A-fib surgery: Types, risks, and what to expect

Atrial fibrillation is a serious medical condition characteristic of an abnormal heartbeat. The irregular response is due to erratic electrical impulses in the heart's upper chambers.

Atrial fibrillation (A-fib) is an irregularity that can result in symptoms, such as heart palpitations, chest pain, and dizziness. However, some people may not experience any symptoms at all.

The Centers for Disease Control and Prevention (CDC) estimate that up to 6.1 million people in the United States may have A-fib. According to the World Health Organization (WHO), there are around 33.5 million people living with A-fib worldwide.

There are different treatment options for managing A-fib, including lifestyle changes, medications, and other nonsurgical options. While these treatments may help some people, they may not work for everybody and are not a cure. Doctors may consider surgery if a patient's medications aren't working and when nothing else has helped.

How is A-fib treated?

Treating A-fib involves preventing blood clots and lowering stroke risk. Other goals include controlling heart rate, restoring heart rhythm, and treating underlying disorders.

Lifestyle changes are a first treatment approach. People with A-fib should quit smoking, get active and stay active, lose weight, and eat a healthful diet. Patients may also take medications to prevent blood clots, control heart rate, and restore heart rhythm.

Rate control involves managing the per minute contraction rate of the ventricles (two large chambers in the heart that help pump the blood).

The heart needs a certain amount of time to circulate the blood and if it is able to work at a regular pace, people will experience fewer symptoms and will feel better. Restoring the heart's rhythm allows it to pump blood effectively throughout the body.

When medications aren't helping to restore normal heart rates and rhythms, the next step is electrical cardioversion.

Electrical cardioversion involves giving a person an electric shock outside their chest wall while they are under low-dose anesthesia. Like defibrillation, electrical cardioversion is designed to reset the heart rhythm. The only difference is that lower levels of electricity are used in electrical cardioversion than in defibrillation.

Whether this procedure is successful or not depends on what is causing the A-fib symptoms and how long the person has been having them. Most people get their heart rhythm back right away, but cardioversion is not a cure.

If A-fib symptoms return, another cardioversion is carried out. When cardioversion is combined with medications, the heart rhythm can stay normal for longer, which could be up to a year or longer.

The risks of cardioversion include skin burns, fluid buildup in the lungs, and an increased risk of heart attack or stroke. However, the success rates for returning the heart to a normal rhythm during the procedure or shortly after are over 90 percent. The potential for success may outweigh the risks, but people should still discuss any and all risks with their doctors.

A doctor may recommend surgery to treat A-fib when lifestyle changes, medication, and cardioversion are not helping. Surgical options include catheter ablation, maze surgery, or the insertion of a pacemaker.

Catheter ablation

Catheter ablation is an option for people whose medications are no longer effective and for those for who electrical cardioversion did not work or was not an option. Before the procedure, a doctor will do electrical mapping, which shows what areas of the heart are causing complications to its rhythm.

The actual procedure involves inserting a thin and flexible tube, called a catheter, into the blood vessels and guiding it to the heart. The purpose of catheter ablation is to destroy the faulty tissues that are sending irregular signals and causing the irregular heart rhythm.

It does this in one of three possible ways:

·         radiofrequency

·         laser

·         freezing

Once the faulty tissues have been destroyed, scarred areas will be left behind. This scar tissue will no longer send irregular signals and the heart will return to its normal rhythm. In some cases, however, A-fib will return, and ablation will have to be redone two or more times.

Catheter ablation is a minimally invasive surgical procedure and recovery time is generally short. A person will still need to take anti-arrhythmic drugs until the procedure takes its full effect.

The success rates for maintaining normal heart rhythms after catheter ablation is up to 90 percent. Success depends on how long an individual has had A-fib and its severity.

For most people, quality of life is significantly improved. A 2010 study found that 2 years after their ablation procedure, 72 percent of the 323 people surveyed were no longer taking A-fib medications.

The risk of life-threatening complications is around 1-2 percent. Other side effects are not life-threatening and include mild pain, bleeding, and bruising.

 Source: Medical News Today

How long does a cup of coffee keep you awake?

Caffeine is a familiar drug that stimulates the nervous system. When it enters the body, caffeine raises the heart rate and blood pressure, increasing energy levels and improving the mood.

