Bipolar Disorder

Bipolar Disorder What Is It?

Bipolar disorder, sometimes called manic depression, is a disorienting condition that causes extreme shifts in mood. Like riding a slow-motion roller coaster, patients may spend weeks feeling like they're on top of the world before plunging into a relentless depression. The length of each high and low varies greatly from person to person. In any given year, bipolar disorder affects more than 2% of American adults.

Depressive Phase Symptoms

Without treatment, a person with bipolar disorder may experience intense episodes of depression. Symptoms include sadness, anxiety, loss of energy, hopelessness, and difficulty concentrating. Patients may lose interest in activities that were once pleasurable. They may gain or lose weight, sleep too much or too little, and contemplate suicide.

Manic Phase Symptoms

During a manic phase, patients tend to feel euphoric and may believe they can accomplish anything. This can result in inflated self-esteem, agitation, reduced need for sleep, being more talkative, being easily distracted, and a sense of racing thoughts. Reckless behaviors, including spending sprees, sexual indiscretions, fast driving, and substance abuse, are common. Having three or more of these symptoms nearly every day for a week may indicate a manic episode.

Bipolar I vs. Bipolar II

People with bipolar I disorder have manic episodes or mixed episodes and often have one or more depressive episodes. People with bipolar II have major depressive episodes with less severe mania; they experience hypomania, a condition that is less intense than mania or lasting less than a week. Patients may seem like the “life of the party” -- full of charm and humor. They may feel and function fine, even if family and friends can see the mood swing. However, hypomania can lead to mania or depression.

Mixed Episode

People with mixed episode experience depression and mania at the same time. This leads to unpredictable behavior, such as sadness while doing a favorite activity or feeling very energetic. It’s more common in people who develop bipolar disorder at a young age, particularly during adolescence. But some estimates suggest up to 70% of bipolar patients experience mixed episodes.

Causes of Bipolar Disorder

Doctors aren't exactly sure what causes bipolar disorder. A leading theory is that brain chemicals fluctuate abnormally. When levels of certain chemicals become too high, the patient develops mania. When levels drop too low, depression may result.

Bipolar Disorder: Who's at Risk?

Bipolar disorder affects males and females equally. In most cases, the onset of symptoms is between 15 and 30 years old. People are at higher risk if a family member has been diagnosed, especially if it’s a first degree relative, but doctors don’t think the disorder kicks in based on genetics alone. A stressful event, drug abuse, or other unknown factor may trigger the cycle of ups and downs.

Bipolar Disorder and Daily Life

Bipolar disorder can disrupt your goals at work and at home. In one survey, 88% of patients said the illness took a toll on their careers. The unpredictable mood swings can drive a wedge between patients and their co-workers or loved ones. In particular, the manic phase may scare off friends and family. People with bipolar disorder also have a higher risk of developing anxiety disorders.

Bipolar Disorder and Substance Abuse

About 60% of people with bipolar disorder have trouble with drugs or alcohol. Patients may drink or abuse drugs to relieve the uncomfortable symptoms of their mood swings. This is especially common during the reckless manic phase.

Bipolar Disorder and Suicide

People with bipolar disorder are 10 to 20 times more likely to commit suicide than people without the illness. Warning signs include talking about suicide, putting affairs in order, and inviting death with risky behavior. Anyone who appears suicidal should be taken very seriously. Do not hesitate to call one of the suicide hotlines: 1-800-SUICIDE (1-800-784-2433) and 1-800-273-TALK (1-800-273-8255). If you have a plan to commit suicide, go to the emergency room for immediate treatment.

Diagnosing Bipolar Disorder

A crucial step in diagnosing bipolar disorder is to rule out other possible causes of extreme mood swings. These may include brain infection or other neurological disorders, substance abuse, thyroid problem, HIV, ADHD, side effects of certain medications, or other psychiatric disorders. There is no lab test for bipolar disorder. A psychiatrist usually makes the diagnosis based on a careful history and evaluation of the patient’s mood and other symptoms.

Medications for Bipolar Disorder

Medications are key in helping people with bipolar disorder live stable, productive lives. Mood stabilizers can smooth out the cycle of ups and downs. Patients may also be prescribed antipsychotic drugs and anticonvulsant drugs. Between acute states of mania or depression, patients typically stay on maintenance medication to avoid a relapse.

Talk Therapy for Bipolar Disorder

Talk therapy can help patients stay on medication and cope with their disorder's impact on work and family life. Cognitive behavioral therapy focuses on changing thoughts and behaviors that accompany mood swings. Interpersonal therapy aims to ease the strain bipolar disorder may place on personal relationships. Social rhythm therapy helps patients develop and maintain daily routines.

