Description
Bipolar disorder is a major health concern that has drawn interest from the general public, media and the scientific community over the past decade. Bipolar disorder, sometimes referred to as manic-depressive illness is a neurological disorder that causes anomalous changes in energy, mood and ability to function in an individual. The disorder distorts moods and thoughts, interferes with rational thought and incites dreadful behaviors in an individual. Bipolar disorder symptoms often lead to deteriorating results at school and work, damaged relationships and sometimes suicide (Treatment Advocacy Centre 1).
Bipolar patients experience moods swings ranging from the lows of depression; extreme sadness, hopelessness and loss of interest in most activities to the highs of mania when one feels full of energy and euphoric. Bipolar disorder is neither a viral, fungal, parasitic nor bacterial disease the disorder is not caused by any pathogen. The disorder is not infectious and cannot be spread from one person to another. Bipolar comordities are classified as either medical or psychiatric. Some of the common comordities of bipolar disorder include Attention deficit hyperactivity disorder (ADHD), Anxiety disorders, substance disorder, obesity and metabolic syndrome (Furham and Anthony 254).
Epidemiology
National Institute of Mental Health (1) estimates that Bipolar disorder affects 5.7 million American adults; this translates to 2.6% of the U.S adult population. The onset of the illness is usually during early adulthood at a medium age of 25 years; however, children and adults in the late 40’s and 50’s have also been diagnosed with the illness. Even though, bipolar disorder is equally common among all social classes, ages, ethnic groups, races and gender, the illness tends to be more common among women. Women are three times more likely to experience rapid cycling compared to men. Women also have more mixed episodes and depressive experiences than men. World health organization ranks bipolar as the sixth cause of disability globally.
The prevalence rate for bipolar is approximated at 1.1% of the country’s population over the age of 18. The incidence of bipolar disorder is estimated at one for every 4000 people worldwide. Meaning that 1.5 million people are diagnosed with the disorder yearly, and around 100, 000 Americans would be diagnosed with the disorder in a year. Treatment advocacy centre have identified suicide as the number one cause of deaths among bipolar disorder patients. 15% to 17% of people diagnosed with the illness are likely to end their life prematurely by committing suicide (Apps 9).
Chromosome/ gene
Knowing the biological foundation of bipolar disorder is of paramount importance. Exploration of the biological foundation involves identification of susceptible genes. Accurate identification of the genes would enhance better understanding of the pathogenesis of bipolar and other mood disorders. Proper understanding of the pathogenesis would result to improved targeted treatments, early diagnosis of at risk population and increased understanding of other risk factors that contributes to susceptibility of bipolar disorder (Leonard and Joann 90).
Most scientist and researcher agree that there is no specific chromosome or gene that could be linked to bipolar disorder causal; despite the numerous genes and loci that have been associated with the disorder. The chromosomal regions associated with the disorder are broad cutting across chromosomes 5, 6, 11, 18, 21 and 22. Candidate genes such DISC1, BDNF, TPH2, 5-HTT, G72/ DAOA and DAT1 have also been found to have a strong association with the disorder (Luggen and Ann 327).
Risk factors
Bipolar disorder has varied risk factors, the most common risk factors include.
Genetics
According to finding from some research, people with certain genes are more susceptible to the bipolar disorder than others who do not have the genes. Research further suggests that children who have siblings or parents who have bipolar disorder have a 10% to 15% chance of developing the condition Goodwin, Guy and Gary (46). Technology is also playing a vital role in the bipolar genetics research. For example, the application of Bipolar Disorder Phenome Database would assist scientists in linking the observable signs of bipolar disorder with the respective genes that could be responsible for the signs. Scientists are further conducting a comparative study between bipolar disorder and similar illnesses such as schizophrenia and major depression to identify genetic hotspots responsible for the illnesses and the influence the genetics hotspots would play on the bipolar disorder occurrence.
Brain structure and functioning
Studies using MRI have revealed that the brain development pattern between children with bipolar disorder and children with the multi-dimensional impairment is similar. This could mean that brain development pattern in the two conditions could highly be associated with mood disorders, since children who suffer from the two conditions later develop mood disorders. Further studies using MRI established that adults with bipolar disorder have reduced and less functional the prefrontal cortex. Prefrontal cortex is responsible for problem solving and decision making. The abnormal development of the prefrontal cortex during adolescence could be responsible for the bipolar disorder (Researchers from Western Psychiatric Institute & Clinic 1).
Lifestyle habits
Lifestyle habits such as sleep deprivation, use of drugs and alcohol and continuous use of antidepressant as the only medication may increases episodes of mania in bipolar disorder patients (Researchers from Western Psychiatric Institute & Clinic 1).
Environmental risk factors
Some of the bipolar disorder diagnoses are as a result of traumatic or stressful event in an individual’s life. The events could be accidents, near death experience, losing a job, starting a new job, family or marriage disagreements and death of a loved one. Stress in itself is not a cause of bipolar disorder, but it increases the susceptibility on people who are biologically vulnerable to the disorder. Age and gender may also play roles in the development of the disorder Researchers from (Western Psychiatric Institute & Clinic 1).