Caffeine acts quickly, and many people notice the effects within minutes. They last until the body fully metabolizes the drug. This duration depends on several factors.

Each person will feel the effects differently, and some may last longer than others. People who are pregnant or have difficulty sleeping should be careful about timing their caffeine intake and may want to avoid it altogether.

How long does it take to metabolize caffeine?

Caffeine has a half-life of about 5 hours.

Someone who consumes 40 milligrams (mg) of caffeine will have 20 mg remaining in their system after 5 hours.

When do effects peak?

Levels of caffeine peak in the blood within about 15–45 minutes of consumption.

They are then quickly metabolized by the liver.

Most people notice the strongest effects during this time, and many report feeling jittery, needing to urinate, and having sudden bursts of energy. These symptoms tend to go away as the caffeine starts to break down.

Can a person build up a tolerance?

As the body becomes resistant to the drug, people who regularly consume caffeine may barely notice its effects.

However, for someone who is very sensitive to caffeine, effects may persist for hours or until the next day.

How long do effects last?

There is no set time limit. The duration of the drug's effects depend upon the dosage and on personal factors, including age, body weight, and how sensitive a person is to caffeine.

Foods and drinks that contain caffeine

Caffeine is usually found in beverages, including:

·         coffee and drinks such as espressos, lattes, and cappuccinos

·         black, green, and white tea

·         yerba maté

·         many soft drinks

·         energy drinks

Even decaffeinated coffee contains some caffeine, and people who are very sensitive to caffeine should avoid it.

Caffeine can also be found in foods, such as:

·         chocolate and products containing it, such as hot cocoa

·         coffee or mocha ice creams

·         guarana seeds and beverages

·         some protein and energy bars

·         pre-workout drinks and powders

Caffeine is also a common ingredient in weight loss pills and over-the-counter headachemedicines, including Excedrin.

How much caffeine is in each product?

The amount of caffeine in products like coffee and tea varies, but the American Academy of Sleep Medicine has listed the following estimates:

·         8 ounces (oz) of brewed coffee – 95 mg

·         1 oz of espresso – 64 mg

·         8 oz of brewed tea – 47 mg

·         16-oz average energy drink – 158 mg

·         12-oz average caffeinated soda – 45 mg

·         1.55-oz milk chocolate candy bar – 9 mg

Drugs that contain caffeine will display exact amounts on their labels.

Source: Medical News Today

Can you overdose on caffeine?

Caffeine overdose is very rare, but it is often related to energy drinks or caffeine supplements that can contain very high levels of this stimulant.

Children and adolescents have a lower tolerance for caffeine and a higher risk of overdose than other people.

In this article, we look at official advice on how much caffeine people can consume, sources of caffeine, and treatment and prevention of an overdose.

We also examine what caffeine is, as well as the risk factors, likelihood, and symptoms of a caffeine overdose.

What is caffeine?

Caffeine occurs naturally in certain plants, nuts, and seeds and manufacturers add it to some foods and drinks.

It has a range of effects on the body, from suppressing appetite to making a person feel more awake.

Caffeine is a stimulant, meaning that it increases some of the body's processes. For example, messages moving between the brain and body can travel faster. This is one reason why a person may feel more alert or focused after consuming caffeine.

Heart rate and breathing may also speed up after someone consumes caffeine. Most of the effects on the body are short term and do not cause lasting harm.

However, consuming a large amount of caffeine can have a harmful effect on the body.

How likely is a caffeine overdose?

A person might find consuming too much caffeine and experiencing side effects to be easy. However, a life-threatening overdose is rare, and a caffeine overdose as a cause of death even rarer.

In a 2018 review of scientific journal articles, researchers identified 92 reported deaths from caffeine overdose. This review included all journals since online databases began. The researchers believe that around one-third of these deaths are likely to be suicide.

In general, caffeine will begin to affect the body if there are more than 15 milligrams per liter (mg/L) in the blood. A concentration of 80 to 100 mg/L can be fatal.

Caffeine overdose is most likely to result from taking a dietary supplement or caffeine tablets rather than from drinking coffee, especially when people combine these products with energy drinks, sodas, or coffee. Supplements increase the risk due to having higher levels of caffeine than foods and drinks.

Unlike drinking coffee, or even taking supplements containing caffeine, using purified caffeine powder is highly dangerous and much more likely to cause an overdose.

