Author: DeAna

Birth Control.  Contraception.  Pregnancy Prevention.  It’s a vital concept for most sexually actively women.  And while we appreciate the varied birth control methods available to us, we can be overwhelmed with choosing which method may be best.

Barrier Methods:

Male condom:

How it works: A thin covering, usually made of latex is unrolled over an erect penis to prevent the entry of sperm into the vaginal canal during ejaculation.

Pros: Also protects against STDs.  Inexpensive.  Can be found at most pharmacies, grocery stores, big box stores, etc.

Cons:  Must be used during each sexual encounter.  Can break or slip off during rough sex.  Human error (i.e. incorrect application) can impact its effectiveness.

Effectiveness: 82-98%

Female Condom:

How it works: A loose pouch is placed inside the vagina, held in place by flexible rings.   During intercourse, the penis goes inside of the pouch, and sperm is trapped during ejaculation.  (NOTE: a female condom and male condom should not be used at the same time).

Pros: Also protects against STDs.  Can be inserted up to 8 hours before intercourse.

Cons: Must be used during each sexual encounter.  Noticeable during sex.  Can break or slip off during rough sex.  Human error (i.e. incorrect insertion) can impact its effectiveness.  About 3x more expensive than male condoms.

Effectiveness: 79-95%

Spermicide:

How it works: Chemicals that immobilize or kill sperm are mixed into foams, gels, creams, films, suppositories, and sponges.  The products are then applied to the vagina.

Pros: Easy to buy at any pharmacy or online retailer.

Cons:  Some people may be allergic to one or more of the ingredients in the product.  Only work during a narrow time window–most types must be applied at least 10 minutes before intercourse, and only work for an hour.  Must be left on the vagina for 8 hours after intercourse.  Again, human error during the application process can affect effectiveness.  Does not protect against STDs.

Effectiveness: 72-91%

Diaphragm:

How it works:  A soft silicone dome holds spermicide, and is placed against the cervix.

Pros: Can be inserted up to 2 hours before intercourse.

Cons: Recommended to use with spermicide.  Does not prevent STDs. You must go the the doctor to be properly fit for one, and get refitted after childbirth or if you gain or lose more than 10 pounds.  Needs to stay in place at least 6 hours after sex.  May become dislodged during sex.  Must be washed after each use.  May cause bladder infections

Effectiveness: 88-94%

Cervical Cap:

How it works: Very similar to a diaphragm.

Pros: Keeps working for up to 48 hours after insertion.

Cons: Recommended to use concurrently with spermicide.  Can become dislodged during sex.  You must go the the doctor to be properly fit for one, and get refitted after childbirth.  Needs to stay in place 6-8 hours after sex.  Must be washed after each use.  Does not  protect against STDs.

Effectiveness: 68-91% (effectiveness decreases after childbirth)

Hormonal Methods:

Emergency Contraception: 

How it works: Taken after unprotected sex to prevent pregnancy, these pills work by giving you a short burst of hormone-like substances, which mimic progestin, to prevent pregnancy.  They may affect ovulation, movement of sperm, or interrupt other processes necessary for fertilization of the egg.  Note, these pills will not abort a currently existing pregnancy.

**Emergency contraception should not used as a regular form of birth control**

Pros: May be effective up to 5 days after intercourse (but most effective within the first 24 hours).  Available over-the-counter to adults over the age of 17.

Cons: May cause side effects such as abdominal pain, chest pain, shortness of breath, headache, blurred vision, and severe leg/arm pain or numbness.

Effectiveness: Depends on the type you take, and how soon you take it after intercourse.

Birth Control Pills:

How it works: Synthetic hormones release estrogen and progestin in your body.  This stops pregnancy by preventing ovulation and thickening the cervical mucus to make it more difficult for sperm to enter the uterus.

Pros: Can regulate or lighten periods.  Easy to use.  May protect against uterine and ovarian cancers.  May reduce acne.

