The Link Between Intelligence and Mental Health

genius and madness

High I.Q. and Mental Stability

Geniuses and highly creative people with high I.Q.s have always been linked to mental health problems such as depression, bipolar disorder, and schizophrenia.  Often we may picture a brainy computer geek who may be a programming whiz but prone to social awkwardness and withdrawals.  We admire masterpieces and learn of its gifted creators who oscillate between mania and depression.  Indeed, in the pantheon of great achievers, there are a number of personalities such as Beethoven, Virginia Woolf, Ernest Hemingway, Buzz Aldrin, and Jackson Pollock who have struggled with mental health issues during their lifetimes.  Even Aristotle was quoted to have said, “There is no genius without having a touch of madness. “

Some individuals with above average to superior I.Q.s commonly tend to exhibit symptoms from these three mental illnesses:  bipolar disorder, schizophrenia, and obsessive-compulsive disorder.  There are about 20-30 studies that support the “tortured genius syndrome,” the strong link between genius and madness.  One decade-long study on a 700,000 Swedish adolescents turned up surprising evidence, which was published in 2010.  Those teenagers that excelled in intelligence tests were four times more likely to have developed bipolar disorder.  Another study on children gifted with superior I.Q. above 130 showed that 65% of these kids had some sort of major depressive disorder.

Why is genius or superior intelligence linked to mental and emotional instability?  Brilliance instils the ability of being able to construct an inner world to fit their views and preferences.  However, when that worldview clashes with reality, it often leaves the person lost and unable to cope well.  Moreover, highly intelligent people are more sensitive to stimuli than average individuals.  Ellyn Saks, a University of Southern California mental health professor reiterates that “people with psychosis do not filter stimuli as well as others without the disorder, meaning that they’re able to ponder contradictory ideas simultaneously and gain insight into loose associations that the general unconscious brain wouldn’t even consider worthy of sending to consciousness.”

A Swedish study also found that many people diagnosed with schizophrenia or bipolar disorder are or have been in highly creative jobs that demand highly functioning cognitive skills and artistic cleverness in levels not usually employed by the average or normal individuals.  This is why artists seem to be functioning at a perspective so different from non-artistic or creative people.

Highly intelligent individuals have the ability to see novel patterns and innovative connections of things which the average intellect may not discern.  This ability also makes a very creative and smart individual, very vulnerable to feeling strong emotions, hallmarks of bipolar disorder.

It is however not entirely accurate to stereotype intelligent people as mentally unstable individuals.  Not all people with very high I.Q.s are unhealthy, mentally; but, there is a percentage of the gifted population that have developed depression and other major mental disorders because of their intellectual gifts.

As high I.Q. can be factor of developing mental illness, low or below average I.Q. can be contributory element as well.  Studies have also pointed out a direct correlation between low intelligence and depression.

Low I.Q. and Depression

Low I.Q. or a low intelligence quotient means lower than average cognitive abilities and problem-solving skills.  People with a 70-79 intelligence rating (below average I.Q. rating) have been surveyed by the Adult Psychiatric Morbidity Survey in England to be generally less happy than those with average or high I.Q.  People with less than average intellectual abilities often have difficulties catching up in school, getting hired in good paying jobs, earning sufficiently for their families, and earning peer respect and regard.  Because of these inabilities, people with below average I.Q.s tend to have poor relationships, low income, scant employment opportunities, and a lot of personal frustration.  These conditions alone are enough to drive a person into clinical depression.

 

Scientists are still unsure about the precise mechanisms on how intelligence affects mental health.  Perhaps there will come a time in which formulated cures would be available to help people balance their intelligence, high or low, against their propensity to develop mental illness.  Until such time, people need to understand that people with low or high I.Q.s may carry the extra burden of ill mental health and therefore should be treated with more understanding.

Seasonal Affective Disorder (SAD)

winter blues

Seasonal Affective Disorder, properly appellated with an acronym SAD, is a type of depression that occurs at the same season each year.  Winter is the most common time for SAD and that is why this emotional phenomenon is also known as winter depression or the winter blues.

The symptoms of depression usually begin sometime during late autumn when days become shorter and continue toward winter.  This low mood takes an upturn when  spring and summer come along.  Unfortunately, SAD may return the next autumn or winter season to begin its cycle.