The United States Food and Drug Administration (FDA) warns that a teaspoon of powdered caffeine can be equivalent to 28 cups of coffee. It stresses that pure and highly concentrated caffeine products can have serious health consequences.

The cause of death from caffeine overdose is typically ventricular fibrillation. This condition happens when the lower chambers of the heart vibrate rather than contracting regularly. Ventricular fibrillation stops the heart from beating normally and causes cardiac arrest.

 Source: Medical News Today

Sunscreen may help maintain blood vessel health

It is a well-known fact that sunscreen protects us against sunburn and reduces the risk of skin cancer. According to a recent study, sunscreen might also help our blood vessels maintain function.

Scientists have known for many years that ultraviolet radiation (UVR) from the sun is a major causative factor in skin cancer.

UVR exposure also causes cellular and molecular damage that promotes skin aging.

With these two examples being well-documented, a recent study looks instead at the relationship between UVR and the performance of blood vessels in the skin.

Earlier studies have shown that UVR influences how blood vessels in the skin behave.

Specifically, it reduces the level of vasodilation that nitric oxide (NO) mediates.

NO is an important signaling molecule in the human body. Among other roles, NO functions as a vasodilator, meaning that it triggers relaxation in the smooth muscles around blood vessels, thereby increasing blood flow.

NO and vasodilation

Vasodilation in the skin serves a vital role in allowing the body to maintain its temperature and respond to heat stress. If the body is overheating, NO produces vasodilation in the skin, which increases blood flow and, therefore, heat loss through the skin.

Virtually every type of skin cell is capable of producing NO, but a chemical called 5-methyltetrahydrofolate (5-MTHF) is essential for this process. Experts believe that UVR reduces the levels of 5-MTHF that are available in the skin, thereby limiting vasodilation.

As the authors of the current study write, NO-associated vasodilation is "a marker of skin vascular health."

NO's influence may reach farther than the skin alone. Some researchers have concluded that vasodilation in the skin may have an overall effect on blood pressure.

A group of scientists recently set out to investigate how using sunscreen might influence the relationship between UVR and vasodilation. They compared NO-associated vasodilation in skin that they had covered with either sunscreen or sweat.

The researchers, from Pennsylvania State University, recently presented their findings at the Experimental Biology 2019 conference in Orlando, FL.

Ultraviolet exposure and sunscreen

To investigate, the scientists recruited 13 healthy participants with light-to-medium skin tone. They exposed one arm of each individual to UVR, while the other arm served as a control. The team calculated the UVR exposure to make it equivalent to spending roughly 1 hour outside on a sunny day.

Each participant underwent three tests in parallel on their exposed arm: UVR alone, UVR plus sunscreen, and UVR plus sweat.

As expected, compared with the control arm, the UVR-only test site showed reduced NO-associated vasodilation. In other words, UVR prevented NO from triggering the relaxation of the muscles in blood vessels, thereby reducing the body's ability to cool itself down.

Conversely, both the sunscreen and sweat testing areas did not show a reduction in NO-associated vasodilation.

Importantly, the researchers also found that when they applied sunscreen before UVR exposure, the sunscreen boosted vasodilation compared with both the sweat-tested region and the control arm. The authors write that "UVR may actually augment NO-mediated vasodilation in the presence of a chemical sunscreen."

Source: Medical News Today

Bipolar disorder speeds up biological aging

A

 recently published study demonstrates a link between telomere length, which is a mark of biological aging, and bipolar risk. The research helps to explain why bipolar disorder often comes hand-in-hand with other age-related diseases.

Individuals with bipolar disorder carry the hallmarks of increased cellular aging.

Individuals with bipolar disorder, which is sometimes referred to as manic depression, experience shifts in mood from feeling extremely energized and elated, to hopeless and depressed. It affects an estimated 2.6 percent of adults in the United States each year.

Aside from the psychological disruption, bipolar disorder is linked to a range of other diseases normally associated with advanced age, such as cardiovascular disease, type 2 diabetes, and obesity.

Recently, researchers from King's College London in the United Kingdom and the Icahn School of Medicine at Mount Sinai in New York City, NY, set out to probe this relationship further. The team were particularly interested in telomeres, which are features of chromosomes that reflect the age of an organism.

Their findings are published in the journal Neuropsychopharmacology.