Lifestyle Tips for Bipolar Disorder

Establishing firm routines can help manage bipolar disorder. Routines should include sufficient sleep, regular meals, and exercise. Because alcohol and recreational drugs can worsen the symptoms, these should be avoided. Patients should also learn to identify their personal early warning signs of mania and depression. This will allow them to get help before an episode spins out of control.

Electroconvulsive Therapy (ECT)

Electroconvulsive therapy can help some people with bipolar disorder. ECT uses an electric current to cause a seizure in the brain. It is one of the fastest ways to ease severe symptoms. ECT is usually a last resort when a patient does not improve with medication or psychotherapy.

Educating Friends and Family

Friends and family may not understand bipolar disorder at first. They may become frustrated with the depressive episodes and frightened by the manic states. If patients make the effort to explain the illness and how it affects them, loved ones may become more compassionate. Having a solid support system can help people with bipolar disorder feel less isolated and more motivated to manage their condition.

When Someone Needs Help

Many people with bipolar disorder don't realize they have a problem or avoid getting help. If you're concerned about a friend or family member, here are a few tips for broaching the subject. Point out that millions of Americans have bipolar disorder, and that it is a treatable illness – not a personality flaw. There is a medical explanation for the extreme mood swings, and effective treatments are available.

Posted from:  http://www.webmd.com

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Lupus

What Is Lupus?

Lupus is a lifelong disorder of the immune system. Immune cells attack the body’s own healthy tissues, leading to inflammation and tissue damage. Symptoms may be limited to the skin, but more often lupus also causes internal problems such as joint pain. In severe cases, it can damage the heart, kidneys, and other vital organs. Although there’s no cure, there are treatments that can minimize the damage.


Lupus Symptom: Joint Pain

Joint and muscle pain is often the first sign of lupus. This pain tends to occur on both sides of the body at the same time, particularly in the joints of the wrists, hands, elbows, knees, or ankles. The joints may look inflamed and feel warm to the touch. But unlike rheumatoid arthritis, lupus usually does not cause permanent joint damage.


Lupus Symptom: Butterfly Rash

A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Other common skin problems include sensitivity to the sun with flaky, red spots or a scaly, purple rash on various parts of the body, including the face, neck, and arms. Some people also develop mouth or lip sores.

Lupus Symptom: Nail Changes

Lupus can cause the nails to crack or fall off. They may be discolored with blue or reddish spots at the base. These spots are actually in the nail bed, the result of inflamed small blood vessels. Swelling may also make the skin around the base of the nail look red and puffy.

Lupus Symptoms: Fever and Fatigue

Most people with lupus experience some degree of fatigue. In many cases, it is severe enough to interfere with exercise and other daily activities. Most patients also run a low-grade fever from time to time. This unexplained fever may be the only warning sign in some people.

Lupus Symptom: Light Sensitivity

Many people with lupus are unusually sensitive to the sun and other forms of ultraviolet light (such as tanning beds.) A day at the beach may trigger a skin rash in areas exposed to sunlight and may worsen other lupus symptoms. Certain medications can make people with lupus even more sensitive to UV light.

Lupus Symptom: Hair Loss

The symptoms of lupus tend to come and go, and this includes hair loss. Patients may go through periods where their hair falls out in patches or becomes thinner all across the scalp. Once the flare-up is over, new hair is likely to grow in evenly.

Lupus Symptom: Raynaud's

Some people with lupus develop a condition called Raynaud’s phenomenon. Their fingers and toes become painful, numb, and tingly in response to cold temperatures or emotional stress. This happens when small blood vessels spasm and restrict blood flow to the area. During an attack, the fingers and toes may turn white or blue. People can also have Raynaud's without having lupus or any serious health complications.

Lupus or Something Else?

When lupus begins, it can look a lot like rheumatoid arthritis, which causes joint pain and swelling, or fibromyalgia, which causes fatigue and pain. One aspect that sets lupus apart is the combination of skin rashes with joint pain and fatigue. There are also lab tests that can help distinguish lupus from other diseases.

Diagnosing Lupus

Diagnosing lupus can be tricky. The disease can mimic other conditions, and it often takes a different course in different people. Many people have it for years before developing tell-tale symptoms. Although there is no one test for lupus, certain proteins usually show up in a patient’s blood. A blood test for antinuclear antibodies (ANAs) can provide a critical clue. Other lab tests may check cell counts, kidney function, and clotting time. A tissue biopsy sometimes helps with diagnosis.

Who Gets Lupus?

