Carbamazepine (Mazetoil) Test

Bipolar disorder is also known as manic depression. This usually sets in low and high moods in a person along with changes in energy and sleep.

People with bipolar disorder tend to have periodical changes; sometimes they are over happy and other times they might feel sad, depressed and hopeless. Between these changes they are normal. The highs and lows are considered as extreme poles of moods, thus the name bipolar disorder.

Manic term is used when a person with bipolar disorder is highly excited and feels confident. Also, feelings of irritability and recklessness along with irrationality might occur. Some people with mania might have a hallucinations that is they see and hear things that are not there, along with delusions.

The term hypomania is used to describe mild symptoms of mania, in which a person does not have hallucinations and delusions and the symptoms do not interfere with their daily life. Similarly, the term depressive is used to describe a person's time when they feel depressed or sad.

Symptoms of Bipolar Disorder

• The highs and lows in a bipolar disorder do not follow any set pattern. One might feel manic or depressed for hours or days or weeks, months and even years together, before they actually switch to a happy mood. The severity depends from person to person and also changes with time by becoming less or more severe.
• Symptoms of mania or the high are extreme excitement, change from being happy to angry and irritable along with restlessness, speech is rapid with low concentration, less sleep and increased energy, grand plans, alcohol and drug abuse and impulsiveness.
• Symptoms of low or depressive phase are lethargy, worthlessness, feeling of sadness and hopelessness, lowered concentration, irritability, loss of sleep or excessive sleeping, loss of appetite and suicidal tendencies.

Diagnosis of Bipolar Disorder

• In case someone exhibits symptoms of bipolar disorder, then talking to a psychiatrist or a doctor helps. Doctors ask questions related to the mental illness and the associated concerns. Diagnosis is basically recognizing the symptoms of the person, whether they are due to some underlying cause or mood swings because of excessive alcohol. The symptoms have to be noted and the duration, for which they last along with the severity should all be noted. The most obvious symptoms are that of lows and highs in mood and changes in behavior, energy, sleep and thoughts.
• Consulting a doctor or talking to family and friends helps to differentiate the symptoms of bipolar disorder from unipolar disorder.

Treatment

• Medicines that have mood stabilizers, such as lamotrigine, valproate, lithium, carbamazepine and antipsychotics such as olanzapine, quetiapine should be taken. Psychotherapy is also recommended.

Post-traumatic stress disorder or PTSD is a mental health condition, which is usually triggered by an unfortunate event experienced or witnessed by the affected patient in the past. The symptoms of this condition are flashbacks, nightmares and extreme anxiety. The patient also thinks about the event in an uncontrolled manner.

PTSD is a serious mental health condition that can damage the affected person's personality to a great extent. Therefore, the person should be given proper treatment at the earliest. There are various treatment methods for PTSD that can help you in changing how you think about a traumatic event. The treatment options that can be used have been mentioned below:

Counselling:
There are different forms of counselling for treating PTSD which include:

1. Cognitive therapy: It is a therapy where you learn how to change your thought patterns regarding the trauma and allow you to eliminate unnecessary fears.
2. Exposure therapy: It involves talking about the trauma over and over again until the fear departs.
3. Eye movement desensitization and reprocessing: It is a process where you are made to focus on several forms of distractions like sounds and hand movements while you think about the trauma. A good therapist is very important to bring positive changes in your life by means of counseling therapy. You require a therapist who will listen to whatever you have to say and guide you through everything to make you feel better.

SSRI medicine:
SSRI or Selective Serotonin Reuptake Inhibitor is a form of antidepressant medicine, which helps you with your sadness and tension. There are certain medicines that are really effective and can be prescribed by your doctor depending on the condition.

Other forms of treatment:
There are several other types of medicines and procedures that can be used for treating PTSD. They include the following:

1. There are other counselling forms, which include group therapy, brief psychodynamic psychotherapy and family therapy.
2. There are other medicines as well for the treatment of PTSD. They include tricyclic antidepressants and atypical antidepressants.
3. Monoamine oxidase inhibitors like isocarboxazid can also be used for curing PTSD.
4. Certain mood stabilizers can be taken along with the medicines such as carbamazepine and lithium.
5. Several antipsychotics, which include risperidone can be used to tackle symptoms such as flashbacks and sleeplessness.
6. Another medicine known as prazosin is also used for dealing with nightmares and sleep disorders caused by PTSD. All kinds of medicines for the treatment of PTSD should be taken only after being prescribed by a doctor.

Post-traumatic stress disorder is a serious mental health condition in which a patient suffers from continuous negative thoughts regarding a traumatic event which has happened in the past. This condition may give rise to other health problems, and immediate treatment is recommended. If you wish to discuss about any specific problem, you can consult a psychiatrist.

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam’s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types – T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body’s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

• Heartbeat
• Body temperature
• Breathing
• Body weight
• Metabolism of fat
• Menstrual cycles in females
• Functioning of Nervous system
• Digestion
• Burning calories etc.

What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body’s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

1. Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
2. Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
3. Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
4. Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
5. Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
6. Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
7. Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
8. Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
9. Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
10. Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby’s heel.

What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

1. Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
2. Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.

Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

1. Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
2. Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.

Who are at risk of developing Hypothyroidism?

1. Women have a higher risk of suffering from hypothyroidism than men.
2. Older people are at increased risk.
3. People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.
4. People with psychiatric conditions such as bipolar disorder
5. People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.

