Bipolar disorder is much more extreme than normal mood variation.
The high or low episodes can be very distressing and overwhelming, which can have a big impact on the patient’s life. Some patients may also experience some psychotic symptoms during manic or depressed episodes, which can be very frightening.
Mania is an extreme sense of well-being, energy and optimism. It can be so intense that it affects your thinking and judgement. You may believe strange things about yourself, make bad decisions, and behave in embarrassing, harmful and – occasionally – dangerous ways.
Like depression, it can make it difficult or impossible to deal with life in an effective way. A period of mania can affect both relationships and work. When it isn’t so extreme, it is called ‘hypomania’.
- Rapid cycling – swinging quickly from a high to low state without having a “normal” phase between the extremes
- Mixed state – symptoms of depression and mania together e.g. depressed mood with the restlessness and over-activity of a manic episode.
Stimulation of the prefrontal cortex by rTMS in depressed patients can lead to complete remission from depression with patients reporting that they feel much more positive; they are more sociable, motivated and talkative.
The treatment protocol as outlined by NICE is typically 2-6 weeks. We have developed treatment protocols which allow for multiple treatments per day, allowing for the full treatment to be delivered in between five days up to six weeks, at the patient’s discretion. Patients will be assessed over the course of treatment to monitor the effect. The actual length of the treatment will vary dependent on how quickly a reduction in the depression level is seen.
NICE Guidelines (2015): https://www.nice.org.uk/guidance/ipg542
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