Causes of SAD

Scientists are not sure what causes Seasonal Affective Disorder but the theory is that the lack of sunlight during autumn and winter’s shortened periods may have some effect on the brain’s hypothalamus which in turn has something to do with:

  • upsetting one’s circadian rhythm which throws your sleep-wake pattern off-kilter
  • lowering the levels of serotonin in the brain.  Serotonin is a hormone that affects one’s mood, sleep, and appetite
  • increasing the production of the hormone, melatonin, which makes one more drowsy than usual

Symptoms of SAD

SAD is a subtype of major depression, the only difference is that it comes and goes with the trigger season.  The symptoms can range from mild to severe, in which case the symptoms may hamper the person’s day-to-day activities.  Symptoms of SAD include:

  • chronic low mood or sadness
  • irritability
  • feelings of hopelessness, despair, guilt
  • plunging self-esteem
  • anxiety
  • lethargy and drowsiness during daytime
  • disinterest in day-to-day activities or even hobbies.  A person with SAD may suddenly take no pleasure from his usual interests
  • sleeping longer hours and still feeling exhausted upon waking
  • insomnia
  • carbohydrate cravings
  • weight gain
  • weakened immune system

Who are Most at Risk?

There seems to be more women patients of SAD than there are men.  People who live far from the equatorial region which have shorter daylight hours are prone to the condition.  It is however interesting to know that Iceland has a very low incidence of seasonal affective disorder.  The theory is that Icelanders eat a voluminous of fish, about 90 kg.  per year, compared to Canadians who average only 24 kg. per year and have a high incidence level of SAD.

SAD is also hereditary so people with the genes may develop the condition.

Additionally, age is a factor for susceptibility as well.  People between the ages of 15-55 are at higher risk of developing SAD than other age groups.

Treatment for SAD

Different treatment strategies are available for Seasonal Affective Disorder.  These are:light therapy

  • Light therapy – a light box is employed for the patient’s needed exposure to light.  This special lamp is made of fluorescent lights that are brighter than indoor bulbs but not as bright as
    natural sunlight.  UV lights, tanning lights, and heat lamps cannot be used to substitute for light boxes.
  • Cognitive Behavioural Therapy (CBT) or other talking therapies.  Counselling can help one understand SAD, manage its symptoms, and help prevent future recurrences.
  • Lifestyle modifications – implementing an exercise regimen, changes in diet, adjustment in sleeping schedules, and the like to maximise exposure to sunlight and manage stress
  • Antidepressant Medication – these include SSRIs such as Paxil and Zoloft or bupropion (Wellbutrin) and venlafaxine (Effexor).
  • Vitamin D supplementation – Another theory of cause for SAD is that the sufferer may not have enough Vitamin D because of insufficient absorption of Ultraviolet-B by the skin.  In this case, Vitamin D supplements may then be included as part of the therapy.
  • Negative air ionization — Releasing a sufficient density of negatively charged particles into the air while a patient is asleep has led to almost a 50% improvement in the condition.

Depression: When Sadness Becomes More Than Itself

depression

Clinical depression is a growing concern in the Western World.  It has become a common debilitating mental disease with one in five persons in the U.K. having had depression at some point in their lives.  It hits all age groups, income levels, and communities.  Its growth is accelerating to the point that it could become one of the most incapacitating conditions in the developed world by 2020, second only to heart disease.

Normal bouts of sadness are natural occurrences.  Death of a loved one, for instance, may cause one, grief.  In a mentally healthy individual, the intensity may last for a short time and taper off eventually to a steady acceptance.  Grief that spirals into clinical depression however will stay with the individual for the long haul and could disrupt his daily functions.

Depression Is a Real Illness

A person with a depressive disorder is truly sick.  Much like a physical illness in which an organ or its system is weakened, so it is with depression of which its compromised organ is the brain.  Diabetes, for instance, is a physical disease that involves the impaired function of the metabolic system to handle the hormone, insulin.  Likewise, the condition of depression involves an impairment of the nervous system manifesting with the imbalance of certain brain chemicals; low production of neurons and nerve cell connections; and impaired nerve cell growth and nerve circuit functions.

Many factors can trigger depression.  Life events can traumatize people into a depression.  Our biological makeup such as genetics and brain chemistry are major factors as well.  Serious medical illnesses such as cancer and Parkinson’s disease can also lead a person into a depressive state.  Some medications used to treat physical illnesses may have depression as its side effect.

The State of Depression Varies for Each Person

The degree, frequency, and length of depressive symptoms are as individualized as the person afflicted by it.  Symptoms vary from person to person with the variety dependent on age, gender, culture, and other factors.  Some people feel only a few symptoms while others are burdened by many.  In addition, there are people, especially children and adolescents, who do not even recognize the symptoms of depression.  Men feel it differently than women and have different coping strategies as well.