Anyone can get lupus. But more than 90% of people with lupus are women. Aside from being female, your odds of getting the disease are higher if you are:

• African-American, Latino, or Asian
• Aged 15 to 45
• Related to someone with lup

Types of Lupus

When people say “lupus,” they usually mean systemic lupus erythematosus (SLE), the most common and serious type. But there are other types. Cutaneous lupus erythematosus – also called discoid lupus -- is limited to the skin and doesn’t cause the organ damage that sometimes occurs with SLE. The most common symptom is a circular rash. Drug-induced systemic lupus causes temporary lupus symptoms in people who take certain medications.

Medical Treatments for Lupus

There are ways to control the symptoms of lupus. These include corticosteroid creams for rashes and nonsteroidal anti-inflammatory drugs (NSAIDs) for joint pain and fever. Antimalarial medications can help fight joint pain, ulcers, and rashes. Higher dose of corticosteroids may be given as pills or injections. People with severe lupus may benefit from drugs that suppress the immune system.

Self-Care for Lupus

Making some changes to your routine can also help reduce lupus flare-ups:

• Cover up when you’re in the sun.
• Don’t smoke.
• Exercise regularly.
• Improve your stress management skills.

Also be sure to get plenty of rest. Some people with lupus need up to 12 hours of sleep a night.

Posted from:  http://www.webmd.com

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Breast Cancer

Breast Cancer Today

 Breast cancer today is not what it was 20 years ago. Survival rates are climbing, thanks to greater awareness, more early detection, and advances in treatment. For roughly 200,000 Americans who are diagnosed with breast cancer each year, there are plenty of reasons to be hopeful.

Breast Cancer Symptoms

There are often no symptoms of breast cancer, but sometimes women may discover a breast problem on their own. Signs and symptoms to be aware of may include:

• A painless lump in the breast.
• Changes in breast size or shape.
• Swelling in the armpit.
• Nipple changes or discharge.

Breast pain can also be a symptom of cancer, but this is not common.

Signs of Inflammatory Breast Cancer

Inflammatory breast cancer is a rare, fast-growing type of cancer that often causes no distinct lump. Instead, breast skin may become thick, red, and may look pitted -- like an orange peel. The area may also feel warm or tender and have small bumps that look like a rash.

Breast Cancer and Mammograms

The earlier breast cancer is found, the easier it is to treat. And mammograms, X-rays of the breast, can detect tumors before they are large enough to feel. The American Cancer Society recommends yearly mammograms beginning at age 40 for women at average risk. While the U.S. Preventive Services Task Force recommends a screening mammogram every two years from age 50 to 74. It also notes that before age 50, each woman should check with a doctor to find out what screening schedule is right for her, considering the potential benefits and harms from screening.

Breast Ultrasound and MRI

Besides a mammogram,  your doctor may order additional imaging with breast ultrasound. An ultrasound can help determine the presence of cysts, fluid-filled sacs that are not cancer. An MRI may be recommended along with a mammogram for routine screening in certain women who have a higher risk of breast cancer.

Breast Self-Exams

It was once widely recommended that women check their own breasts once a month. But studies suggest these breast self-exams play a very small role in finding cancer. The current thinking is that it’s more important to know your breasts and be aware of any changes, rather than checking them on a regular schedule. If you want to do breast self-exams, be sure to go over the technique with your doctor.

What If You Find a Lump?

First, don’t panic. Eighty percent of breast lumps are not cancerous. Lumps often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But you should let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier it’s found the better. And if it’s not, testing can give you peace of mind.

Breast Biopsy

The only sure way to determine whether a lump is cancer is to do a biopsy. This involves taking a tissue sample for further examination in the lab, sometimes through a small needle. Sometimes surgery is done to take part of or the entire lump for testing. The results will show whether the lump is cancer, and if so, what type. There are several forms of breast cancer, and treatments are carefully matched to the type of cancer.

Hormone-Sensitive Breast Cancer

Some types of breast cancer are fueled by the hormones estrogen or progesterone. A biopsy can reveal whether a tumor has receptors for estrogen (ER-positive) and/or progesterone (PR-positive). About two out of three breast cancers are hormone sensitive. There are several medications that keep the hormones from promoting further cancer growth.
The image shows a molecular model of an estrogen receptor.

HER2-Positive Breast Cancer

In about 20% of patients, breast cancer cells have too many receptors for a protein called HER2. This type of cancer is known as HER2-positive, and it tends to spread faster than other forms of breast cancer. It’s important to determine whether a tumor is HER2-positive, because there are special treatments for this form of cancer.
A HER2-positive breast cancer cell is illustrated here, with abnormal growth signals shown in green.

