Neil Hunt - Bipolar Disorder E-book

YOUR QUESTIONS ANSWERED

Neil Hunt

MA MD MRCPsych

Consultant Psychiatrist

George MacKenzie House

Fulbourn Hospital

Cambridge, UK

EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 2005

For Elsevier

Commissioning Editor: Fiona Conn

Project Development Manager: Isobel Black

Project Manager: Frances Affleck

Designer Direction: George Ajayi

Illustration Manager: Bruce Hogarth

Illustrator: David Graham

Copyright

ELSEVIER CHURCHILL LIVINGSTONE

Cover image Martin Riedl/Science Photo Library

2005, Elsevier Limited. All rights reserved.

The right of Neil Hunt to be identified as author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988

), by selecting Customer Support and then Obtaining Permissions.

First published 2005

ISBN 0 4431 0070 5

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress

Notice

Medical knowledge is constantly changing. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the Publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.

The Publisher

Printed in China

Preface

Manic depression (also know as bipolar disorder) affects about 1 in 50 people, but the illness is almost invariably recurrent and often chronic. Every general practitioner will have had experience of making the diagnosis and providing treatment for this group of patients. The nature of the illness is that it is changeable, which makes recognition difficult and distinguishing bipolar disorder from recurrent depression is particularly challenging. Treatment can be complicated because of the way the symptoms vary and some treatments, including antidepressants, can make manic depression more unstable.

This book follows the question and answer format which has proved popular in the other books in this series, enabling the reader to quickly find the information they need. It is a practical guide to the recognition and management of bipolar disorder, from the crises of mania to the chronic care of debilitating depression.

The book is aimed specifically at GPs but may also be of value to other professionals involved in the day-to-day care of bipolar patients psychiatric nurses, psychologists and social care staff. The book was developed in part from articles written for the Manic Depression Fellowship and many questions are aimed specifically at patients and their families, enabling them to understand the nature of the illness and the best approach to managing bipolar disorder in the longer term.

Acknowledgements

I remain indebted to Trevor Silverstone for his help and encouragement over the years which led me to focus my professional life on improving the lot of those who suffer from manic depression.

The inspiration and source of this book have been the many patients who have shared their experiences of bipolar illness in all its manifestations with me. I hope that I have managed to transmit something of their lives in my writing.

Phil Alsop of the Manic Depression Fellowship in Cambridge has been a great help to me and many of the questions come from queries that he and other members of the Fellowship have raised with me in their newsletter.

Margo Stevens has patiently word processed my rather ragged material into a form that could be presented. Philip Augar and Dr Paul Calloway kindly commented on an early draft of the book.

I, like many doctors, am entirely reliant on the forbearance of my wife and also my daughters who all need acknowledgement for their patience and good humour with me.

How to use this book

The Your Questions Answered series aims to meet the information needs of GPs and other primary care professionals who care for patients with chronic conditions. It is designed to help them work with patients and their families, providing effective, evidence-based care and management.

The books are in an accessible question and answer format, with detailed contents lists at the beginning of every chapter and a complete index to help find specific information.

ICONS

Icons are used in the book to identify particular types of information:

highlights information important to clinical practice

highlights side-effect information

highlights case studies which illustrate or help to explain the answers given

What is manic depression (bipolar disorder)?