Cons: Must be taken daily.  Does not prevent against STDs.  May cause several side effects, the most severe of which is increased risk of stroke, blood clots, and certain cancers. May be less effective when taken with certain medications, such as antibiotics.  Requires a prescription.

Effectiveness: 91-99%

The Patch:

How it works: A bandage-like patch that sticks to your skin, and releases estrogen and progestin.  It can be applied to the abdomen, buttocks, upper arm, or upper torso.

Pros: Only needs to be applied once weekly.  Easy to use.  May regulate or lighten periods.

Cons: Does not prevent STDs.  May cause skin irritation.  Less effective for women >198 pounds.  May increase risk of blood clots, heart attack, and stroke.  Requires a prescription.  Effectiveness may be lowered when taken with certain medications.

Effectiveness: 91-99%

Vaginal Ring:

How it works: Your body absorbs hormones through a clear, soft, flexible ring that is inserted into your vagina.  Your body absorbs the estrogen and progestin through your vaginal wall.

Pros: Only requires once monthly insertion.

Cons: Does not protect against STDs.  May cause vaginal discharge/irritation, headache, weight gain, nausea, irregular bleeding, breast tenderness or mood changes.  Its effectiveness may be altered by other medications.  May increase risk of blood clots, heart attack or stroke.  Requires a prescription.

Effectiveness: 91-99%

The Shot:

How it works: A long-acting injection of synthetic progestin, which stops the ovaries from releasing eggs and also thickens the cervical mucus.

Pros: Low-maintenance.  Each injection lasts 3 months.  Decreases risk of endometrial cancer, ovarian cancer, uterine cancer and pelvic inflammatory disease.  May decrease menstrual cramping and frequency of periods.

Cons: Does not prevent against STDs.  May increase risk of weight gain and osteoporosis (due to loss of bone density).  Requires a doctor’s visit for each injection.  May alter your menstrual cycle, including breakthrough bleeding and the absence of periods altogether.  Not recommended for women who may want to get pregnant in the near future, as it can take up to 18 months for the body’s hormonal cycle to normalize.

Effectiveness: 94-99%

Long-Term Methods:

Implant:

How it works: A soft rod that releases artificial progestin hormone into your body is placed under the skin in your upper arm .

Pros: Low maintenance.  Lasts 3 years.

Cons: Does not protect against STDs.  Insertion site may get infected.  May cause irregular breakthrough bleeding, heavy bleeding, or the absence of periods.  Serious side effects may include allergic reaction, infection, weight gain, or mood changes.  Effectiveness may be decreased by certain medications.

Effectiveness: 99%

Intrauterine Device (IUD)-cooper:

How it works: A small T-shaped device is inserted into the uterus through the cervix.  It changes the cervical mucus, fallopian tubes, and lining of the uterus.  These changes stop the fertilization of the egg.

Pros: Low maintenance.  Lasts 10+ years.  Does not contain artificial hormones.

Cons:  Does not protect against STDs.  Requires a doctor’s visit for insertion and removal.  May cause heavier, more painful periods.  Can occasionally be felt during sex.

Effectiveness: 99%

IUD-progesterone:

How it works: Same as the copper IUD,  but it releases synthetic progestin.  This makes egg fertilization harder.

Pros: Low maintenance.  Lasts 5 years.  May cause lighter, less painful periods for some.

Cons: Does not protect against STDs.  Sometimes causes cramping.  May cause breakthrough bleeding, or the absence of periods.  Some women experience mood changes, less pleasure while having sex, and headaches.  Is sometimes felt during sex.  Clinic visit required for insertion and removal.

Effectiveness: 99%

Sterilization (i.e. getting your “tubes tied”):

How it works: The follopian tubes are burned, tied, blocked with a substance, or cut with a small incision.

Pros: Effective immediately, and has a low failure rate.  Requires no further action.

Cons: Irreversible, completely permanent.  Does not protect against STDs.

Effectiveness: 99%

Knowledge-Based Methods:

Withdrawal (i.e. Pulling Out): 

How it works: During intercourse, the male partner pulls his penis out of the female partner’s vagina prior to ejaculation.

