The perinatal episode of care pilot is part of the maternal health reforms of NurtureNJ, a statewide campaign led by First Lady Tammy Murphy to make New Jersey the safest and most equitable place in the nation to deliver and raise a baby.
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Sometimes people have both manic and depressive symptoms in the same episode, and this is called an episode with mixed features. During an episode with mixed features, people may feel very sad, empty, or hopeless while at the same time feeling extremely energized.
A person may have bipolar disorder even if their symptoms are less extreme. For example, some people with bipolar II disorder experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done, and keep up with day-to-day life. The person may not feel that anything is wrong, but family and friends may recognize changes in mood or activity levels as possible symptoms of bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression.
Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment can help people manage these symptoms.
The most common types of medications that health care providers prescribe include mood stabilizers and atypical antipsychotics. Mood stabilizers such as lithium or valproate can help prevent mood episodes or reduce their severity. Lithium also can decrease the risk of suicide. Health care providers may include medications that target sleep or anxiety as part of the treatment plan.
An episode is also a narrative unit within a continuous larger dramatic work. It is frequently used to describe units of television or radio series that are broadcast separately in order to form one longer series.[2] An episode is to a sequence as a chapter is to a book. Modern series episodes typically last 20 to 50 minutes in length.[3]
Milton Friedman and Anna Jacobson Schwartz (1980) observe that World War II ushered in a period of inflation comparable to the inflationary episodes that occurred during the Civil War and World War I.[1] Prices also surged after World War II ended. In 1947, inflation jumped to over 20 percent, as shown in Figure 1. According to the Bureau of Labor Statistics (BLS), the rapid post-war inflationary episode was caused by the elimination of price controls, supply shortages, and pent-up demand.
This inflationary episode was caused by a booming economy, which increased prices. From 1965 through 1969, for instance, real quarterly GDP growth averaged 4.8 percent at an annual rate. Inflation fell after President Nixon instituted a freeze on wages and prices.
This fifth inflationary episode occurred when Iraq invaded Kuwait, leading to the first Gulf War. The price of crude oil increased significantly due to heightened uncertainty, leading to a short bout of high inflation.
The period right after World War II potentially provides the most relevant case study, as the rapid post-war inflationary episode was caused by the elimination of price controls, supply shortages, and pent-up demand. Figure 2 shows the change in prices in the five years following World War II.
According to Benjamin Caplan (1956), the inflationary episode after World War II ended after two years as domestic and foreign supply chains normalized and consumer demand began to level off. (Caplan also observes that private fixed investment started to decline, which contributed to the decline in prices and caused the economy to fall into a mild recession, with real GDP declining by 1.5 percent).
No single historical episode is a perfect template for current events. But when looking for historical parallels, it is useful to concentrate on inflationary episodes that contained supply chain disruptions and a spike in consumer demand after a period of temporary suppression. The inflationary period after World War II is likely a better comparison for the current economic situation than the 1970s and suggests that inflation could quickly decline once supply chains are fully online and pent-up demand levels off. The CEA will continue to carefully gauge the trajectory of inflation.
This episode was produced by Emma Peaslee and Willa Rubin. It was engineered by James Willetts and fact-checked by Sierra Juarez. Keith Romer edited this series and Jess Jiang is our acting executive producer.
Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.
Brown, B. (Host). (2020, March 27). Brené on Comparative Suffering, the 50/50 Myth, and Settling the Ball. [Audio podcast episode]. In Unlocking Us with Brené Brown. Cadence13. -on-comparative-suffering-the-50-50-myth-and-settling-the-ball/
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In one of the AMAs from 2018 or 2019, Bob Kaplan is asking Peter questions and creatine comes up. Peter said he was not taking creatine at the time, but Bob was taking creatine (5g per day). Much later (not sure exactly which episode #) and probably after the episode with Layne Norton, Peter said he was taking creatine at 5g per day. In episode #276, Peter did not say anything about taking creatine as part of his current supplements, so it seems he is not taking creatine anymore.
Identifying the onset of a depressive episode can be unnerving. Feeling panicked or anxious is an understandable reaction to the initial symptoms of depression. However, these reactions may contribute to low mood and worsen other symptoms, such as loss of appetite and disrupted sleep.
Anyone who has experienced depressive episodes before may wish to remind themselves that they can overcome these feelings again. They should focus on their strengths and on what they have learned from previous depressive episodes.
Accepting that a depressive episode may occur from time to time may help people deal with it when it does. It is important to remember that it is possible to manage symptoms with treatments, such as lifestyle changes, medication, and therapy.
Depressive episodes can often leave people focusing on the negatives and discounting the positives. To counteract this, people with depression can keep a positivity journal or gratitude journal. This type of journal helps to build self-esteem.
A person who is experiencing a depressive episode may have symptoms that include feelings of sadness, worthlessness, or hopelessness. They may also have low energy or fatigue, a loss of interest in activities once enjoyed, and more.
Mixed features refers to the presence of high and low symptoms occurring at the same time, or as part of a single episode, in people experiencing an episode of mania or depression. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed features experiences symptoms of both mood "poles" -- mania and depression -- simultaneously or in rapid sequence.
Mixed episodes are common in people with bipolar disorder -- half or more of people with bipolar disorder have at least some mania symptoms during a full episode of depression. Those who develop bipolar disorder at a younger age, particularly in adolescence, may be more likely to have mixed episodes. People who develop episodes with mixed features may also develop "pure" depressed or "pure" manic or hypomanic phases of bipolar illness. People who have episodes of major depression but not full episodes of mania or hypomania also can sometimes have low-grade mania symptoms. These are symptoms that are not severe or extensive enough to be classified as bipolar disorder. This is referred to as an episode of "mixed depression" or a unipolar (major) depressive episode with mixed features.
For example, a person in an episode with mixed features could be crying uncontrollably while announcing they have never felt better in their life. Or they could be exuberantly happy, only to suddenly collapse in misery. A short while later they might suddenly return to an ecstatic state.
Mood episodes with mixed features can last from days to weeks or sometimes months if untreated. They may recur ,and recovery can be slower than during episodes of "pure" bipolar depression or "pure" mania or hypomania.
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