Symptoms of Depression

The tell-tale signs of depression include but are not limited to the following:

  • Sad or anxious mood that does not go away for a long time
  • Chronic empty feeling
  • Thoughts of suicide; attempts at suicide
  • Increased pessimism; hopelessness
  • Restlessness
  • Irritability
  • Insomnia or oversleeping
  • Decreased cognitive functions.  Depressed person has trouble remembering or making sound judgements or decisions.
  • Physical aches, pains, and other symptoms, such as headaches, palpitations, and stomach aches which do not test positive for any physical illness
  • Feelings of very low self-worth, inferiority, and guilt
  • Chronic reduced energy levels; exhaustion; fatigue
  • Fast weight changes and appetite changes
  • Loss of interest in things previously enjoyed; loss of interest in anything and anyone
  • Markedly reduced libido

Some people may not be aware of their depressed state because symptoms can come gradually to them.  They may have kept themselves busy to avoid feeling sad or hurt.  Eventually the strain does catch up to them and they start to exhibit some of the above symptoms.  Physical pains however without any physical cause may also signal that a person has a psychological issue.

Treatment for Depression

The good news is that depression, even severe cases, can be treated; however, diagnosis and treatment is best at the early stages where recovery is faster.  When you suspect yourself of being depressed, seek professional help as soon as possible.  Expect treatment to include talking therapies with your psychiatrist.  Antidepressant medication may also be prescribed if your situation warrants it.

What You Can Do to Help Yourself

Aside from seeking professional help, there are a number of ways by which you can help yourself feel better.  First thing you can do is take charge of your physical health.  As the mind and body are tied together, whatever affects the body affects the mind and vice-versa.  You can start by:

  • Eating a well balanced diet everyday
  • Beginning and sticking seriously to an exercise program
  • Avoid alcohol, caffeine, smoking, and illicit drugs.  These substances just worsen depression.
  • Fixing your sleeping patterns.  Getting a good night’s rest everyday is crucial to your recovery.

Your emotional state needs nurturing as well:

  • Find a trusted friend or family member you can talk to about your issues and emotional condition.
  • Approach depression with a plan.  Write down what you think is causing the problem and the positive ways you can fight your negative state.
  • Join a support group of people with the same problem.
  • Avoid making any major life decisions until you can handle big changes.
  • Avoid piling up more work to perpetually take your mind away from your issue.  You need to set aside time to go over the problem so you can eventually come to terms with it.

stronger than depression

Learn all you can about depression in order to understand the condition better.  The road to recovery may be a shorter path if you simply work positively toward achieving that healing goal.

Hypomania and Mania:  What is the Difference?

Hypomania, mania, and depression are all symptoms of bipolar disorder.  A bipolar disorder does not necessarily entail extreme emotional swings from mania to depression.  There is a moderate emotional and mental state in between termed hypomania.

What is Hypomania?

bipolar_type2

Hypomania is felt as a much lesser degree of mania.  It is a state in which a person has all the symptoms of mania but with less the severity and the impairment that mania usually creates.  A hypomanic person is on a “high” which puts him in a condition in which he feels more self-assured, energetic, expansively generous, sensual, and the like.  On the flip side, hypomania can also bring on irritability, distracted thinking, racing thoughts, anger, and a dissociative feeling from the world.

Although the positive side of hypomania sounds like a good thing (and indeed it does feel great), it nevertheless will inevitably dip into depression or escalate into mania if a hypomanic person’s bipolar disorder remains undiagnosed.

Just as mania and depression are mental states that may last for some time, hypomania can last anywhere from weeks to years.  Since the hypomanic condition does not really impair a person’s ability to function, hypomania may not be easily recognized enough to require a serious diagnosis or check.

Hypomania is more common in people with Bipolar II disorder.  Bipolar II differs from Bipolar I in the severity of the upswing moods.  Bipolar II patients do not experience extreme “elation” or “euphoria” typifying mania which often debilitates normal functioning, usually to a dangerous degree as to require hospitalization.  Instead, they experience the dampened version of mania in which recognizable symptoms are present but do not pose as much impairments to judgement as mania does with dangerous behaviour that is highly destructive to one’s self and others.

What is Mania?

manic episode

Mania is the state in which symptoms such as recklessness, irritability and aggression, super-inflated self-esteem and self-importance, and heightened senses are manifested in such extreme degree that resulting behaviour poses a significant threat to the bipolar patient’s safety and that of others.  A manic patient’s symptoms debilitate him and usually impair normal functioning and reasoning so much so that sometimes, hospitalization may be required.  A person who has impulsively thrown all his life’s savings on a sports car he can ill afford may be having a manic episode.