Pros: Free, and available anytime.  No hormonal-related side effects.

Cons: Does not protect against STDs.  Requires special attention, and is completely dependent on the man’s  self-knowledge and self-control.  It is important that the male ejaculate away from the woman’s body, as even sperm left on the female’s legs or vaginal lips can travel into the vagina.  Less effective than other forms of birth control.

Effectiveness: 77%

Fertility Awareness:

How it works: The female sexual partner becomes highly aware of her menstrual cycle.  She then avoids sex, or uses a barrier method of protection, on the days that she is ovulating.

Pros: No health risks or hormonal side effects.  In addition to preventing unwanted pregnancy, can also be used to improve your chances of getting pregnant when ready.  Alternative means of pregnancy prevention for religious couples opposed to other methods.

Cons: Takes time, effort, and meticulous record-keeping…especially in the beginning.

Effectiveness: 76-99%

Abstinence:

How it works: Sexual intercourse is avoided.

Pros: The only completely fail-proof method to avoiding pregnancy.

Cons: Requires self-control to be effective.

Effectiveness: 100%

You are in control of your body, and are best qualified to determine what birth control method is best for you.  For more information, and the ability to actually do a head-to-head comparison of up to 3 methods, click here: http://www.birth-control-comparison.info/

“Yeast infection” is a phrase commonly used to describe a vaginal infection caused by candida albicans, a type of fungus.  Seventy-five percent of women will experience a yeast infection at least once in their lifetime.  While they may cause significant discomfort, yeast infections are usually minor and can be treated in just a few days.  Additionally, unlike other vaginal infections, a yeast infection is generally not considered to be an STD, though it is possible to transmit the infection to your partner during intercourse.

Cause.  Our vaginas are very delicate organs.  A healthy vagina has a certain amount of bacteria and fungus present.  Yet when something throws off the balance of these organisms, the fungus can overgrow and cause painful symptoms.  Antibiotics, high estrogen levels, and a weakened immune system caused by a condition such as cancer or HIV can all negatively alter the balance of the organisms present in our vaginas.

Symptoms.  Someone with a vaginal yeast infection may experience inflammation, burning, itchiness, soreness (especially during intercourse) and the presence of a thick white odorless discharge.

Treatment.  Minor yeast infections can be self-diagnosed and treated with OTC products such as Monistat (miconazole), Gyne-Lotrimin (clotrimazole), and Terzol (terconazole).  OTC options are available as tablets, suppositories, and creams, and their duration of treatment may last 1-7 days.  Please note, if you are using a antifungal cream, you should avoid using latex-based contraceptive products (i.e. condoms) as the oils in some topical products can weaken the latex.

If you have repeated infections (>4 within a year), you should visit your doctor.  He/she may recommend a prescription product such as Diflucan (fluconazole).

Prevention.  You can reduce your risk of yeast infection by practicing good vaginal hygiene:

• Avoid exposing your vagina to unnecessary chemicals.  Your vagina is a self-cleaning organism.  It does not require fancy lotions, creams, douches and deodorants.  Mild unscented soap and water should be sufficient.  Unwanted discharges or odors are likely indicative of a more serious problem.
• After using the bathroom, always wipe from front to back to avoid transferring unhealthy organisms from your anus to your vagina.
• Wear cotton underwear.  Cotton allows your vagina to breath, keeping it dry and cool.
• Avoid tight-fitting clothes, as they may make your vagina too warm.
• Change out of wet clothes and swimsuits immediately.  Moisture allows for bacterial and fungal growth.
• Frequently change your pads and tampons.  Consider using pantyliners even on days you are not menstruating as they help absorb any extra moisture.  Again, unscented products are likely best and some fragrances and other added chemicals may lead to vaginal irritation and/or alter your vaginal pH.

Polycystic Ovarian Syndrome (PCOS) is a disorder that causes the ovaries to develop small cysts, which cause the ovaries to enlarge.  The cysts themselves are generally not painful, but they can lead to hormonal and metabolic imbalances. PCOS is fairly common, affecting 5-10% of women of childbearing age, regardless of ethnicity.

