A Question Of Health: Is hypomania the same as bipolar affective disorder? And does the flu jab always work?

HIGHS AND LOWS

HIGHS AND LOWS

Our son has recently been hospitalised because he became seriously manic. He was eventually arrested by the police and detained under section in a mental hospital. After a couple of weeks, he was back to normal, although he continues to take medication. He has been given conflicting information about the cause of his problems. One doctor said that he was suffering from hypomania, and another classified him as having bipolar affective disorder. What is the difference? Is one more severe? Are the treatments the same?

Bipolar affective disorder is another name for manic depression. People who suffer from this condition tend to have times when they are depressed and low, and times when they are manic and "high". The word hypomania is sometimes used to describe the highs, if they are not full-blown manic episodes. People who have hypomania are not always suffering from bipolar affective disorder. But often, the hypomania is only half of the story, and a period of depression follows the episode of being high and out of control. For parents, it is difficult to know the best way to help a child who is having these problems. You may find it useful to get in touch with other parents who have been through similar episodes. Try getting in touch with the Manic Depression Fellowship (020-7793 2600; www.mdf.org.uk). Another good source of support is Sane (0845 767 8000; www.sane.org.uk).

FLU VACCINE DOUBTS

I am coming under pressure from a practice nurse to have a flu vaccine. I've never had one before and can't convince myself that it's necessary. I am 55 and, apart from mild high blood pressure, I am healthy. I think I read that this year's flu virus isn't covered by the vaccine. If so, what is the point of having it?

There have been quite a few cases of flu in the UK already this year, and the Department of Health thinks we are entering the flu season. The past three winters have been relatively quiet on the flu front, and it is possible that this year will be worse. The problem with flu vaccination is that the virus changes every year, and the vaccine is prepared before anyone knows for certain what strain of flu is going to be circulating. This year's vaccine contains protection against three strains, including one known as the H3N2 Panama strain. Unfortunately, the strain that seems to be causing flu this year is known as the H3N2 Fujian-like strain. This is similar, but not identical, to the Panama strain. The Department of Health believes that this year's vaccine will provide some protection against the Fujian strain, at least to the extent of making a dose of flu milder than it would otherwise have been. For a healthy person like you, I doubt if flu vaccination is important. For the over-65s, and people with serious underlying illnesses, such as diabetes, or heart or lung problems, the vaccination could prevent a nasty illness and possibly even save their lives.

THYROID TROUBLES

Four months ago, I gave birth to my second child. For the first two months I felt well, but I then became anxious and shaky and began to lose weight. The symptoms were eventually diagnosed as an overactive thyroid gland. I was told that this was fairly common after childbirth and it would eventually clear up. I am now taking anti-thyroid drugs, but hope to be able to stop these soon. Does this mean that I will have thyroid problems the next time I am pregnant?

A surprisingly large number of women - as many as one in 10 - have thyroid problems in the year after giving birth. The commonest problem is known as postpartum thyroiditis, a painless inflammation of the thyroid gland. Thyroiditis can have unpredictable effects. Usually, it starts off by making the thyroid gland overactive. Your symptoms of anxiety, shakiness and weight loss can all be caused by an overactive thyroid. Once the overactivity slows down, the gland sometimes then swings into an underactive phase. This causes different symptoms, such as tiredness, weight gain and a general slowing down of the metabolism. These symptoms will improve rapidly if you take thyroid supplements. By the end of a year, most women with postpartum thyroiditis are back to normal. But a proportion - perhaps a quarter or a third - will go on to have thyroid problems later in life, either after a subsequent pregnancy, or many years later. Both thyroid problems can be treated, but often the symptoms are mistaken for postnatal mental illness, and inappropriate treatment is suggested.

HAVE YOUR SAY: READERS WRITE

TD from south London brought down his triglyceride levels without drugs:

Many years ago, I was told that I had high levels of triglycerides in my blood, and that diet was the way forward. I found that Omega-3 oils, available everywhere, do work. But you need to give it six months, and then take them forever.

AJ found a solution to sunlight allergy:

I used to come out in a sun rash every holiday. I found that taking an antihistamine product, such as Allereze, for two weeks before departure and the first week into the holiday, stopped it all together. What a relief!

Send questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions