Recently, Catherine Zeta-Jones made the surprising announcement that she suffers from bipolar disorder.  Bipolar disorder is a mental illness that is met with a lot of confusion and incorrect assumptions.  Here, we’ll clear up some common questions about the disorder.

What is bipolar disorder?

Bipolar disorder, according to PubMed Health, involves periods of elevated or irritable mood, called mania, which alternate with periods of depression. The mood swings between mania and depression can be abrupt and occur without cause or warning.

The disorder typically presents itself between the ages of 15-25.  If affects men and women equally, and though the exact cause is unknown, doctors have observed that it occurs more often in relatives of people with bipolar disorder.

Doctors have identified that some situations are more likely to trigger episodes than others.  The situations include: life changes such as childbirth, medications such as antidepressants or steroids, periods of sleeplessness, and recreational drug use

What are the symptoms?

Manic episodes can last from days to months include a number of symptoms, including: agitation or irritation, inflated self-esteem, little need for sleep, hyperactivity, lack of self control, reckless behavior, poor temper control, and a tendency to be easily distracted.  Sleep is very important in preventing the onset of a manic phase.

The depressed phase of bipolar disorder includes symptoms like: low mood, difficulty performing mental tasks, altered eating habits, fatigue, feelings of worthlessness or guilt, persistent sadness, suicidal thoughts, sleep disturbances, and withdrawal from friends and activities.

Abusing alcohol or other drugs during either phase of bipolar disorder can potentially make symptoms worse.

How is it treated?

Bipolar disorder is typically treated with drugs called mood stabilizers.  They include carbamazepine, lamotrigine, lithium and valproate.  Sometimes doctors may also prescribe antiseizure drugs, antipsychotic drugs, anti-anxiety drugs or antidepressants.

In severe cases, electroconvulsive therapy (ECT) has been used to treat people who do not respond to medication.  ECT is a psychiatric treatment that uses an electrical current to cause a brief seizure of the central nervous system.

What support programs are available?

There are a number of family treatment programs that combine support and education about bipolar disorder as well as community support services for people who lack family support.  The goal of these programs is to help people suffering from bipolar disorder to cope with their symptoms, learn a healthy lifestyle, learn how to take medications correctly and learn to watch for signs of relapse.  Contact your local hospital to learn what programs are available in your area.

According to a new study, children who see flashing lights during a migraine may be twice as likely to have a hole-in-the-heart, the BBC News reported.

US doctors examined 109 children over six who suffered from migraines.  About half of those with migraines accompanied by a visual disturbance called an aura had the heart defect.

This is nearly double the rate seen in a normal populations.

The medical term for hole-in-the-heart is called patent foramen ovale or PFO.  It is a flap or valve-like opening in the wall between the two upper chambers of the heart.

When there is pressure inside the chest, such as that caused by coughing, the flap can open and allow blood to flow through in either direction, bypassing the body’s filtering system.  If there is debris present in the blood it can pass through the left atrium of the heart and lodge in the brain, causing a strock.

Previous studies have found a link in adults with migraines accompanied by aura and PFO.

Around one in 10 patients experience aura with their migraines.  Symptoms include seeing flashing or flickering lights, numbness, tingling sensations and slurred speech.

The study was published in the Journal of Pediatrics.

Click here to read more from the BBC News.

Results from a clinical trial have shown that cutting-edge gene therapy on Parkinson’s disease patients significantly improved the tremors, rigidity and other motor skill problems that are associated with the disease, US News and World Report reported.

The study, involving 45 patients with moderate to advanced Parkinson’s disease, randomly assigned half of the patients to receive the gene therapy and the other half to undergo a mock procedure designed to mimic the therapy.

The therapy was done with local anesthesia and used a harmless, inactive virus to deliver a glutamic acid decarboxylase (GAD) gene into the part of the brain that regulates motor function. The GAD gene was meant to prompt the production of a chemical that improves motor control, and therefore re-establish the normal chemical balance that becomes dysfunctional as Parkinson’s disease progresses.

