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Suggest Treatment For A Person Suffering From Bipolar Disorder
Question: Hi, I have a sibling, male, 46 years old, caucasian, irish ancestry, who suffers from the following combination of conditions:
- Anxiety (excessive in certain situations, ie: as a passenger in a car )
- Depression (Inactivity, lack of interests, social withdrawal, extreme low self esteem)
- Extremely poor eating habits (have led to obesity; he is 5'-7" tall, but + 215 lbs)
- Prone to episodes of paranoia and delusions (typically related to interpersonal issues)
- Prone to moments of intense RAGE leading to personal confrontations that include excessive verbal abuse, and at times that escalate into physical abuse toward others
Our family has a history of anxiety and depression, so I understand the first three conditions very well. However, it is the following two, paranoia and rage, that have me confused. Some seem to believe he is 'bi-polar,' but I am not convinced; although he experiences the very low, I have not observed him in a state of elevated activity or hyper-activity that represents the other end of the spectrum of that disorder. Could it be that the 'high' polarity is manifested as the 'rage' that afflicts him, or could it be that he suffers from a disorder, or multiple disorders, beyond the anxiety and depression?
- Anxiety (excessive in certain situations, ie: as a passenger in a car )
- Depression (Inactivity, lack of interests, social withdrawal, extreme low self esteem)
- Extremely poor eating habits (have led to obesity; he is 5'-7" tall, but + 215 lbs)
- Prone to episodes of paranoia and delusions (typically related to interpersonal issues)
- Prone to moments of intense RAGE leading to personal confrontations that include excessive verbal abuse, and at times that escalate into physical abuse toward others
Our family has a history of anxiety and depression, so I understand the first three conditions very well. However, it is the following two, paranoia and rage, that have me confused. Some seem to believe he is 'bi-polar,' but I am not convinced; although he experiences the very low, I have not observed him in a state of elevated activity or hyper-activity that represents the other end of the spectrum of that disorder. Could it be that the 'high' polarity is manifested as the 'rage' that afflicts him, or could it be that he suffers from a disorder, or multiple disorders, beyond the anxiety and depression?
Brief Answer:
"Bipolar disorder" ? 'agitated depression'
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Description of symptoms is suggestive of "Bipolar disorder"as evident by mood swings of depression (Inactivity, lack of interests, social withdrawal, extreme low self esteem) and increased psychomotor activity/irritable
mood ( intense rage,excessive verbal abuse,physical aggression).
Swings in mood from mania (or hypomania) to depression is characteristic of 'Bipolar disorder'.
In severe mania, patients may experience delusions and paranoid thinking.
Bipolar disorder may present with a mixture of psychomotor activation with anxiety.
However the mood fluctuations are chronic and should be present for at least 2 years before the diagnosis is made.
How long he is having these features?
Is there any history of a substance (e.g. drug abuse, a medication, or other treatment) or presence of any other medical condition?
Alternatively he might be having 'agitated depression'.
Episodes of paranoia and delusions distinguishes Mood Disorders from Generalized Anxiety Disorder(GAD).
Mood disorders can be treated and the recurrent nature of bipolar mood disorder necessitates
maintenance treatment. You need to consult a Psychiatrist.
Compliance is frequently an issue and often requires enlistment and education of concerned
family members. Efforts to identify and modify psychosocial factors that may trigger episodes are important, as is an emphasis on lifestyle regularity.
Weight gain which may be due to overindulgence in eating as an outlet for depression is to be avoided by counselling and diet control.
Close monitoring/restraining or confinement may be required during the phase of over-activity to avoid physical harm to others.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
"Bipolar disorder" ? 'agitated depression'
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Description of symptoms is suggestive of "Bipolar disorder"as evident by mood swings of depression (Inactivity, lack of interests, social withdrawal, extreme low self esteem) and increased psychomotor activity/irritable
mood ( intense rage,excessive verbal abuse,physical aggression).
Swings in mood from mania (or hypomania) to depression is characteristic of 'Bipolar disorder'.
In severe mania, patients may experience delusions and paranoid thinking.
Bipolar disorder may present with a mixture of psychomotor activation with anxiety.
However the mood fluctuations are chronic and should be present for at least 2 years before the diagnosis is made.
How long he is having these features?
Is there any history of a substance (e.g. drug abuse, a medication, or other treatment) or presence of any other medical condition?
Alternatively he might be having 'agitated depression'.
Episodes of paranoia and delusions distinguishes Mood Disorders from Generalized Anxiety Disorder(GAD).
Mood disorders can be treated and the recurrent nature of bipolar mood disorder necessitates
maintenance treatment. You need to consult a Psychiatrist.
Compliance is frequently an issue and often requires enlistment and education of concerned
family members. Efforts to identify and modify psychosocial factors that may trigger episodes are important, as is an emphasis on lifestyle regularity.
Weight gain which may be due to overindulgence in eating as an outlet for depression is to be avoided by counselling and diet control.
Close monitoring/restraining or confinement may be required during the phase of over-activity to avoid physical harm to others.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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