What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

1. Depression
2. Constipation
3. Hair loss
4. Dry hair
5. Dryness of the skin
6. Tiredness
7. Body pains
8. Fluid retention in the body
9. Irregular menstrual cycles
10. Increased sensitivity to cold
11. Reduced heart rate
12. Increase in size of the thyroid gland – called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
13. Weight gain
14. Carpal tunnel syndrome
15. Hoarse voice
16. Infertility
17. Loss of libido/sex drive
18. Confusion or memory problems especially in the elderly

What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

1. TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
2. T4: A low level of thyroxine indicates hypothyroidism.
3. T3: these levels are generally not needed to diagnose hypothyroidism
4. Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
5. Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
6. Ultrasound of the neck is done if the patient presents with a thyroid swelling.

What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

• Heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
• Obesity
• Infertility
• Joint pains
• Depression
• A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
• Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an endocrinologist.

Bipolar disorder is also known as manic depression. This usually sets in low and high moods in a person along with changes in energy and sleep.

People with bipolar disorder tend to have periodical changes; sometimes they are over happy and other times they might feel sad, depressed and hopeless. Between these changes they are normal. The highs and lows are considered as extreme poles of moods, thus the name bipolar disorder.

Manic term is used when a person with bipolar disorder is highly excited and feels confident. Also, feelings of irritability and recklessness along with irrationality might occur. Some people with mania might have a hallucinations that is they see and hear things that are not there, along with delusions.

The term hypomania is used to describe mild symptoms of mania, in which a person does not have hallucinations and delusions and the symptoms do not interfere with their daily life. Similarly, the term depressive is used to describe a person's time when they feel depressed or sad.

Symptoms of Bipolar Disorder

• The highs and lows in a bipolar disorder do not follow any set pattern. One might feel manic or depressed for hours or days or weeks, months and even years together, before they actually switch to a happy mood. The severity depends from person to person and also changes with time by becoming less or more severe.
• Symptoms of mania or the high are extreme excitement, change from being happy to angry and irritable along with restlessness, speech is rapid with low concentration, less sleep and increased energy, grand plans, alcohol and drug abuse and impulsiveness.
• Symptoms of low or depressive phase are lethargy, worthlessness, feeling of sadness and hopelessness, lowered concentration, irritability, loss of sleep or excessive sleeping, loss of appetite and suicidal tendencies.

Diagnosis of Bipolar Disorder

• In case someone exhibits symptoms of bipolar disorder, then talking to a psychiatrist or a doctor helps. Doctors ask questions related to the mental illness and the associated concerns. Diagnosis is basically recognizing the symptoms of the person, whether they are due to some underlying cause or mood swings because of excessive alcohol. The symptoms have to be noted and the duration, for which they last along with the severity should all be noted. The most obvious symptoms are that of lows and highs in mood and changes in behavior, energy, sleep and thoughts.
• Consulting a doctor or talking to family and friends helps to differentiate the symptoms of bipolar disorder from unipolar disorder.

Treatment

• Medicines that have mood stabilizers, such as lamotrigine, valproate, lithium, carbamazepine and antipsychotics such as olanzapine, quetiapine should be taken. Psychotherapy is also recommended.

Related Tip: "5 Signs That You Or Your Loved One May Have Bi Polar Disorder"

Bipolar disorder is a serious mental health condition in which episodes of mania - an abnormally elevated mood often accompanied by feelings of euphoria - are interspersed with bouts of depression.

People with bipolar disorder generally need to be treated with mood stabilizers and other medications. But maintaining a healthy lifestyle is also important. Eating right, sticking to a regular sleep schedule, and other healthy habits can help people with bipolar disorder manage their condition

1. Take your meds - Take your medication every day as prescribed by your doctor. In all, 1 in 3 people will remain completely free of symptoms of bipolar disorder by taking mood-stabilizing medicine, such as carbamazepine or lithium, for life.
2. Exercise daily - Moderate physical activity for 30 minutes a day can help control mood swings.
3. Eat a balanced diet - Make sure you are getting all the nutrients you need. Eating meals at regular times will help establish a stress-reducing daily routine.
4. Avoid traveling into other time zones - If you are planning to travel extensively, you may want to call your doctor before you leave. Traveling into other time zones can disrupt your medication schedule and trigger a manic episode.
5. Get the same number of hours of sleep every night - Changes in your sleep patterns can sometimes trigger a manic or depressive episode. Try your best to keep the same bedtime and rise time, varying them by no more than an hour.
6. Avoid alcohol and illegal drugs - Even one drink can disrupt your sleep, change your mood, or interfere with your medicines, which can make symptom
7. Reduce stress at work and at home - Try to keep regular hours at work so stress won't trigger a manic or depressive episode. If stress at work or at home is a problem, counseling may help.
8. Limit caffeine and nicotine during manic episodes - Caffeine and nicotine can both act as stimulants, which can make symptoms worse. Plus, too much caffeine can change your sleeping habits.
9. Seek treatment immediately

Getting treatment immediately will help you to proactively manage symptoms of a depressive or manic episode and avoid disruptions to your life. Often you don't notice early signs or symptoms, so take the time to educate whoever is closest to you what signs and symptoms to look for. They can alert you when they see a change that suggests the beginning of a mood episode. Show them you welcome such feedback, and be sure to take it seriously if you get it