According to the study authors, the 22 patients whose brains were infused with the GAD gene experienced “clinically meaningful improvements” of their symptoms within six months of surgery – a 23.1 percent improvement versus a 12.7 percent improvement in placebo patients on a scale used to assess motor function in Parkinson’s patients.  Furthermore, the treatment did not appear to have any serious, adverse effects.

“It’s a completely novel therapy — unlike anything that’s currently offered,” said co-investigator Dr. Andrew Feigin, an associate investigator at the Center for Neurosciences at Feinstein Institute for Medical Research in Manhasset, N.Y.

Parkinson’s disease affects one million aging Americans and is the second most common neurodegenerative disease after Alzheimer’s, according to the National Parkinson Foundation.

The study is was published in The Lancet Neurology.

Click here to read more from US News and World Report.

The tsunami triggered by Friday’s 8.9 magnitude earthquake in Japan left an impossible amount of destruction and devastation in it’s wake – and the aftereffects could last for even longer.  Following a natural disaster, food and water supplies are often contaminated and people are forced to live in deplorable conditions.

This, naturally, can lead to the outbreak of a number of serious, life-threatening diseases.  Here is a list of the diseases typically linked with tsunamis, according to the World Health Organization, how they spread, and how to fight them.

1. Cholera

Cholera recently came under a worldwide spotlight after Haiti suffered an outbreak following last year’s earthquake.  It is an infection of the small intestine and that causes large amounts of watery diarrhea.  Symptoms include abdominal cramps, dry skin, excessive thirst, lethargy, nausea, vomiting, and a rapid pulse.  Cholera is spread by drinking water or eating food contaminated with fecal matter.  Doctors treat the disease by replenishing the body with lost electrolytes and fluids.

2. Hepatitis

Hepatitis A and E, like cholera, are spread through ingesting anything contaminated with fecal matter.  The infection causes the liver to swell and is associated with symptoms such as fatigue, itching, fever, nausea and yellow skin (jaundice).  There is no known treatment for Hepatitis, and recovery can take months.

3. Leptospirosis

Leptospirosis is a severe bacterial infection spread through drinking water that has been contaminated with animal urine.  It can also be spread through breast milk, or from mother to unborn child.  Symptoms include cough, fever, headache, muscle pain, nausea, vomiting and chills.  If treated with the proper medications, the prognosis for leptospirosis is good.

4. Typhoid Fever

Typhoid fever is a bacterial infection that is spread through contaminated food and water.  People can unknowingly become carriers of the disease and spread it for years.  Its symptoms include fever, abdominal pain, diarrhea, chest and belly rashes, hallucinations, nosebleeds, severe fatigue, lethargic feeling, and weakness.  To treat typhoid fever fluids and electrolytes may be given through a vein.  Doctors will also administer the appropriate antibiotics to kill the bacteria.

5. Plague

The plague is a serious, potentially deadly disease that people can get when they are bitten by a flea that carries the plague bacteria from an infected rodent.  Certain types, like pneumonic plague can also be spread from person-to-person, when an infected person coughs in the presence of another person.  Symptoms include chills, fever, severe headache, muscle pain, difficulty breathing, seizures, and bleeding. Antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin are used to treat plague. Oxygen, intravenous fluids, and respiratory support usually are also needed.  Without immediate treatment (within 24 hours) most people infected with the plague will die.

6. Japanese encephalitis

Japanese encephalitis is a virus that causes the brain to swell.  It is spread through mosquitoes.  It can cause fever, headache, neck stiffness, stupor, disorientation, abnormal movements, occasional convulsions (especially in infants), coma, and paralysis.  One if four cases result in death.  There is no specific treatment once it is contracted, but there is a vaccine to protect against it.

Hypertension is known as the silent killer for good reason. Some 50 million Americans have high blood pressure and one-third of those don’t even know it, despite the fact that it’s very easy to diagnose.

Hypertension kills some 40,000 Americans each year, and another 200,000 die annually of a high-blood-pressure-related illness. People with hypertension are seven times more likely to have a stroke, six times more likely to have congestive heart failure, and three times more likely to develop a heart attack.

