Text/Yangcheng Evening News all-media reporter Lin Qingqing Intern Lin Shuhan Correspondent Song Yiqian
Photo/Visual China
"The difference between genius and madness is only a line"? This well-known saying describes people with bipolar disorder. However, bipolar disorder is not specifically looking for "geniuses". Sometimes depressed, sometimes manic, patients with bipolar disorder are easily misdiagnosed and missed.
30 March is World Bipolar Disorder Day. Xu Guiyun, director of the Department of Affective Disorders at the Brain Hospital Affiliated to Guangzhou Medical University, reminded that although the pathogenesis of bipolar disorder is unknown, a number of studies have shown that its incidence is closely related to genetic factors, and the incidence is high in adolescents under 25 years old. If there is bulimia and anorexia at the same time, the pursuit of extreme sensory stimulation, and the reversal of work and rest day and night, these are all "early warning signs" that need special attention.
Easy to misdiagnose and miss diagnosis! It is high in adolescents under 25 years of age
Bipolar disorder, also known as bipolar disorder, generally refers to a clinical mood disorder that has both manic or hypomanic episodes and depressive episodes. How many people are suffering from bipolar disorder? Data from a recent national epidemiological survey conducted by Professor Huang Yueqin of Peking University Sixth Hospital show that the prevalence of bipolar disorder is about 0.6% nationwide, while data from a 2011 World Mental Health Survey of 11 countries around the world shows that the prevalence of bipolar disorder in Guangdong is 1.5%. Why is there such a big difference between two pieces of data? Xu Guiyun said that this is precisely where bipolar disorder deserves attention.
Youth are at high risk of bipolar disorder
"The epidemiological survey data of bipolar disorder around the world are relatively different, because bipolar disorder is difficult to identify, often confused with depression, and easy to misdiagnose and miss diagnosis. In addition, because patients with bipolar disorder generally have a greater sense of shame, they are afraid of being 'labeled' and will bring inconvenience to their lives, and they tend to be too cautious about seeking help from specialists. Therefore, the academic community generally believes that the flow data is seriously underestimated. Therefore, it is necessary to understand the early warning signals of bipolar disorder for patients and their families. Xu Guiyun said.
Theoretical studies have found that bipolar disorder can be as heritable as high as 80%. Beginning in 2010, a study conducted by Xu Guiyun's team that has been followed up for more than 10 years has screened more than 200 adolescents aged 8 to 25 in Guangdong whose parents are bipolar disorder, and at the time of last year's follow-up, more than 10 of these children had suffered from bipolar disorder. "The study does not yet have a clear phased conclusion, but it also suggests that genetically related populations should pay more attention to the early warning indications for bipolar disorder and need early prevention and early intervention."
Xu Guiyun said that for people with a more clear family history of emotional disorders, especially those with bipolar disorder in their immediate family, if insomnia, anxiety, emotional ups and downs occur in the adolescent age, and even some symptoms of depression, or there are psychological disorders such as fear of heights, fear of animals, fear of social interaction, etc., such as alcohol dependence, behavioral addiction, the pursuit of extreme emotions and sensory experience, it is an early warning signal that requires special attention.
In addition, since the high incidence of bipolar disorder is high before the age of 25, even if there is no clear family history of emotional disorders, parents should pay special attention if adolescents have the above warning signs, or some symptoms of hypomania such as obvious emotional instability and excessive energy such as continuous excitement.
Gluttony and anorexia coexist? Pursuing extreme sensory stimulation? Pay attention to the Alert signal
In addition to early symptoms such as emotional ups and downs, addiction, and fear, Xu Guiyun said that the study found that patients with bipolar disorder had damage to some brain areas when they did not have the disease, so some cognitive functions, such as poor memory of space and slower response speed than children of the same age, may also be "early warning".
The preference for extreme experiences is a sign that many people tend to overlook. "For example, I suffer from bulimia and anorexia at the same time." Xu Guiyun said that due to the pursuit of extreme sensory experience by patients with bipolar disorder, seeing food will eat too much uncontrollably, easy to obesity, this obesity not only has the risk of inducing cardiovascular and cerebrovascular diseases, diabetes, cancer and other risks, but also may cause damage to brain cognitive function. Patients with bipolar disorder are likely to have psychological burdens after bulimia and obesity, which induces vomiting, dieting, anorexia, and falls into a vicious circle.