Cause.  The cause of PCOS is not completely understood, but there does seem to be a strong genetic link.  Therefore, the chance of developing PCOS increases if another woman in your family has been diagnosed with it.  High levels of androgen (male hormones) and/or insulin are also thought to play a role.

Diagnosis.  Your doctor may suspect PCOS based on your reported symptoms, but the only way to definitively diagnose it is to have a pelvic ultrasound.  This allows your doctor to look for cysts on your ovaries.

Symptoms. Common symptoms of PCOS include irregular, heavy, or missing periods; unexpected weight gain; acne; oily skin; infertility; hair loss; development of male features such as unwanted facial hair; and depression.

Complications.  If untreated, long-term complications of PCOS may include infertility, endometrial cancer, diabetes, high cholesterol and heart disease as a result of these hormonal imbalances.

Treatment.  Unfortunately, there is not cure for PCOS, so treatment focuses on management of symptoms. Oral contraceptives (birth control pills) help regulate the menstrual cycle.  Weight loss, regular exercise and a healthy diet may help prevent diabetes and heart disease.  Facial creams and/or electrolysis  can aid with hair removal. Additionally, counseling and/or antidepressants can be used to help manage symptoms of depression.  Though it is still possible to get pregnant if suffering from PCOS, fertility treatments may be recommended to improve your chances.

Ovarian cysts are fluid-filled sacs that develops on one of the ovaries.  Most women experience them at one time or another, but they are often painless and symptomless.   Ovarian cysts are simply the presence of said cysts in the ovaries, while polycystic ovarian syndrome (PCOS) is a complicated collection of symptoms resulting from the presence of those cysts.  In other words, it is possible for a woman to have ovarian cysts without it developing into PCOS.  On the other hand, PCOS is a cascade of symptoms and complications resulting from the development of ovarian cysts.

Risk Factors.  Known risk factors of ovarian cysts include being post-menopausal; being a smoker; being overweight; not having had children; taking certain infertility drugs; undergoing hormone replacement therapy; and a family history of ovarian, breast, or colorectal cancer.

Symptoms.   If symptoms are present, one may experience abdominal bloating or swelling; painful bowel movements; painful menstruation; painful sex; pain in the abdomen or lower back; weight gain; breast tenderness; or nausea and vomiting.

Complications. In most instances, ovarian cysts are benign.  But occasionally, they can be cancerous.  Ovarian torsion occurs when a large cyst causes an ovary to twist or shift from its usual position.  As a result, the blood supply to that ovary is cut off, which can cause death or damage to the affected tissue.  Ruptured cysts occur when the cyst(s) burst, causing internal bleeding and severe pain.  Untreated recurrent ovarian cysts during childbearing years may lead to infertility.

Diagnosis.  In most cases, an ovarian cyst is first detected via  manual pelvic exam by your gynecologist.  Confirmatory testing may be done via a CT scan, PET scan, MRI, or ultrasound.

Treatment.  Most cysts disappear on their own, so your doctor may not recommend any interventions if it is not causing any severe symptoms.  Oral contraceptives may be prescribed to stop ovulation and prevent the development of additional cysts.  As an added bonus, birth control decreases your risk of ovarian cancer.  In severe cases, the cyst(s) may be surgically removed, sometimes requiring a full hysterectomy.  Cancerous cysts can be treated with chemotherapy and/or radiation.

Pelvic inflammatory disease (PID) is an infection of the female reproductive system.  PID can lead to irreversible damage of varying organs within the reproductive system to include the uterus, ovaries, and fallopian tubes.  PID is common, affecting 1 million American women each year, and is the #1 preventable cause of infertility in women.

Cause. Sexually transmitted diseases, such as gonorrhea and chlamydia, are the most common causes of PID.  Abortion, childbirth, and other trauma may also cause PID.

Symptoms. Common symptoms of PID are abdominal pain; vaginal discharge; painful urination; chills; high fever; nausea and vomiting; and painful sexual intercourse.