In all, hypertension claims more lives per year in the United States than cancer. Those numbers are doubly sad: first, because they are so high, and second, because they could easily be so much lower. More than half of the people with hypertension are not receiving treatment at all, and one-quarter of them are being inadequately treated. Only about one-fifth are receiving the proper treatment to control their blood pressure.

There are two types of hypertension. More than 90 percent of all cases of hypertension involve what is known as essential hypertension, which is high blood pressure without a definite cause. The rest, fewer than 10 percent of the cases, have a known cause; this is known as organic hypertension, or secondary hypertension. Organic hypertension occurs when a specific disease, such as a tumor of the kidneys, vascular disease, or hormonal disease, causes your blood pressure to be elevated.

When we talk about blood pressure, we are referring to a comparison of the blood pressure when the heart is beating versus the pressure when the heart is resting. A blood pressure reading is represented as the systolic (or beating pressure) over the diastolic (or resting) pressure. A normal blood pressure is anything lower than 120 over 80. But if you are 140 over 90 or above, you have high blood pressure. Anything in between the two sets of numbers is considered prehypertensive.

How can you tell you have high blood pressure? Certainly not by your symptoms; most people with hypertension don’t have any. But any qualified health professional can measure your blood pressure in a very non-evasive way using a blood pressure machine. Of course, if your blood pressure is very high, you will have symptoms like nose bleeds, irregular heartbeats, headaches, and dizziness.

Hypertension affects more males than females and more blacks and Latinos than whites. The lifestyle characteristics that can put you at risk of developing hypertension include obesity, lack of exercise, a diet rich in sodium, and excessive alcohol consumption. Smoking raises blood pressure as well. Genetic factors may be involved, too, as some individuals have a family history of hypertension.

In younger women, hypertension is sometimes associated with birth control pills. Other medications that can give you high blood pressure include some nonsteroid anti-inflammatories, cold remedies, decongestants, and appetite-suppressant pills.

Your diet plays a very significant role in blood pressure. Foods high in cholesterol thicken the blood with fat, and that forces the heart to work harder, thereby raising your blood pressure. As the heart works harder to push that blood through, the heart becomes larger because it has to expand more to grab enough volume in order to squeeze the blood out of its chambers. If the heart has to work harder, the heart and the arteries come under tremendous pressure and stress, and this, of course, weakens the heart. It also means that organs like the kidneys and eyes and liver don’t get enough oxygenated blood, which causes cell damage to those organs that ultimately damages them.

A high salt intake also makes you retain more water in your vascular system, and that, too, increases your blood pressure. To reduce your risk of high blood pressure, the American Heart Association (AHA) suggests that you ingest no more than 2,400 milligrams of sodium a day. That’s just one and a quarter teaspoons of salt per day, and it mounts up faster than you think; many foods, especially prepared foods, contain large amounts of sodium. And then there is all the salt we actually add to our food.

Being overweight is also a fundamental factor in developing high blood pressure. Conversely, losing weight is one of the essential ways of improving your blood pressure. Lack of exercise and physical inactivity is another risk factor for heart disease. This means that exercising will improve your cardiac performance, making your heart work better, thus lowering your blood pressure.

Stress has also been linked to hypertension: it narrows the blood vessels, thereby causing high blood pressure, so it is vital for people who have high blood pressure to learn how to manage their stress.

The treatment of high blood pressure involves making dietary changes, losing weight, lowering cholesterol, practicing relaxation and meditation techniques, and getting some exercise. If these don’t work, there are medications that can specifically target the kind of hypertension you have.

So how do we prevent high blood pressure?
Number one, watch your weight. If you are 30 percent above your ideal body weight, you’ve got a problem and are more likely to develop high blood pressure.

Second, if you’re drinking excessively—more than three hard drinks a day—this also is a problem.

Third, watch your salt intake; eat fewer processed foods. If you go out to eat, ask your wait person if the kitchen can reduce the amount of salt in your order. Eat a balanced diet. Consume foods that can help lower your cholesterol, like vegetables and grains.

Don’t smoke; nicotine is a major vasoconstrictor.