Symptoms of Hypomania and Mania

Both hypomanic and manic periods exhibit more or less these same symptoms:

  • Very energetic
  • Increased self confidence
  • Increased aggression and irritability
  • Feelings of intense happiness or “high”
  • Increased sense of entitlement or self-importance
  • Reduced concentration or focus; high distractibility
  • Decreased inhibitions
  • Increased sexual urges
  • Thoughts and ideas coming in fast
  • Increased sociability and social congress
  • Indulgence in daring behaviour, sometimes bordering on recklessness
  • Sharper sense of smell, taste, sight, and other senses

The Difference

While hypomania and mania share the same symptoms, the major difference between them is degree of severity.  Where mania takes these symptoms to a feverish pitch, hypomania simply coasts with these so that hypomanics actually feel great and are even grateful for this state as a relief from depression.  To illustrate, where a woman in a manic state may damagingly splurge on 20 handbags, a hypomanic one may still exhibit some reasonable financial judgement by buying only five handbags at her shopping spree.

If hypomania just weren’t part of a disorder, a majority of us would actually enjoy being in this state of mind.  With more energy and an increased feeling of purpose, hypomania can put us on a creative and productive high.  It may come with a certain degree of crankiness and feelings of disconnectedness; yet for people with bipolar disorder, hypomania is a much better condition to be in than having to ride depression and mania.

Hypomania however can morph into a full blown manic period or crash into a depression; so treatment must be sought to help to stave off the other undesirable mental states.

Treatment

The trouble with getting treatment for people in a hypomanic period is that they feel too good to believe they are sick enough to need help.  Professional help, however, is vital to stabilize the extremities of mental states of people with bipolar disorder.

There are several approaches to treating hypomania and mania.  Talking therapies such as Cognitive Behavioural Therapy (CBT), psychotherapy, and Mindful-Based Cognitive Therapy (MCBT) form one approach. Medications to help prevent a hypomanic’s from sliding into mania or depression is another.   Such drugs which should be prescribed by a psychiatrist, not just a GP, are antipsychotics, common of which are:

  • risperidone (Risperdal).
  • olanzapine (Zyprexa)
  • quetiapine (Seroquel)

Bear in mind that medications, prescribed or otherwise, usually carry side effects about which one must always discuss with their psychiatrist.

Electroconvulsive Therapy (ECT)

 

What is Electroconvulsive Therapy?

Electroconvulsive Therapy or ECT is a form of medical therapy for people with severe mental illness who do not respond to counselling, medication, or other forms of treatment.  The therapy involves sending carefully controlled electric impulses to the brain to stimulate a brief epileptic fit with the goal of relieving extreme depression, mania, or catatonia.  The electric stimuli seem to provoke changes in brain chemistry which help alleviate the patient’s mental symptoms.

When ECT is administered, the patient is given a muscle relaxant and put to sleep with anaesthesia.  Electrodes are placed on the head after which a finely channelled electric current is sent to stimulate the brain.  These impulses trigger slight seizure-like movements in the sleeping patient.  The session is painless and lasts only several minutes after which the patient awakes with no memory of the treatment or the events leading up to it.  He may also wake up disoriented but this will last only for a while.

Improvements in patients are noticed usually after the first three sessions and major improvements are palpable after six.  These improvements could manifest as better sleeping patterns, less lethargy, or better appetites.

Is Electroconvulsive Therapy Dangerous?

ECT today is a generally safe method as it involves no pain or bad shocks.  There is a side effect though which involves memory impairment lasting about several weeks after the treatment.  Although memory is usually resolved in the short-term, there are rare cases in which patients do lose personal and skill memories and have difficulty processing new information.

In cases of extreme depression, the benefits however may outweigh the risks of a memory disadvantage especially in patients whose need for some symptom alleviation are urgent.  For instance, a mother with severe postnatal depression may require the symptom alleviation ECT may provide, when other therapies have failed to, in order to for her to adequately nurture her infant.

ECT has gotten a bad reputation because of the errors done during its early developmental phase.  ECT’s stigma stemmed from misuse of equipment, inadequate information and staff training, and improper treatment administration.  These errors had proved to be injurious to some patients who were administered with high electric charges without anaesthesia causing memory loss, fractured bones, and other serious injuries.  Electroconvulsive therapy has evolved to today’s relatively safe administration of finely controlled charges, anaesthesia, and strict supervision.

electroconvulsive-therapy-adverse effects

Who are Candidates for ECT?

