W dniu 30 marca przypada Światowy Dzień Choroby Afektywnej Dwubiegunowej. Na czym polega to schorzenie? Czym się objawia i jak wygląda jego leczenie? O tym w niniejszym artykule.
Czym jest ChAD?
Choroba afektywna dwubiegunowa jest przewlekłym, nawracającym zaburzeniem psychicznym, które istotnie oddziałuje na nastrój, myślenie i zachowanie pacjenta. Potrafi zdezorganizować życie nie tylko osoby chorej, ale również jego najbliższych.ChAD najczęściej rozpoznaje się u osób w wieku 20-30 lat, bywa też, że jest diagnozowane u nastolatków i dzieci.
Jako odpowiedzialne za rozwój tej choroby wskazuje się czynniki biologiczne, psychologiczne, społeczne i środowiskowe, w tym:
- uwarunkowania genetyczne,
- zaburzenia równowagi neuroprzekaźników w mózgu,
- sytuacje z dużym ładunkiem stresowym,
- nadużywanie alkoholu lub substancji psychoaktywnych.
Choroba może także nie być wywołana przez żaden z wymienionych czynników i rozwinąć się samoistnie.
Objawy choroby afektywnej dwubiegunowej
ChAD charakteryzuje się zaburzeniami nastroju występującymi pod postacią cyklicznych i naprzemiennych epizodów:
- depresji,
- manii,
- hipomanii,
- epizodów mieszanych (o różnym czasie trwania).
Pomiędzy poszczególnymi epizodami następuje etap remisji, czyli okres stosunkowo normalnego funkcjonowania. W tym czasie występują symptomy o niewielkim nasileniu albo w ogóle brak jest objawów.
Przebieg choroby
Zazwyczaj epizody zaczynają się nagle, mogą trwać od 2 tygodni do kilku miesięcy.
Epizod depresyjny może charakteryzować się znaczącym spadek nastroju, stanami lękowymi, niezdolnością do wykonywania najprostszych czynności, np. wstania rano z łóżka. Depresja w chorobie dwubiegunowej nierzadko kończy się myślami samobójczymi, a nawet czynami samobójczymi.
W kolejnym okresie pacjent doświadcza manii. Epizody maniakalne sprawiają, że osobie chorej wydaje się, że może wszystko, że jest niesamowicie zdolna, jest przekonana o swojej wyższości nad innymi. Cechuje ją wyolbrzymione poczucie dobrego samopoczucia i pewności siebie (euforia). W takim stanie często zachowuje się impulsywnie, podejmuje ryzykowne, nieprzemyślane decyzje. Może nadużywać alkoholu i innych używek.
Osoba z ChAD doświadcza też hipomanii, która jest lżejszą postacią manii. Dla tego epizodu charakterystyczna jest nadmierna wesołość, podniecenie, podwyższona aktywność. Inaczej niż w manii, chory częściowo kontroluje swoje działania. Dąży do ich natychmiastowej realizacji, a w braku powodzenia doznaje frustracji.
Leczenie ChAD
Chorobę afektywną dwubiegunową można wyleczyć, jest to jednak proces długotrwały. Możliwe jest uzyskanie całkowitej remisji lub zmniejszenie nasilenia objawów oraz powrót do normalnego i satysfakcjonującego życia.
Na powodzenie leczenia składają się stosowane łącznie: farmakoterapia – jako podstawowa forma leczenia – oraz psychoedukacja i psychoterapia. W ramach psychoedukacji pacjent i jego bliscy uczą się rozpoznawać sygnały zwiastujące nawrót choroby, psychoterapia zaś dostarcza wsparcie potrzebne w codziennym funkcjonowaniu, najczęściej w okresach remisji. Podkreśla się również duże znaczenie wczesnego rozpoznania, dobrej współpracy z psychiatrą oraz pomocy ze strony najbliższych.


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