Complications.  Recurrent PID may lead to infertility, ectopic pregnancy, and chronic pelvic pain.

Risk Factors.  Risk factors of PID include douching; using an IUD as a form of birth control; having unprotected sex (particularly with more than one partner); having an untreated STD; and a personal history of PID.

Diagnosis.  PID is usually first suspected by your doctor after performing a manual pelvic exam.  An ultrasound, biopsy, or laparoscopy can help confirm the presence of PID.

Treatment.  Oral antibiotics are generally the first line treatment for PID.  For severe infections, hospitalization and IV antibiotics may be warranted.  Generally, your sexual partner(s) should be treated too as the assumption is they also have the causative STD.  They need to be treated even if they are not experiencing any symptoms.  Otherwise, reinfection may occur the next time the two of you have sex.  If your PID has caused an abscess, surgery may be needed to remove it and prevent it from rupturing.

Prevention.  To avoid PID, it is important to practice safe sex.  Avoid multiple sexual partners, use protection (either a condom or diaphragm), and consider forms of birth control other than IUDs.  Be sure to seek medical care at the first sign of vaginal discharge, pelvic pain, or bleeding.  Lastly, be sure to maintain your annual gynecological visits.

Endometriosis is a condition in which the endometrium, the lining of the uterus, grows outside of the uterus.  The tissue can be found on any part of the reproductive system, to include the ovaries, fallopian tubes, or the intestines.  Despite growing in an unintended place, the tissue continues to act as it would in the uterus–thickening, breaking down, and bleeding with each menstrual cycle.  This tissue may also cause cysts (endometriomas), development of scar tissue, and adhesions (organs that stick together).

Risk factors.  While the exact cause of endometriosis remains uncertain, there
are several known risk factors such as: having never birthed a child; starting menstruation at an early age; going through menopause at a later age; having shorter periods; regular alcohol consumption; low body mass index; and a family history of endometriosis.

Symptoms.  A woman with endometriosis may experience abdominal, pelvic, rectal, or vaginal pain; painful intercourse; irregular, heavy, or painful menstruation; constipation; nausea; abdominal cramping; and infertility.

Complications.  Infertility and ovarian cancer are the two most concerning complications of endometriosis.  Approximately 1/3 – 1/2 of women who suffer from the condition have fertility issues, yet pregnancy is still possible.  Fortunately, the rates of associated ovarian cancer are much lower.

Diagnosis. Possible diagnostic tools when endometriosis is suspected are a pelvic exam, transvaginal ultrasound, or laparoscopy.

Once diagnosed, endometrosis can be classified into 4 different stages based on their severity.   Stage I (minimal) and II (mild) are most common.  Stage III (moderate) typically means that cysts and severe scarring are present.  Stage IV (severe) indicates that the damage has caused infertility.

Treatment. Self-care can help to improve minor symptoms.  Warm baths and heating pads can reduce pain and cramping by relaxing the pelvic muscles.  OTC pain medications can also help to alleviate muscle cramps.

Hormonal therapy, such as birth control medications, can be effective in relieving the pain associated with endometriosis.  It is the rise of fall of hormones as a part of the menstrual cycle that causes the tissue to thicken, break down, and bleed.  Hormone medications help to slow tissue growth, and prevent new tissue from building.

If hormonal therapy fails, conservative surgery may be used to remove the displaced tissue.  This option removes only the abnormal tissue and leaves the female reproductive organs intact.  In the most severe cases, a hysterectomy may be required.

Uterine fibroids are benign (noncancerous) tumors that grow in the uterus.  Fibroids can range in size from tiny to as large as a grapefruit.  They can also exist as a single fibroid or in multiples.  Most women (up to 80% of them) will have a fibroid at some point in their lifetime, but are unaware because they don’t experience any symptoms.  Fortunately, fibroids generally do not increase a woman’s risk of developing any cancers of the reproductive system.