Exercise regularly; try to do 30 minutes’ worth of aerobic activities three to four times a week.

The bottom line on hypertension is to do your best to prevent it. If you can’t, identify it, and then treat it. Whatever you do, don’t become a statistic like so many other Americans.

Your heart is not the only potential victim of cardiovascular disease. Your brain can be, too. Stroke is a type of cardiovascular disease that affects the arteries leading to and within the brain. A stroke occurs when the blood vessels that carry the oxygenated blood and nutrients to the brain are either blocked by a clot or break.

This prevents the brain from getting the oxygen and nutrients it needs, and within minutes to a few hours brain cells begin to die. Every 45 seconds someone in the United States has a stroke, and every three minutes someone dies of stroke. That’s about seven hundred thousand strokes a year, of which about 160,000 result in fatalities.

I can’t stress enough how important it is to learn how to recognize the symptoms of stroke because it can save your life or the life of someone you know. The most characteristic symptom is a sudden numbness, weakness, or paralysis of the face, arm, or leg, usually on one side of the body. Other symptoms include loss of speech or trouble talking, blurry vision, double vision, decreased vision, dizziness, loss of balance and coordination, an out-of-the-blue bolt of pain, headache, vomiting, or altered consciousness and disorientation or memory loss. Usually these symptoms strike suddenly and without warning.

It is important to recognize the signs and symptoms of stroke because every minute counts when it comes to treating one. The longer a stroke goes untreated, the greater the damage and potential disability. So if you have any of the signs and symptoms of stroke, it is important to get help immediately.

Eighty percent of strokes are ischemic, which means they are caused by an obstruction from a blood clot or particle of cholesterol plaque that reduces the blood flow to the brain. The brain cells die within minutes of this happening. There are two types of ischemic stroke. Thrombotic strokes are caused by clots that originate in the arteries that supply the brain, like the neck arteries, or the arteries within the head itself. Embolic strokes originate from blood clots that form away from the heart but are swept up through the bloodstream and into the narrow arteries of the brain.

The other 20 percent of strokes are hemorrhagic; they occur when a blood vessel in the brain leaks or breaks. The most common risk factor for hemorrhagic stroke is uncontrolled hypertension, though it can also be caused by an anatomical weakness of the blood vessel itself, that is, an aneurysm, or by an abnormal connection of the arteries and veins in the brain.

There are several risk factors for stroke.

People who have transitory ischemic attacks—a temporary halt to the flow of blood to the brain—have a ninefold increase of developing a full-blown stroke. At higher risk are those who have a family history of stroke, are older (the older we get, the greater the chance of stroke), and are African American, partly due to the high prevalence of high blood pressure and diabetes among the black community.

Other factors include hypertension, high cholesterol, cigarette smoking, diabetes, obesity, cardiovascular disease, and high homocysteine levels. Homocysteine is an amino acid in the blood, and people with elevated homocysteine levels have a higher risk of stroke. Women taking birth control pills or hormone replacement therapy may also be at higher risk for stroke.

The good news is that there actually are some things you can do to avoid being a victim of stroke. Even though you cannot do anything about your race, your sex, your family history, or your age, since cardiovascular disease and stroke go hand in hand, you certainly can look at your risk factors for heart disease and hypertension and focus on early screening.

Get your blood pressure checked; learn what your body mass index is; and check your cholesterol and glucose levels every two to five years.

Exercise, manage your stress, limit your alcohol consumption, don’t smoke, and stay away from foods with saturated fats.

Take a vitamin B complex, like B6, B12, and folic acid, which are essential in helping to reduce the levels of homocysteines in the body.

Don’t take illicit drugs, like cocaine, which may trigger a stroke.

People with risk factors for stroke should consider a brain-healthy diet that includes several servings daily of fruit and vegetables with nutrients rich in potassium, folate, and antioxidants. Eat foods high in soluble fiber, like oatmeal, to help reduce cholesterol, as well as foods rich in calcium and soy that help reduce your bad cholesterol and raise your good cholesterol. Foods rich in omega-3 fatty acids, which include, of course, plant oils, salmon and other cold-water fish like tuna, are also good weapons in the battle against stroke.