Telomeres and biological aging

Telomeres act as protective caps on the ends of DNA strands. Each time a cell divides, the telomere becomes shorter, until it is so short that the cell can no longer replicate.

In this way, telomere length can be used as a measure of biological aging and susceptibility to disease. In older people, telomeres are generally shorter. However, biological aging is different from chronological aging.

Various genetic and environmental factors can influence the rate of biological aging, meaning that two people of the same chronological age might be different ages biologically.

Telomere length is currently being investigated as a biomarker for neuropsychiatric conditions. For instance, shortened telomeres have been found in individuals with major depressive disorder, schizophrenia, and dementia.

An association has also been found between telomere length and the structure of the hippocampus, which is an area of the brain involved in memory and mood regulation. Similarly, shorter telomeres are associated with reduced memory function.

Lithium reduces bipolar-related aging

For the new study, scientists took DNA samples from 63 patients with bipolar disorder, 74 first-degree relatives, and 80 unrelated healthy individuals. Relatives of individuals with bipolar disorder were included because telomere length is known to be heritable.

They found that, in the first-degree relatives, telomere length was significantly shorter than in the healthy controls. In the bipolar group, telomere length was dependent on another factor: lithium.

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Lithium is a drug commonly used to treat bipolar disorder. Individuals with the condition who had taken this drug did not have significantly shorter telomeres, but those that had not taken the medication showed the same reduced length as their relatives.

This suggests that lithium prevents or minimizes the premature aging associated with bipolar disorder, backing up previous findings.

Telomere length and the hippocampus

To investigate the relationship between telomere length and brain structure, the researchers conducted MRI scans on the participants. As predicted, the team found that shorter telomeres were associated with reduced hippocampal volume.

"Our study provides the first evidence that familial risk for bipolar disorder is associated with shorter telomeres, which may explain why bipolar disorder patients are also at a greater risk for aging-related diseases."

First author Dr. Timothy Powell, King's College London

These findings are interesting in their own right, but they open up a range of new questions to be answered. Dr. Powell gives an example, asking, "For instance, do those at risk for bipolar disorder carry genes predisposing them to faster biological aging, or are they more likely to partake in environmental factors which promote aging (e.g. smoking, poor diet)? Identifying modifiable risk factors to prevent advanced aging would be a really important next step."

These findings may open up new avenues of research into new interventions. In fact, co-senior author Dr. Sophia Frangou says that the results suggest "that proteins which protect against telomere shortening may provide novel treatment targets for people with bipolar disorder and those predisposed to it."

There is much work to be done, but the links between telomeres, premature aging, and neuropsychiatric conditions are sure to yield fascinating and useful results

Source:MedicalNewsToday

How to spot the symptoms of bipolar disorder

B

ipolar disorder is a mental health disorder that can cause dramatic changes in mood and energy levels. Symptoms can affect daily life severely. Spotting the signs of bipolar disorder can help a person to get treatment.

The person's mood can range from feelings of elation and high energy to depression. There can also be disruption in sleep and thinking patterns and other behavioral symptoms.

The extremes of mood are known as manic episodes and depressive episodes.

Hypomania has symptoms of a manic episode that are less severe.

According to the National Alliance on Mental Illness (NAMI), people receive a diagnosis on average at the age of 25 years, but symptoms can appear during the teenage years, and less commonly, during childhood.

Signs and symptoms

Symptoms of mania include euphoria.

Bipolar disorder is a condition with mood swings that can range from euphoria to depression.

However, for a diagnosis of bipolar I disorder, a person only needs to have a manic episode.

In fact, a person with bipolar I disorder may never experience a major depressive disorder, despite the name bipolar.

Signs of mania

When someone has mania, they do not just feel very happy. They feel euphoric.

A person with mania may:

·         have a lot of energy

·         feel able to do and achieve anything

·         have difficulty sleeping

·         use rapid speech that jumps between topics and ideas

·         feel agitated, jumpy, or "wired"

·         engage in risky behaviors, such as reckless sex, spending a lot of money, dangerous driving, or unwise consumption of alcohol and other substances

·         believe that they are more important than others or have important connections

·         show anger or aggression if others challenge their views or behavior

Severe mania can involve psychosis, with hallucinations or delusions. Hallucinations can cause a person to see, hear, or feel things that are not there.