Overeating may be a sign of bipolar disorder
In addition, if there is insomnia and other sleep disorders, especially when the day and night are reversed, it should cause special attention. Xu Guiyun said, "Although the modern life pattern has changed and the number of young people who like to stay up late has increased, many studies have reported that compared with the lark type who wake up early and go to bed early, the nightingale type people whose work and rest time is reversed day and night are more likely to have sleep disorders, anxiety and other problems, and the incidence of bipolar disorder is also higher." Day and night upside down is not a normal work and living state, especially for students who do not have the need for night shifts, it is recommended to adjust as soon as possible. ”
Early intervention in scientific prevention and control can block or delay development
Bipolar disorder is not terrible, and early intervention and scientific prevention can block or delay the development of the disease. It is reported that at present, the mainland has joined the International Bipolar Disorder Society, and the level of diagnosis and treatment in China is at the same level as that of international advanced developed countries.
Xu Guiyun introduced that at present, there are three major suggestions for the prevention and treatment of bipolar disorder: one is to go to bed on time, get up on time, and maintain a normal and regular rhythm of life; the other is to insist on exercise. At present, there have been many studies that show that exercise is of great benefit to alleviating depression, anxiety and other emotional disorders, and has obvious benefits for the development of the human brain, the improvement of cognitive function and the improvement of sleep quality; third, if the symptoms of bipolar disorder have caused substantial distress to people's social and life, it is necessary to go to a psychiatric professional institution as soon as possible to find a professional doctor for diagnosis and treatment, and can be targeted for psychotherapy, emotional management and standardized medication. Preliminary research results and clinical experience suggest that early recognition and early intervention can prevent or delay the onset of bipolar disorder.
Good lifestyle habits help prevent bipolar disorder
At present, the standardized drug treatment is mainly three categories: one is emotional stabilizers, such as lithium carbonate, valproate, lamotrigine, etc.; the other is atypical antipsychotic drugs such as quetiapine, risperidone, rulassidone, etc.; the third type is antidepressants, and adolescents need to use caution. "In the early stages, sometimes a single use of one of the first two classes of drugs alone can potentially block or delay the progression of the disease." Xu Guiyun reminded that the so-called standardized use of drugs is to go to professional institutions to diagnose and treat and drug treatment under the guidance of professional doctors, and once the medication needs to be persistent, do not interrupt itself at will. "Standardized medication is the foundation of emotional management, and emotional management becomes feasible thereafter only if the medication is taken on time and in quantity under the guidance of a specialist."
Social return is conducive to emotional management and calls on society to reduce discrimination
For bipolar disorder, emotion management is both a preventive and therapeutic tool. For people who have appeared early warning signs, patients themselves should pay attention to self-control of emotions, diet and standardized work and rest time to overcome some emotional flooding. In addition, patients should quit smoking and alcohol for life, because alcohol is easy to make emotions out of control, and tobacco has an adverse effect on the efficacy of drugs, which will also cause distress to the patient's mood.
Emotional management also requires the involvement of society. Xu Guiyun called for schools and society to minimize discrimination against adolescents with bipolar disorder. In the early stage of the disease or the symptoms are not serious, there is no risk of self-harm and injury, it is recommended not to take a break from school, once the condition improves, it should be allowed to return to school as much as possible to study and live normally, which is conducive to maintaining a good rhythm of life, a sense of social participation, a sense of self-worth and a sense of rules.
How should the patient's family and friends be treated correctly? "Treat him as a patient and don't treat him as a patient." Xu Guiyun said that it is necessary to urge patients to accept standardized and professional diagnosis and treatment, while not overprotecting, to allow them to carry out some housework and normal interpersonal communication within their capabilities, and to try to return to normal social life. However, when the patient commits self-harm or harm to others, the family should contact the professional institution in time and send it to the hospital for treatment. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Wang Moyi