Patients who merit a prescription for electroconvulsive therapy may be:

  • suicidal because of severe depressive symptoms.  About 80% of these cases report a mood improvement with ECT.
  • unresponsive to drugs or talking therapies
  • in a severe manic episode lasting for a long period of time
  • catatonic
  • those that have a history of responding well to ECT therapy in the past
  • aggressive or extremely agitated because of dementia
  • pregnant and cannot take medications
  • intolerant of the side effects of drugs
  • mothers with severe postnatal depression.  As electroconvulsive therapy works more quickly than counselling or medication, it helps cut down the time that the mother spends away from infant nurture.
  • nutritionally compromised because patient refuses food or sustenance owing to extreme depression
  • severely psychotic or schizophrenic

Is ECT Effective?

There is a huge body of evidence now that ECT is an invaluable treatment tool for those with acute depression and psychosis.  Although electroconvulsive therapy can go a long way in treating patients, this must be followed up with talking therapies and medication to avert recurrence of extreme symptoms.

Types of Electroconvulsive Therapies

There are two types of ECT administration which is differentiated by the location of electrode placement:

  • Right Unilateral Treatment

Right unilateral treatment involves the placement of one electrode at the crown of the head and the other, at the right temple.  The placement produces milder stimuli and therefore has lower risks of side effects concerning memory.  The patient response rate, however, is also slower compared to bilateral ECT, the other type of treatment.  If patients do not respond to right unilateral treatment, they may be switched to the stronger bilateral one.

  • Bilateral Treatment

Bilateral treatment is a full-on type that requires electrodes to be placed on both the left and right temples of the patient’s head.  In this case, the electric stimuli are much stronger, but still controlled, and therefore more effective in resistant patients.  Bilateral ECT however carries more risk of some memory loss.

Bilateral ECT

The patient and doctor should work out which treatment type is best.  This usually involves taking into consideration the patient’s medical and psychiatric history, severity of symptoms, and personal concerns as well.

 

 

Major Mental Disorders (MMD)

The acronym MMD stands for Major Mental Disorder of which there are five broad categories:  anxiety disorder, mood disorder, psychotic disorder, dementia, and eating disorder.  These mental illnesses are not a result of one cause but rather an interplay of a variety of factors which include environment, genetics, and lifestyle.

mmd

Anxiety Disorders

An anxiety disorder is positive in a diagnosis if the patient has any of these three symptoms:

  • illogical or inappropriate fearful and anxious response to objects, events, people, and situations
  • inability to control these fear responses
  • having no control over anxious feelings so much so that it disrupts normal functioning

Anxiety disorders are specifically manifested by these mental sub-illnesses:

  • Generalized Anxiety Disorder (GAD) — GAD is characterized by excessive or chronic worrying about one or many areas of life such as family, income, career, friends, and school, among other things.  The fears may often be unfounded and skew off tangent; if there is some basis, the amount of worrying is excessively way out of proportion to the real situation.  A person afflicted with GAD may find himself unable to go about his life normally because of excessive dread.
  • Panic Disorder — characterized by feelings of terror and fear which may or may not occur suddenly.  These are repeated panic attacks accompanied by physical symptoms such as rapid heartbeat, chest pain, sweat, tremors, and disorientation.
  • Phobias — intense fear, often irrational, of something that actually does not pose any immediate or even potential danger.  Ex.  fear of enclosed spaces (claustrophobia); fear of crowds (agoraphobia);  fear of darkness (achluophobia)
  • Post-Traumatic Stress Disorder (PTSD)  — often characterized by emotional numbness and recurring vivid memories of traumatic incidents.

 

Psychotic Disorders

Psychotic disorders are known as a set of mental illnesses that involve a distortion of reality.  To someone plagued with psychosis, delusions (assignations of unreal meaning to normal and innocent events) and hallucinations (experiences of non-existent things that are not connected to any genuine sources such as hearing voices) are perceived to be as real as normal people see things to be.

Mental maladies under psychotic disorders are:

  • Schizophrenia — a serious mental disorder that is marked by distorted thought patterns, hallucinations, delusions, and paranoia, all of which lead the individual toward strange, irrational behaviours.  Schizophrenics may hear voices not attached to any source or may believe in delusions such as being a real princess or warrior.
  • Schizo-affective Disorder — a variant of schizophrenia mixed with mood disorders such as mania or depression.