When it comes to the treatment of strokes, some hospitals have actually established special stroke emergency rooms that are manned by a multidisciplinary team well versed in their diagnosis and treatment. Whoever the doctor is, however, he or she must first determine the type of stroke and its location before treating it.

A wide variety of diagnostic tests are available to the doctor, and they all fall into one of three categories: imaging tests, which provide a better-than–X-ray picture of the brain; electrical tests, which record the impulses in the brain; and blood flow tests, which show any problem that may be causing changes in blood flow to the brain.

Essentially, all emergency room doctors will attempt to improve and restore blood flow to the brain of a stroke victim. One way to do that is by injecting a clot-bursting drug, or thrombolytic, that helps dissolve the clot. Other techniques include performing a surgical procedure such as a carotid endarterectomy, in which the surgeon opens the carotid arteries and removes the plaque from them, or angioplasty, in which a balloon-tipped catheter dilates the arteries to improve the blood flow.

Once a stroke has been diagnosed and treated, most individuals end up taking preventive medicines to minimize the chances of recurrence. Some may receive antiplatelet drugs to make platelet cells in the blood less sticky and less likely to form a clot, or anticoagulants, which again prevent the blood from clotting. In cases of hemorrhagic stroke, where a blood vessel has ruptured, surgical intervention is needed to minimize further bleeding by clipping, cauterizing, or removing the clot and any vessel that is actively bleeding.

Stroke survivors must cope with a life-changing experience. They are often significantly disabled and, as a result, need a strong support system. Usually the support system is a team of rehabilitation doctors, which might include a psychiatrist, a dietitian, an occupational therapist, a physical therapist, a speech therapist, and social workers.

A stroke victim has to deal with impaired movement, which has implications for walking, balancing, speaking, swallowing, and breathing; bladder and bowel dysfunction; and diminished sex drive—as well as all the emotional issues that result from those problems. A stroke victim’s family is also profoundly affected because they now have to take part in caring for the individual.

Stroke can change your life completely, so learn to recognize it and treat it urgently to minimize the terrible disabilities it can inflict on its victims.

The Other Victims of Stroke

The obvious result from a major stroke is devastating disability—such as speech impairment, weak hand and leg movement, and depression. But a stroke can also have an indirect effect on the health of the victim’s family and friends.

Imagine a very strong and vibrant man who has never been sick, who has been a good husband and provider, who has been a great father. His family, and especially his wife of 45 years, marveled at his strength. He was healthy and looking forward to a peaceful and blessed retirement. Then one day he suffered a major stroke, which left him unable to speak and walk. For the family, the confusion and shock were intense. How could this have happened?

This is not a fictional story. It happened in my family. When I first met my future father-in-law, I never imagined that one day his life would end up in such a way. However, this same scenario is played out over and over again in many families across the United States and around the world.

All of a sudden, responsibilities that were the stroke victim’s are now delegated to other members of the family, and in some cases the majority of the responsibilities falls on the spouse. From everyday things like shopping or paying bills to new responsibilities like making daily trips to the rehabilitation center; feeding, bathing, and keeping up with all the medications; and becoming a motivational guru.

All of this can have a tremendous impact on the caregiver’s health. Suddenly, what was once an ordinary life becomes an extraordinary one burdened by the pressure and eased by the love for the ailing family member. We doctors sometimes forget about the families, and that’s a big mistake. When dealing with stroke survivors, focusing on the family as a whole is always important. We must listen, support the changes that are needed, and monitor stress and the effect that it has on the people taking care of stroke survivors.

Family members take care of one another; they become the pillars of health care in the home and improve the outcome that any therapy in the hospital could bring. I remember the look of my mother-in-law as she dealt with her husband’s disabilities, a look of love, duty, and compassion. But we must always make sure that, as we take care of others, we take care of ourselves.

If you don’t take care of your own health, you may very well end up being unable to take care of the person you love. So stay healthy. They don’t say “in sickness and in health” for nothing.