An Introduction to Bipolar Disorder
Bipolar disorder, also known as manic-depression, is a psychological disorder that causes the person to experience rapid, often severe, changes in mood, energy, and ability to function properly. There is a difference between typical mood changes the average person experiences on a daily basis; the symptoms of Bipolar disorder often leave people with ruined lives, and high tendencies of suicide(Cassano, G.B., &Rucci, P., &Frank, E., &Fagiolini, A., et al. 2004). The diagnosis of Bipolar disorder is not ultimately a death sentence to one’s productive life, for there are innovations and treatments that can help one suffering with the disorder lead a productive and to some extent enjoyable life.
Typically, it begins to develop in late adolescence; however, some patients have experienced symptoms as early as childhood, and others still may develop it in later adulthood. Often times, Bipolar disorder is misdiagnosed as an illness or depression, and not dealt with effectively(William, N.A.,& Luckenbaugh D.A.,& Altshuler, L.L.,& Suppes, T., et al 2004). This neglect often allows the disorder to become increasingly worse and more likely to commit or succeed in suicide. Suicidal tendencies are just one of the symptoms that can repeatedly break down the individual suffering from Bipolar disorder. Like any other chronic disease, Bipolar requires a lot of careful management and effort on part of the patient, doctors, and loved ones over a lifetime(Cassano, G.B., et al 2004).
Bipolar disorder is marked by severe mood swings that can make an individual go from contentment/aggression/irritable to extreme sadness/hopelessness/melancholy; then back again in a matter of minutes without any explicable change in environment or situation. The two stages of Bipolar disorder, mania and depression, both have individual characteristics that are vastly different than their counterpart. Both can have detrimental affects on the individual’s personal, social, and financial life.
Mania is commonly trademarked by over activity, increased energy, and restlessness. Often times, individuals find themselves extremely happy for no apparent reason, and even experiencing a euphoria of some sort. They often will exhibit traits that were for the most part, uncommon to them, such as an increased irritability and irrationality. They may talk extremely fast, have trouble focusing on one or more topic, and need little to no sleep to feel productive and healthy(Cassano, G.B., et al. 2004). Although it is commonly believed that the depression of Bipolar is the most lethal aspect (suicide), mania has dangerous elements on the individual’s judgement and behavior. Individuals may start experimenting with controlled substances, most notedly cocaine, alcohol, and barbituates. The sense of inhibition goes down, and increased sexual drive can lead to often provacative, unwanted, and even sexually aggressive behavior. To be considered a manic episode, the person must experience three or more of these behaviors most of the day, for almost every day, for at least one week. However, when swings of irritation are present, the individual must display at least four other characteristics in order for a doctor to diagnose Bipolar.
There are many signs of depression that get confused with everyday sadness. Depression is a long lasting sadness, with feelings of hopelessness, anxiety, or an empty feeling of isolation. Constant pessimism and helplessness may also be present. Individuals may lose interest in activities they once loved and enjoyed, may suffer from a problematic insomnia or the opposite, sleep too much (William, N.A., et al 2004). During depression episodes, the individual may experience horrible pains and irritations that aren’t caused by physical means. Often times, they experience a total lack of appetite and may go days without eating. Depressive episodes can have a serious affect on one’s social life. The depressed individual becomes withdrawn, asexual, and non-responsive to society or loved ones, putting a huge damper on his/her interpersonal skills(Cassano, G.B., et al. 2004).
The physiological effects of the depressive state are nonetheless harmful and dabilitating as the psychological ones. Patients may experience a change in apetite causing unwanted weight loss. This can have an adverse affect on other areas of the body, for this type of behavior can last as long as the depressive state. Another physiological symptom of the depressive state is chronic pain. The chronic pain can be extruciating; however, there appear to be no medical or physical explanations for the cause of pain.
As you can see, the symptoms of the deppressive state of bi-polar can have serious adverse affects on patients suffering from the disorder. To tell the difference between a depression episode or just plain being sad, is that an episode of depression is when you experience five or more of these symptoms most of the day, nearly everyday, for at least 2 weeks or longer.
The Bi-Polar Spectrum
The Bi-Polar spectrum consists of five different stages, ranging from severe mania to severe depression. In between lies hynomania (mild mania), a normal mood/balanced, and mild depression (respectively). The symptoms for both extremes are similar to the ones labeled above; however a new state of of mood swing is brought about in what is known as a mixed state. In a mixed state, the patient may experience depression and mania at the very same time (Magill, Chandra 2004). The individual may very well feel agitated, experience trouble sleeping, significant changes in appetite, psychosis, and suicidal thinking-while at the same time feeling energized and euphoric. This can be quite confusing and exhausting on someone during a mixed state (Magill 2004).
Diagnosis of Bi-Polar
Like other mental disorders, Bi-Polar cannot be diagnosed through phsyiological means-such as blood work or brain scanning. As of now, the only way to diagnose Bi-polar disorder is examining the symptoms, course of the illness, and when available a family history of the disorder. When diagnosing bipolar disorder, doctors use the Diagnostic and Statistical Manuel for Mental Disorders, fourth edition (DSM-IV).
People who suffer from bipolar disorder can become suicidal, especially in a depressive state. Suicidal thoughts often occur early in the state of bipolar; therefore, it is extremely beneficial to diagnose the disorder early in order to receieve successful treatment and avoid potentially harmful behavior. If anybody shows signs of suicide or suicidal tendencies, it is extremely important for them to receieve attention immediately, espcially from a trained professional counselor, psychologist/psychiatrist, or physician. Some signs you should be aware of that can signal suicidal feelings are talking about suicide or wanting to die, feeling hopeless or that nothing will ever get better, feeling helpless, feeling like a burden to friends and family, abusing alcohol and drugs, putting affairs in order, or intentionally putting oneself in harm’s way (Cassano et. al. 2004). When you see a person experiencing these types of behaviors you should contact an emergency official (doctor, 911, etc.), not leave the person at risk alone, and block access to drugs, weapons, or any other items that may be used as potential devices for killing oneself.