Mood Disorders

Mood disorders are also known as affective disorders.  Persistent feelings of sadness or abnormal elation over a certain period of time may qualify under this mental malady.  Extreme emotional fluctuations also characterize this category under which these illnesses belong:

  • Bipolar Disorder — a disorder identified by extreme changes in mood from mania (“high” mood state) to depression (“low” mood state).     major mental disorder
  • Clinical Depression — surpasses the normal feelings of sadness and puts one in a chronic state of pessimism, hopelessness, emptiness, worthlessness, anxiousness, and other severely low mood situations.  Patients cannot just bounce back from their low moods, unlike unafflicted individuals who have the abilities to cope with abysmal feelings.  Clinical depression has been known to be the cause of some suicide cases.
  • Dysthymic Disorder — an illness marked with constant low-grade depression for more than two years.  Symptoms include low energy, feelings of hopelessness and low self-esteem, sleep and appetite problems, poor focus, and indecisiveness.

The danger to these depressive mood disorders is that the risk for suicide among sufferers is high.

Dementias

Dementia refers to a slew of mental health problems symptomised by rapidly declining memory and other cognitive functions.  Dementia is diagnosed when the one or more of the following are impaired:

  • Memory
  • Ability to concentrate or pay attention
  • Visual perception
  • Language and communication abilities
  • Judgement and reasoning

The cause to all these impairments are brain cell damages which hinder these cells from communicating adequately with each other.  Alzheimer’s disease makes up a large percentage of dementia cases, followed closely by vascular dementia and dementia due to medical problems such as Parkinson’s and Huntington’s disease.  Toxic substances such as drugs, alcohol, mercury, lead, etc. can contribute to the development of dementia as well.

Eating Disorders

Eating disorders involve extreme thoughts, attitudes, and behaviour towards food and weight.  These disorders manifest as either of these issues:

  • Anorexia Nervosa  — a condition that is indicated by an overwhelming and all-consuming dread of being fat.  Anorexics have a distorted body image and obsessive thoughts about food, calories, and weight on which they impose severe restrictions.  For sufferers, one can never be too thin.  Anorexia is dangerous because the condition can cause death from suicide, cardiac arrest, starvation, and other medical complications.
  • Bulimia Nervosa —  an eating disorder in which the sufferer chronically binge eats and then frantically purges the calories consumed as an attempt to lose weight or not gain the pounds from overeating.  Bulimics, like anorexics, have an obsession with food; only they overeat with the thought that they can purge their “sins” later.  A person with bulimia can consume between 3,000 – 5,000 calories in a short hour.  In the next, he often guiltily purges what he has consumed by inducing vomiting, applying enemas, exercising voluminously, or going on crash diets.  The constant binge-and-purge cycle wreaks havoc on the metabolic system, forcing bulimics to gain weight over time.
  • Binge Eating Disorder — chronic overeating without any purging involved.  The cycle moves around binge eating, feeling guilty and ashamed for gluttony,  then emotional eating again to assuage the guilt.  Binge eaters are usually obese and may suffer from hypertension, cardiovascular disease, depression, and anxiety.

 

These major mental illnesses are treatable but need the help of professional mental health practitioners.  The stigma associated with mental maladies however is the main cause of why  people avoid treatment or fail to recognize that they need treatment.  More information and education about mental illnesses should be provided so that early stages may be recognized and tended to correctly.

Antipsychotic Medication

Antipsychotic medications are prescribed drugs used to treat people with some form psychosis.  Psychosis is an umbrella of mental disorders that are characterized by radically impaired emotions and thought patterns, so convoluted that the afflicted person actually loses touch with reality.  These mental disorders include bipolar disorder, borderline personality disorder (BPD), schizophrenia, and paranoia, all of which include the psychotic marks of delusions and hallucinations in their roster of symptoms.

ANTIPSYCHOTIC-DRUGS

How Do Antipsychotic Drugs Work?

Antipsychotic drugs target the neurotransmitters in the brain which are dopamine, noradrenaline, serotonin, and acetylcholine.  These brain chemicals have the main hand in regulating moods, emotions, and behaviour.  Of all these neurotransmitters, dopamine is the most important target.

By changing the effect these neurotransmitters currently have on an individual’s brain, antipsychotic drugs can suppress, reduce, or even prevent the onslaught of:

  • hallucinations (ex. hearing voices)
  • delusions (perceiving things, situations, and events not based on reality.  Ex.  A delusional person may firmly believe that the restaurant waitresses are laughing at him because they know his spouse has been cheating with someone else…even if they do not know him.)
  • Extreme mood swings
  • Thought disorders

What antipsychotics cannot do is cure a patient of his mental disorder.  These drugs can only act on the symptoms not on the entire illness.

Types and Side Effects

Antipsychotic medication was introduced in the 1950s and has to a large extent been successful in alleviating hallucinatory and delusional symptoms in psychotic patients so much so that these individuals have been able to lead a relatively normal life.  Although a boon to the mental health field at that time, early antipsychotics (termed typical) possessed its fair share of mild to severe side effects which manifested as:

  • muscle stiffness
  • tremors and spasms
  • restlessness
  • increased skin sensitivity to sunlight
  • low blood pressure
  • liver poisoning; so with some typical medications, liver tests may be mandatory
  • Parkinson’s disease-like symptoms
  • gastrointestinal disturbance
  • weight loss
  • skin rashes, ranging from mild to serious cases which may develop into Stevens-Johnson syndrome, a life-threatening illness  (rare side effect)
  • spontaneous ejaculation
  • tinnitus (ringing in the ears)
  • vertigo
  • drooling
  • excessive thirst

These typical drugs are still prescribed today because there are patients who tolerate these better than the newer atypical drugs.

Atypical antipsychotic drugs are considered the newbies in its category although the first, clozapine (Clorazil) was formulated over twenty years ago in 1990.  Atypicals have fewer side effects thanantipsychotic meds the older typical antipsychotics and are thus more often prescribed as a first-line treatment.

Most of the atypical drugs were developed for the treatment of schizophrenia and mania.  These are contraindicated for people with cardiovascular problems or with a history of epilepsy or Parkinson’s disease.  Many of these drugs such as risperidone and olanzapine should not be prescribed to older people as they increase the risk for stroke.  Atypical drugs may also compromise cognitive skills such as driving or operating heavy machinery.

The most noteworthy side effect of atypical antipsychotics is weight gain, increased appetite, and other metabolic issues.  Other side effects are:

  • dizziness
  • extreme sleepiness
  • low blood pressure when standing
  • fainting
  • rapid heartbeat (tachychardia); slow heartbeat, irregular heartbeat
  • tardive dyskinesia — uncontrollable movements of the lips, tongue, face, trunk, and limbs.  Usually a side effect of long-term drug use.
  • Parkinsonism
  • insomnia
  • anxiety; restlessness; agitation
  • raised prolactin levels provoking milk production
  • sexual problems
  • seizures
  • indigestion
  • headache
  • lethargy; lack of energy; tiredness
  • drooling
  • impulsive behaviour like gambling (attributable to Aripiprazole)
  • unusual taste sensations
  • numb lips and mouth
  • still muscles
  • raised levels of enzymes in liver
  • loss of menstrual periods
  • blurred vision

Side effects vary from individual to individual.  Other symptoms not on the common list may manifest as well; so, medical monitoring is crucial.

Withdrawing Intake of Antipsychotic Drugs

It is highly inadvisable to suddenly stop taking the prescribed drugs once already under antipsychotic medication.  Doctor’s approval is highly recommended as one has to follow a medical plan for a gradual and slow withdrawal from the drug over a period of several weeks or months.  While there are people who can stop taking their prescriptions without issues, the majority usually experience a recurrence of psychotic symptoms when suddenly going off their medications.

Furthermore, withdrawing from the drug is not a simple matter of gradual decrease of intake.  Situational factors such as timing of circumstances and availability of support from family and friends are crucial to making this huge leap.  Withdrawal can begin when there are no life-changing events or stressful things going on such as moving house, getting a new job, travelling to a new place, etc.  But as people can never be pigeon-holed, there are some patients that do withdrawals well when preoccupied with new things going on in their life.  No matter what type of patient one is, it is important to know that the manner of withdrawing from antipsychotic drugs is crucial because the aim is to avoid relapses.

Understanding Bipolar Disorder

bipolar moods

 

A staggering estimated 51 million adults worldwide suffer from bipolar disorder. China is home to the most bipolar sufferers with 12 million cases compared to Britain’s measly 250,000 patients. Still, bipolar disorders cost the U.K. an estimated £342 million worth of healthcare based on 2009-2010 prices.

In men, this mental disease is prevalent in early adulthood between the ages of 15 and 25 while women often exhibit the symptoms at the later ages between 25 and 30. Somehow, it is rarely found in children less than 10 years of age or in adults over 40 years of age.

What is Bipolar Disorder?