People may have delusions and distorted thinking that cause them to believe that certain things are true when they are not.

They may believe, for example, that they have important friends (such as the president of the United States) or that they descend from royalty.

A person in a manic state may not realize that their behavior is unusual, but others may notice a change in behavior. Some may see the person's outlook as sociable and fun-loving, while others may find it unusual or bizarre.

The individual may not realize that they are acting inappropriately or be aware of the potential consequences of their behavior.

They may need help in getting help and staying safe.

Hypomania

Not everyone will have a severe manic episode. Less severe mania is known as hypomania. Symptoms are similar to those of mania, but the behaviors are less extreme, and people can often function well in their daily life.

If a person does not address the signs of hypomania, it can progress into a more severe form of the condition at a later time.

Depression

During a low phase, a person may feel depressed and unable to do anything.

Signs of a depressive episode are the same as the symptoms of a major depressive episode.

They may include:

·         feeling down or sad

·         having very little energy

·         having trouble sleeping or sleeping a lot more than usual

·         thinking of death or suicide

·         forgetting things

·         feeling tired

·         losing enjoyment in daily activities

·         having a "flatness" of emotion that may show in the person's facial expression

In severe cases, a person may experience psychosis or a catatonic depression, in which they are unable to move, talk, or take any action.

Although rare, bipolar disorder could occur in young children and teenagers.

In children

Bipolar disorder is a lifelong condition. It can be present in young children, although it often does not emerge later, often in the late teens or early adulthood.

This may happen when a trigger causes clear signs of mania or depression, but often there is no clear trigger.

It can be hard to detect bipolar disorder in toddlers or young children, as children of this age often display uncontrolled behavior until they learn new ways of behaving. This has led to controversy over the diagnosis of bipolar disorder in young children.

Children with bipolar disorder may have severe temper tantrums that can last for hours, possibly with signs of aggression. These may not improve with age, as bipolar disorder makes it harder than others to learn alternative behaviors.

Parents may also notice periods of extreme happiness and silly moods in their child.

At this age, the signs of bipolar disorder may resemble those of another condition, such as attention deficit hyperactivity disorder (ADHD).

Teens

Teenagers may show some of the more common signs of bipolar disorder, especially an increase in risky behaviors, such as:

·         reckless sexual activity, drug or alcohol use

·         poor performance in school

·         fighting

·         thinking more about death or suicide

It is important that any young person showing these symptoms sees a mental health professional.

Learn more here about how bipolar disorder can affect teens.

Causes

Doctors do not know exactly what causes bipolar disorder, but the following appear to play a role:

Genetic factors: A person with bipolar disorder may have a parent with the condition. However, having a parent or even a twin with bipolar disorder does not mean a person will have it.

Stress: Someone who has a genetic predisposition may experience their first episode of depression or mania during or after a time of severe stress, for example, the loss of a job or a loved one.

Should I see a doctor?

It is always a good idea to speak with a doctor when there is concern about severe mood swings that seem to come and go or make it difficult to work.

The best person to start with may be a primary care physician or family doctor. However, they will likely refer someone with these symptoms to a psychiatrist, or a specialist who cares for people with mental health disorders.

Someone who notices these symptoms in a friend or loved one can also speak with their doctor about their concerns. The doctor can help find local support groups or other mental health resources.

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Suicide risk

Risk-taking and thinking about suicide can pose real dangers for a person with bipolar disorder.

Whenever there is a possibility of harm or suicide, it is important to address the concern quickly and directly.

If there is an imminent risk, someone should contact the local police or suicide crisis hotline immediately.

Suicide prevention

·         If you know someone at immediate risk of self-harm, suicide, or hurting another person:

·         Call 911 or the local emergency number.

·         Stay with the person until professional help arrives.

·         Remove any weapons, medications, or other potentially harmful objects.

·         Listen to the person without judgment.

·         If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

Related conditions

Bipolar disorder has a number of comorbidities, or conditions that often occur alongside it.

Other mental health conditions that people might experience include:

·         anxiety

·         posttraumatic stress disorder (PTSD)

·         ADHD

·         misuse of alcohol and other substances

These can complicate the diagnosis.

It can take time to receive a correct diagnosis of bipolar disorder, as a doctor may identify one of these conditions, or a personality disorder, instead.