Cause.  The exact cause of fibroids is unknown, but there is a possible link to genetics, increased levels of the hormones estrogen and progesterone, and increased levels of insulin.

Risk Factors.  A family history of fibroids, increased age (30s through menopause), African American ancestry, early-onset of menstruation, use of birth control, obesity, vitamin D deficiency, frequent use of alcohol, and a diet high in red meat all seem to increase a woman’s risk of developing fibroids.

Symptoms. Common symptoms of fibroids are pain in the abdomen, lower back, or pelvis; heavy, painful, or irregular periods; frequent urination; difficulty urinating; constipation; and abdominal cramps.

Complications.  Though rare, fibroids may cause infertility.  If able to get pregnant despite the presence of fibroids,  miscarriage, breeching of the baby, fetal growth restriction, and preterm delivery may result.

Diagnosis.  Most often, uterine fibroids are first identified with a manual pelvic exam at your annual gynecological visit.  The presence of fibroids may be confirmed with an ultrasound, MRI, x-ray, cat scan, hysterosonogram, or hysterosalpingogram.

Treatment.  If the fibroids are small or painless, your doctor will usually just recommend “watchful waiting.”  This means no interventions will be done unless symptoms worsen at some point in the future.  Regular exercise and eating a diet high in fresh fruits and cruciferous vegetables (arugula, broccoli, cabbage, cauliflower, and greens) may help lower risk of developing further fibroids.  OTC pain medication such as Tylenol or Motrin can help treat mild-to-moderate pain.  Iron supplements can help prevent anemia in women who suffer from heavy periods.  Hormonal medications such as oral contraceptives, the Depo-Provera shot, and the Mirena IUD can all help to shrink fibroids and/or relieve heavy periods.  Surgery at varying levels of intensity can remove fibroids.  And in the most extreme cases, a hysterectomy may be done to remove all female reproductive organs.

A pap smear is a test that checks for cervical cancer.  A small sample of cells are scraped from the opening of the cervix, and then sent to a lab for examination under a microscope.

How should I prepare?  Try to avoid scheduling your pap smear during your period.  In the 48 hours prior to the exam, be sure to avoid douching, tampons, sex, and vaginal medications, foams, creams, jellies, etc.

What happens during the test?  Pap smears are generally done by your gynecologist at your annual wellness exam.  During the test, you lay down on the exam table with your legs spread open in stirrups.  The provider inserts a small tool (a speculum) into your vagina to keep it open, and then removes the needed cell sample.  The cells are then sent to a lab for microscopic examination.  For most women, the test is not painful, but may cause some discomfort.  Fortunately, the entire procedure is usually over in just a few minutes.

Why is it important?  Cervical cancer is the 4th most common cause of cancer-related death in women.  Generally cervical cancer does not have any symptoms, so getting your pap smears on schedule is vital as the primary screening tool.  Like many other cancers, the earlier it is detected, the better your chances of survival.  Pap smears are highly accurate, and getting one done regularly can decrease your risk of cancer and cancer related-death by 80%.

How often should I get a pap smear?  Generally, screening should start at age 21. If sexually active as a teenager, your doctor may recommend that you start your pap smears sooner.  After that, the test should be repeated every 3 years.  If you have a history of human papillomavirus (HPV) or abnormal pap smears in the past, you may need to get them done more frequently.  If aged 30-65, you can get both a pap smear and HPV test every 5 years as long as they both remain negative.  Most women can stop having pap smears after age 65 as long as their previous 3 pap smears have been negative.

What do my test results mean?  A normal result indicates that there are no abnormal cells present.  An abnormal result means that atypical, precancerous, or cancerous cells are present.  Your doctor will decide the appropriate intervention depending on the severity of your results.

Anxiety is defined as “a nervous disorder characterized by a state of excessive uneasiness and apprehension, typically with compulsive behavior and/or panic attacks.”   The effects of anxiety disorders are so severe that they interfere with normal daily activities.