Symptoms of bipolar disorder
In the course of the illness bipolar disorder patients are likely to experience four distinct mood episodes
Mania
Mania mostly is defined by feeling of increased energy, social ease and creativity. The feelings if not closely monitored could easily escalate into serious manic episode. Individuals undergoing mania are easily irritated and angrily blame anyone who tries to point-out that there is a problem with their behavior. The patients are always in denial that something is peculiar in their mood and lack self- awareness. The persons also tend sleep often despite having great amount of energy. Talk so fast that following the flow of thought becomes difficult, are easily destructed, have feelings of extreme greatness or importance and tend to behave recklessly without giving serious thought on the consequences of the actions (Treatment Advocacy Centre 1).
Hypomania
Hypomania and mania share symptoms, the only difference is that hypomania experience milder symptoms while mania experience severe symptoms (Treatment Advocacy Centre 1)
Depression
Depression is the opposite on mania. During depression one lacks the capacity to feel pleasure, is profoundly sad, and experience low concentration and change in sleep patterns. One may also experience low self-esteem, loss of appetite, hopelessness and suicidal feelings. Individual who undergoes acute depression may experience hallucination and delusions (Treatment Advocacy Centre 1).
Mixed episode
Mixed episode involves experiencing mania and depression either simultaneously or at different times, it is the most complex and most disabling symptom (Treatment Advocacy Centre 1).
Diagnosis
Bipolar disorder is diagnosed using guidelines from the Diagnostic and Statistical Manual of Mental Disorder (DSM). DSM diagnoses bipolar I disorder, bipolar II disorder, bipolar disorder not otherwise specified (BP-NOS) and Rapid- cycling Bipolar Disorder.
Bipolar diagnosis includes lab tests, interviews and physical examination. The doctor or mental health specialist is always interested in getting the family history concerning bipolar disorder or other mental illnesses. The information would help in better understanding of the symptoms. Currently, bipolar disorder cannot be diagnosed using brain scans or blood test. However, results from the two examination aids in nullifying other factors that could be responsible for mood problems such as thyroid complications, brain tumor or stroke. Proper medical history is important during diagnosis to limit the chances of misdiagnosis of bipolar disorder, which is mostly mistaken for major depression or schizophrenia. Early diagnosis and treatment of the condition is important because it reduces the frequency and severity of the episodes (Luggen and Ann 326).
Treatment
Even though bipolar disorder has no cure, the condition is treatable; the major medication methods used in treating the disorder include mood stabilizers and antidepressants
Mood stabilizers
The treatment method has been effective in preventive treatment of mania and depression. Mood stabilizers improve symptoms of mixed episode, mania or hypomania and may reduce symptoms in depression. Common mood stabilizers include carbamazepine, valproate and lithium. In addition to mood stabilizers, anti-anxiety medications and antipsychotic drugs also play important functions in managing agitation and insomnia (Leonard and Joann 91).
Antidepressants
Antidepressants are used along mood stabilizers because if applied as the only medication. The drugs could stimulate moods resulting to rapid cycling, hypomania or mania. In the case of bipolar disorder experts recommend sertraline, paroxetine, fluvoxamine and fluoxetine.
Other treatment methods that have also been used effectively are electroconvulsive therapy, sleep medications, herbal supplements and psychotherapy (Leonard and Joann 91).
Prognosis
Treatment success rate of bipolar disorder is approximated to be 80%. Mortality rate among untreated patients of bipolar disorder is higher when compared to heart diseases and some types of cancer. The population experience high suicide risk compared to the general population. In ten years, 25% of treated cases of bipolar disorder either completely recovers or experience improved health, 15% experience no improvement and 10% die mostly from suicide. If medications are discontinued, the lapse rate is approximately at 80% within two years while continued treatment experience 40% relapse among the recovered patients (L.A. Doerfler and Co-Researchers 1).
Works Cited
Apps, Jennifer Winkler. "Bipolar Disorders: Symptoms and Treatment in Children and Adolescents.(Updates & Kidbits)(Disease/Disorder Overview)." Pediatric Nursing 1 Jan. 2008: 9. Print.
"Bipolar Disorder - Fact Sheet - Treatment Advocacy Center." Bipolar Disorder - Fact Sheet - Treatment Advocacy Center. Web. 31 Oct. 2014.
"Bipolar Disorder in Adults." NIMH RSS. Web. 31 Oct. 2014.
Furnham, A., and E. Anthony. "Lay Theories of Bipolar Disorder: The Causes, Manifestations and Cures for Perceived Bipolar Disorder." International Journal of Social Psychiatry: 255-69. Print.
Goodwin, Guy, and Gary Sachs. Bipolar Disorder. 2nd ed. Abingdon: HEALTH, 2010. 46. Print.
Leonard, Basia, and Joann Jovinelly. Bipolar Disorder. New York: Rosen Pub., 2012. 89- 92. Print.
Luggen, Ann Schmidt. "Bipolar Disorder: An Uncommon Illness? Recognizing and Caring for the Elderly Person with Bipolar Disorder." Geriatric Nursing: 326-29. Print.
"New Bipolar Disorders Findings from L.A. Doerfler and Co-Researchers Published.(Report)." Pediatrics Week 23 July 2011. Web. 31 Oct. 2014. <http://www.highbeam.com/doc/1G1-262223378.html?>.
"Recent Findings in Bipolar Disorders Described by Researchers from Western Psychiatric Institute & Clinic." Psychology & Psychiatry Journal 5 Mar. 2011. Print.