If the person experiences psychosis, this can sometimes lead to a misdiagnosis of schizophrenia, a mental health disorder marked by persistent hallucinations and delusions.

Treating these conditions may make it more difficult to diagnose or treat bipolar disorder. It can also take time to find a suitable medication and the correct dose for the individual.

However, once a person receives a correct diagnosis and appropriate treatment, medication can help to control the symptoms of bipolar disorder, and these related conditions usually improve as well.

Types of bipolar disorder

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) describes four types of bipolar disorder.

1. Bipolar I disorder

This involves periods of mania that last at least 7 days, or any duration if the person is hospitalized.

If a person experiences severe manic or depressive episodes, they may need emergency treatment in the hospital to prevent harm to themselves or to others, for example through reckless behavior.

2. Bipolar II disorder

A person with bipolar II disorder has episodes of depression and hypomania. Hypomania is less extreme than a full manic episode.

People with bipolar II disorder tend to not have full mania.

Learn more here about the differences between type I and II bipolar disorder.

3. Cyclothymic disorder

Someone with cyclothymic disorder will also have alternating periods of hypomania and depression lasting for at least 2 years.

The main difference between cyclothymic disorder and bipolar II is that the symptoms of a person with cyclothymia tend to be less severe and do not meet the criteria for hypomania and depression.

4. Other specified and unspecified bipolar disorders

A person may have bipolar disorder that does not fit within the above patterns. They may receive a diagnosis of either "other specified bipolar disorder" or "unspecified bipolar disorder," depending on their symptoms.

Diagnosis

A doctor will talk to the person about their symptoms and use the DSM-5 criteria to make a diagnosis.

In order to diagnose bipolar disorder, a healthcare provider should begin with a complete medical interview and a physical exam to rule out a physical cause for the person's behaviors.

There is currently no blood test or imaging that can diagnose the condition, but a doctor may suggest tests to rule out other medical conditions that might have similar symptoms.

If no medical conditions or medicines are causing the symptoms, the healthcare provider will consider bipolar disorder. They may refer the person to a mental health specialist.

The best person to diagnose bipolar disorder is a psychiatrist or psychiatric nurse practitioner who specializes in the care of people with mental health disorders.

Treatment

Prescribers usually treat bipolar disorder with a combination of medications and talk therapy, or psychotherapy.

Because bipolar disorder is a lifelong disease, treatment should also be lifelong.

Medications

Medications for treating bipolar disorder include:

·         mood stabilizers, such as lithium and some antiseizure medicines

·         antipsychotics, to help manage mania and psychotic symptoms

·         antidepressants may be used in some cases, depending on the person's symptoms and other considerations

It can take time to find a suitable medication and dose for the individual.

Some people discontinue their medication because it has adverse effects. If adverse effects occur, it is essential to speak to the prescriber, who may be able to change the dose or treatment. Discontinuation of medications for bipolar disorder can result in a return of symptoms.

Some people discontinue the medication because they miss the "highs" that bipolar disorder brings. They may feel they are no longer "themselves." People with this condition may be highly creative during a manic or hypomanic phase, and they may miss this aspect of their personality.

People with bipolar disorder are more likely to approach a doctor with depression than with mania.

Some treatments for depression can trigger an initial manic phase in a person who has the condition. This first experience of mania may be the first sign that a person has bipolar disorder.

Talking therapy

Counseling or cognitive behavioral therapy (CBT) can help a person with bipolar disorder, as it can make them more aware of the negative aspects of their behavior and of triggers that could sabotage their treatment, such as substance use.

Learning tips for getting enough sleep, dealing with stress, and establishing a steady work-life balance may all help to control mood changes.

Electroconvulsive therapy

If medication and talk therapy are not effective in managing the symptoms of bipolar disorder, a psychiatrist may consider electroconvulsive therapy (ECT).

In ECT, a doctor applies a controlled electric shock to certain areas of the brain in order to cause a seizure. Doctors do not know exactly how it works, but there is evidence that ECT can help to regulate mood and other symptoms.

A doctor will only recommend it if symptoms are severe, if medication and counseling do not work, or if the person is unable to take or tolerate medication.

Living with bipolar disorder

Bipolar disorder is a lifelong disorder that can have a severe impact on the individual and their family and friends.

Getting help early and actively participating in treatment are the keys to successfully managing this condition.

Source:MedicalNewsToday