Course of Bipolar
Episodes of mania and depression recur across an entire life span. In the lapse between episodes, most patients experience few to no symptoms; however, at least one-third of Bipolar sufferrers experience residual symptoms. An even smaller number of patients experience chronic symptoms despite any form of treatment (Antai-Ontang, Deborah 2004).
Bipolar I is the classic form of the disorder in which the individual suffers recurrent episodes of depression and mania. Another form of the disorder, known simply as Bipolar II, is when the patient never develops severe mania, but instead experience milder episodes of hypomania and depression (Antai-Ontang 2004). In other cases, the patient may experience four or more episodes within a twelve-month span in which is known as rapid cycling bipolar disorder. In this state of the disorder, people may experience several different episodes in a week or even within a single day. Rapid cycling bipolar disorder tends to show up in the later stages of the illness and is often observed more in women rather than men.
Youth and Bipolar Disorder
Just like adults, children and adolescents are both prone to bipolar disorder. Children who’s parents have a history of bipolar disorder are much more likely to contract the illness than children who do not (Clark, Norma 2003). There is some slight differences between bipolar in children and that in adults. For instance, children experience very rapid mood swings and can often times go through several depressive and manic episodes in a single day. Children going through a manic episode are often very temperamental and irritable. Instead of being euphoric, relaxed, and overly happy like the adult manic episode, they will throw tantrums which can often times be quite destructive (Clark 2003).
When a child or adolescent exhibits symptoms for bipolar disorder, it is sometimes difficult to differentiate these symptoms with simple reactions from other problems which occur at this particular age group. Irritability and throwing tantrums can be described for a number of mental disorders such as attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder and other types of mental illnesses which occur more frequently in this demographic (Clark 2003). However, just like adults, early diagnosis and treatment can help lead to a successful, active lifestyle.
Causes of Bipolar Disorder
Scientists and medical professionals continue to study about what may cuase bipolar disorder through many different kinds of studies. They have concluded that there is no one single cause, but rather a number of factors that act in tandem to cause the disorder. These factors are genetic as well as environmental (Hannigan, Ben 2003).
Since it has been proven that bipolar runs in families, scientists continue to look for a specific gene that may increase a person’s chance for developing bipolar. But the problem doesn’t lie on genes alone. In twin studies, research has shown that if one identical twin has bipolar disorder then his twin sibling is more likely to develop the disorder as well-but not all the time. Therefore, this evidence shows that there are environmental factors that need to be examined as well as genetic information (William et. al. 2004).
It has also been shown that bipolar disorder probably doesn’t develop from a single genes, but a combination of genes acting together (Hannigan 2003). These genes acting with the individual’s outside environment are what scienctists have concluded probably causes bipolar disorder. Finding these genes however, has proven to be extremely difficult. However, the scientific and medical community continue to research and find new developments in the areas of cause and treatment for bipolar disorder.
A new development in studying the cause of bipolar disorder is the process of brain-imaging studies. This allows researchers to take pictures of the human brain while alive and working. This allows them to examine its structure and activity without invasive procedures. These brain imaging studies are done through magnetic resonance imaging (MRI), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI) (Hannigan 2003). Recent studies done with this new technology has shown that the brains of people suffering with bipolar disorder often differ than those of healthy individuals. With new technology and advancements in these fields, scientists hope to better identify these differences in attempts to better understand the underlying cause of the illness and eventually predict which types of treatment will be most effective.
Treatment of bipolar disorder
With proper treatment, even people with the most severe cases of bipolar disorder can in many ways control and stabilize their mood swings and other related symptoms. Since bipolar is a life-long disorder, long-term treatment is required. Usually, a combination of medication and psychosocial treatment are used to help the patient cope with living with bipolar (Bahk, W.M., Yoon, B.H., Lee, K.U., Chae, J.H 2004).
Treatment of bipolar tends to be more successful with continuous treatment than with “on and off.” However, even with non-stop treatment mood swings and episodes are still prevalent. When this happens, the doctor may make adjustments to the patients’ treatment in hopes to prevent full blown episodes from occurring. A close doctor/patient relationship is an integral part in the treatment of bipolar and can make a significant difference. Also the doctor may recommend keeping a chart of daily mood symptoms, treatments, sleep patterns, and life events (William et. al. 2004). This may help people with bipolar disorder and their families to better understand the illness. This chart also can help the doctor track and treat the illness more effectively.
In conjunction with therapy, people suffering from bipolar disorder are given medication to help them cope with the symptoms and possibly prevent episodic behavior (Bahk et. al. 2004). Often times, the patients are given what are known as “mood stabilizers.” There are several different types of mood stabilizers out there. Some are given for an extensive period of time, while others are added only when needed for short term use. Some of the common used mood stabilizers include lithium, valproate, topomax, and neurontin. Some medication that is specifically used to treat bipolar depression include risperdel, clozaril, zyprexa, and ambien (Bahk et. al. 2004).
Bipolar disorder is a serious illness that can often times ruin the patient’s life if not properly treated. Researchers continue today to try and find the best treatment and understand the causes of this disorder. Bipolar affects over two million America adults and although we have not found a cure or cause, with new innovative research and developments we reach closer to that goal each and every day. It’s important that everybody has a better understanding of the disorder because it can have a very traumatizing affect on the persons we love. Suicide is a real risk when someone is experiencing a depressive episode, and through better education of the public on bipolar we can help people understand the severity of the situation, and help those who are suffering get the professional attention they so need.