Bipolar Disorder is a mental illness characterized by alternating manic-depressive emotional states. Bipolarity is symptomised by extreme shifts in mood, energy, behaviour, and way of thinking. Normal emotional shifts are usually fleeting and do not generally cause major life disruptions. With bipolar illness, the severe ups and downs in emotions and consequent behaviour negativelybipolar moods impact careers, relationships, personal lives, and school performance.

A person with bipolar illness may feel intensely excited, euphoric, and have the delusion of being able to take on the world for a couple of days or months. These super high moods inadvertently come crashing down in time to a particularly low state of despair, hopelessness, depression, and lack of motivation.

Hypomania, the Manic Episodes

Hypomania is somewhat akin to a drug user’s “high” phase in which an individual feels unrealistically powerful, confident, and so energetic that even his sleeping patterns suffer disruptions. The person in a manic state may feel invincible and behave in ways he would normally avoid. He may splurge and acquire credit card debts, quit his job on impulse, speak volubly about grandiose schemes, be sexually promiscuous, and engage in other high-risk behaviours while being on this temporary emotional high.

It is not easy to spot bipolarity in hypomanic people as these types seem so elated, positive, and generally happy. People in this state hardly believe they can be ill of something much less run to doctors for their happy condition. When the dire consequences of their extreme decisions come crashing down, hypomanic people transition fast into a depressed state in which living day-to-day become a big struggle.

The Depressive State

Coming down hard from an all-time high is one of the worst states a person with a bipolar disorder can find himself in. It is this stage in which feelings of hopelessness, self-doubt, self-loathing, despair, and lethargy assault the individual. He begins to struggle holding down a job; maintaining rapport with colleagues, friends, and family members; dealing with consequences of financial decisions; and the like. Unfortunately, this negative state lasts longer, time making it all the more dangerous for the entertainment of serious thoughts on self-harm and suicide.

Nature of the Mood Swings

A 3d rendering of the classic comedy-tragedy theater masks isolated on white with a clipping path

 

The patterns of mood swings vary greatly among bipolar patients. Some go from mania to depression in a matter of days. Others may go for years without experiencing problems.

Often, most bipolar sufferers stay in the depressive phase more than in their manic state. Some mania may be so mild that the condition can go unnoticed.

There is also such a thing as a mixed episode. This is characterized by a combination of hypomania and depression, or high energy and low moods. A bipolar sufferer in the middle of a mixed episode may be energized and distracted by rapid, changing thoughts while exhibiting anxiety, irritability, and restlessness. This combination mode is particularly lethal as this episode poses a high risk of suicide.

Extreme mood swings affect other parts of a person’s life such as memory, concentration, energy level, judgement, sleep patterns, sex drive, confidence, and motivation. Bipolar disorder has also been linked to other health issues such as substance abuse, alcoholism, cardiovascular disease, diabetes, and high blood pressure.

What Causes Bipolar Disorder?

There is no single cause to this mental illness; although, genes play a big part in it. Not everyone however with an inherited risk develop the illness. Other factors that accompany heredity may trigger the onset of the disorder:

Stress — sudden life-changing events, whether these are good or bad
Medication — Some antidepressant drugs, corticosteroids, thyroid medicines, appetite suppressants, and even OTC cold medications may trigger bipolar disorder.
Substance abuse — Although substance abuse does not cause bipolarization, it may act as an episodic trigger. Alcohol, caffeine, and tranquilizers can kick-start the depressive state while uppers such as amphetamines and ecstasy can trigger mania.
Insomnia — Lack of sleep can cause a manic episode.
Seasons — Summer brings out the mania while winter, spring, and autumn make for the low moods.

A bipolar disorder left untreated only exacerbates the problem leading to dire consequences. Bipolar illness can have fatal consequences with the sufferer usually turning to suicide as a way out.

Treatment for the mental illness is a long drawn out affair but one well worth the effort. Since the disorder is chronic, relapses are to be expected so continuance of treatment is still necessary even when the person feels better.

Being a complex disorder, bipolarity needs to be handled by an experienced psychiatrist. Diagnosis is not simple and planning out a treatment strategy is best left with a mental health professional. For one, drug prescriptions need to be closely monitored.

Psychiatric treatment may follow a manifold approach involving a combination of drugs, psychotherapy, lifestyle changes, and social support.

Bear in mind that bipolar disorder is a treatable illness which one can learn to live with. There is no cure for it but people who undergo professional treatment do have the promise of living normal lives, even ones with successful careers and happy family and friend relationships.

mania and depression sign