Breast Cancer Stages

Once breast cancer has been diagnosed, the next step is to determine how big the tumor is and how far the cancer has spread. This process is called staging. Doctors use Stages 0-4 to describe whether cancer is localized to the breast, has invaded nearby lymph nodes, or has spread to other organs, such as the lungs. Knowing the stage and type of breast cancer will help your health care team formulate a treatment strategy.

Breast Cancer Survival Rates

The odds of surviving breast cancer are strongly tied to how early it is found. According to the American Cancer Society, 100% of women with Stage 1 breast cancer live at least five years, compared to women without cancer – and many women in this group remain cancer-free for good.  The more advanced the cancer, the lower this figure becomes. By Stage 4, the five-year relative survival rate declines to 20%. But these rates can improve as more effective treatments are found.

Breast Cancer Surgery

There are many types of breast cancer surgery, from taking out the area around the lump (lumpectomy or breast-conservation surgery) to removing the entire breast (mastectomy.) It’s best to discuss the pros and cons of each of these procedures with your doctor before deciding what’s right for you.

Radiation Therapy for Breast Cancer

Radiation therapy uses high-energy rays to kill cancer cells. It may be used after breast cancer surgery to wipe out any cancer cells that remain. It can also be used along with chemotherapy for treatment of cancer that has spread to other parts of the body. Side effects can include fatigue and swelling or a sunburn-like feeling in the treated area.

Chemotherapy for Breast Cancer

Chemotherapy uses drugs to kill cancer cells anywhere in the body. The drugs are often given by IV, but are sometimes taken by mouth or shot. Chemotherapy may be done after surgery to lower the odds of the cancer coming back. In women with advanced breast cancer, chemotherapy can help control the cancer’s growth. Side effects may include hair loss, nausea, fatigue, and a higher risk of infection.

Hormone Therapy for Breast Cancer

Hormone therapy is an effective treatment for women with ER-positive or PR-positive breast cancer. These are cancers that grow more rapidly in response to the hormones estrogen or progesterone. Hormone therapy can block this effect. It is most often used after breast cancer surgery to help keep the cancer from coming back. It may also be used to reduce the chance of breast cancer developing in women who are at high risk.

Targeted Drugs for Breast Cancer

Targeted therapies are newer drugs that target specific properties within cancer cells. For example, women with HER2-positive breast cancer have too much of a protein called HER2. Targeted therapies can stop this protein from promoting the growth of cancer cells. These drugs are often used in combination with chemotherapy. They tend to have milder side effects compared to chemotherapy.

Life After Diagnosis

There’s no doubt that cancer is a life-changing experience. The treatments can wear you out. You may have trouble managing daily chores, work, or social outings. This can lead to feelings of isolation. It’s crucial to reach out to friends and family for support. They may be able to go with you to treatments, help out with chores, or just remind you that you are not alone. Many people choose to join a support group -- either locally or online.

Breast Reconstruction

Many women who have a breast removed choose to undergo reconstructive surgery. This replaces the skin, nipple, and breast tissue that are lost during a mastectomy. Reconstruction can be done with a breast implant or with tissue from somewhere else in your body, such as the tummy. Some women opt to begin reconstruction at the same time as their mastectomy. But it’s also possible to have reconstructive surgery months or years later.

Breast Forms

An alternative to breast reconstruction is to be fitted for a breast form. This is a breast-shaped prosthesis that fits inside your bra. Wearing a breast form allows you to have a balanced look when you are dressed -- without undergoing additional surgery. Like reconstructive surgery, breast forms are often covered by insurance.

Breast Cancer: Why Me?

The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but it is about 100 times more common in women. Other top risk factors include being over age 55 or having a close relative who has had the disease. But keep in mind that up to 80% of women with breast cancer have no family history of the illness.

Breast Cancer Genes

Some women have a very high risk of breast cancer because they inherited changes in certain genes. The genes most commonly involved in breast cancer are known as BRCA1 and BRCA2. Women with mutations in these genes have up to an 80 percent chance of getting breast cancer at some point in life. Other genes may be linked to breast cancer risk as well.

Risk Factors in Your Control

Being overweight, getting too little exercise, and drinking more than one alcoholic beverage per day can raise the risk of developing breast cancer. Birth control pills and some forms of postmenopausal hormone therapy can also boost your risk. But the risk goes back to normal after these medications are stopped. Among survivors, good lifestyle choices may be helpful. Recent studies suggest that physical activity may help lower the risk of a recurrence and it's a proven mood-booster.

Breast Cancer Research

Doctors continue to search for more effective and tolerable treatments for breast cancer. The funding for this research comes from many sources, including advocacy groups throughout the country. Many of the 2.5 million breast cancer survivors and their families choose to participate in walk-a-thons and other fundraising events. This links each individual fight against cancer into a common effort for progress.

Posted from:  http://www.webmd.com

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