Subtypes.  There are many different types of anxiety disorders.  Examples include:

• Generalized anxiety disorder (GAD) – people with GAD experience chronic excessive anxiety and worry in relation to several different stressors
• Panic disorder – those who suffer from panic disorder experience recurrent unexpected panic attacks
• Social anxiety disorder – people with social anxiety disorder fear social situations in which they may be embarrassed, judged, or rejected
• Post-traumatic stress disorder (PTSD) – anxiety related to PTSD is triggered by a terrifying event.  This event may have been a natural disaster, serious accident, terrorist attack, war, or violent personal attack.
• Obsessive compulsive disorder (OCD) – someone with OCD will experience unwanted and repeated thoughts or behaviors that make them feel driven to complete a specific task (compulsion)

Symptoms.  Fatigue, restlessness, excessive sweating, hypervigilance, irritability, excessive worry or fear, feelings of impending doom, inability to concentrate, and increased heart rate are all possible symptoms of an anxiety disorder.

Diagnosis. Psychological testing is the primary means of diagnosing anxiety disorders.

Management. If experiencing symptoms of anxiety, exercise and relaxation techniques may be beneficial.  Seeking professional help, such as with a clinical social worker or psychologist, should also help.  Mental health professionals can teach you skills that will help you deal with stress, negative thoughts, and unhealthy emotional responses related to those thoughts.  These skills may include relaxation techniques (meditation, yoga, and self-hypnosis), muscle relaxation, and deep-breathing exercises.  Avoiding stimulating substances such as caffeine and certain illicit drugs is also important.

Medications. If still struggling with anxiety despite putting these skills into practice, your doctor may suggest trying a medication to help.  Available options include antidepressants, anxiolytics, sedatives, and beta-blockers.

Anxiety may be caused by a combination of factors including changes in the brain and environmental stress.  There is no shame in having anxiety or any other mental illness.  Having anxiety does not mean that you are “paranoid” or “crazy.” If experiencing any of the symptoms above, I encourage you to seek help so that you can manage your symptoms and be your best self.

Bipolar disorder, sometimes also known as manic depression, is a mental health disorder in which someone’s mood alternates between periods of depressive lows and manic (or hypomanic) highs.  Each phase may last a few weeks up to several months.

Cause.  Bipolar disorder is caused by an imbalance in neurotransmitters in the brain, namely norepinephrine, serotonin, and/or dopamine.  The manic phase is caused by overactivity of these neurotransmitters, while the depressive phase is caused by a deficiency of them.

Symptoms.   Manic episodes are marked by high levels of energy and productivity, combined with decreased need for sleep.  Depressive episodes bring the opposite effects–low energy, low motivation, and loss of interest in day-to-day tasks.

Diagnosis. Bipolar disorder is diagnosed through psychological testing.

Management.  Psychological treatment options for people with bipolar disorder include psychotherapy and support groups.  See last week’s post on depression for a full list of activities you can do to try to help improve your mood when its low. (http://www.healthandblackness.com/depression/).

Management of manic phases is a little more difficult as many people find that they enjoy feeling manic.  They feel full of life…as if they can conquer the world.  Yet, due to this sense of euphoria, people often find that they may battle with hypersexuality, taking unnecessary risks (i.e gambling), or other dangerous behaviors during this phase.  So it is important to continually be aware of your mood, and avoid potentially self-destructive activities even if they provide pleasure at the time.

Medications.  In addition to therapy, medications that may be helpful include mood stabilizers and antipsychotics.  These medications work to balance the neurotransmitters in the brain.  Your doctor will decide which is best depending on your symptoms, frequency of mood swings, other diseases you may have, etc.  If prescribed any medication within these two groups, it is important to take them everyday, even on days that you are feeling well.  Also, be sure to discuss any unwanted side effects with your doctor, versus discontinuing the medication(s) abruptly.

As with all mental health disorders, it is important to remember that there is no shame in having bipolar disorder.  A diagnosis does not mean that you are “broken” or that something is “wrong” with you.  If experiencing any of the symptoms above, I encourage you to seek help so that you can mange your symptoms and be your best self.

If ever experiencing thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK(8255).