains that voluntary action and self-regulation by companies is the answer to the obesity problem, was less supportive of the WHO plan's call for countries to consider taxing unhealthy foods and subsidising healthier choices in a bid to impact eating habits. "Fiscal measures aimed specifically to change behaviour are complex to design and enforce," Reid wrote in an email to AFP, adding there was little proof such taxes would help improve eating habits. And, she maintained, a food tax "would be felt hardest by low-income families", who might "compensate for unanticipated budget shortfalls by buying more energy-dense, lower-nutrient foods". Stewart meanwhile cautioned against giving the industry players widely blamed for the obesity epidemic too much say in how to solve the problem. "What we really need are statutory regulations that are binding and make a real impact on kids' health," he said. – AFP |
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