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Overview
Based on a 2005 survey that was published in the Archives of General Psychiatry, 2.6 percent of the adult population has a bipolar disorder (National Institutes of Health, n.d.). Among these people, 82.9 percent have severe cases of the said condition. Bipolar disorder, also known as manic-depressive disorder, is a serious condition which affects patients’ day to day lives. The National Institutes of Health (n.d.) describes this condition as a “dramatic shifts in mood, energy, and activity levels.” In the popular culture, this disorder have been presented in many American films. For instance, in the year 2012, actor Bradley Cooper stars as a person who has been treated for bipolar disorder in the movie entitled Silver Linings Playbook. He is depicted as someone who tends to be violent instantly any moment when he is triggered by certain circumstances. In real life, patients with bipolar disorder can really be aggressive in a snap, and they can also calm down in an instant. This kind of mood swings can negatively affect the way they live their lives, and it can impact their relationships and work. For instance, it has been reported that 90 percent of marital union which involves a partner who suffers from bipolar disorder end up in divorce (Marano, 2003). What makes this problem worse is that many patients are not diagnosed correctly early on. This means that many people live their lives with bipolar disorder without even knowing it. This is why knowing more about bipolar disorder is of great importance. By looking at the history, symptoms, diagnosis, effects, and treatments associated with bipolar disorder, one can have a better understanding of what this condition is all about.
History
Although several physicians in the Ancient Greece have already observed some patients who displayed characteristics, such as melancholia and mania, commonly known at that time as insanity, the modern concept of bipolar disorder began to develop during nineteenth century. One of the first few people who described the condition that resembled bipolar disorder was Jean-Pierre Falret. During the 1800’s, Falret coined the term folie circulaire or circular insanity because he observed it to have genetic foundation (Healy, 2008). Later on, several other physicians studied the condition. During 1900’s, Emil Kraepelin, a german psychiatrist, started to establish the modern form of bipolar disorder when he used the term manic-depressive insanity to refer to the condition (Healy, 2008). He used the word depressive instead of melancholic because he felt that the latter has been over used. In his work entitled Manic Depressive Insanity and Paranoia, Kraeplin explained how manic-depressive illness and praecox differ from each other (Healy, 2008). Praecox is now known as schizophrenia. His classification for manic-depressive illness became the basis for today’s bipolar disorder.
Symptoms
“Bi,” the prefix used in the term bipolar, refers to the two extreme moods associated with the condition while the term polar refers to the two opposing mental states. In general, a patient with bipolar disorder experiences extreme sadness or depression at one point. They also experience mania or extreme excitement. The symptoms of bipolar disorder can be categorized into three: manic symptoms, depressive symptoms, and psychotic symptoms.
Manic Symptoms
People with bipolar disorder go through episodes of mania from time to time. During this phase, they tend to be more active and more talkative (Sorento, 2013). They also talk at a faster rate, and oftentimes, they express ideas that are “larger than life” which don’t materialize (Sorento, 2013). They tend to have so many ideas which they seem to be very excited about. They are more energetic and over active than normal.
Depressive Symptoms
Although feeling sad and depressed after facing a stressful event is quite common in every person’s life, the episodes of depression being experienced with people who have bipolar disorder is quite extreme. It is more intense and it lasts longer, usually the entire day or so (Leonard and Jovinelly, 2012). According to Sorento (2013), “a person going through the depressive phase may seem to the world as if he or she is not taking care of his or her self.” The medical field used to find it hard to distinguish between regular depression and the depression experienced by bipolar patients, but currently, they have already found a way to measure and differentiate between these two types of depression through clinical assessments.
Psychotic Symptoms
Psychotic symptoms refer to a mixture of manic and depressive symptoms. During a psychotic phase, people with bipolar disorder experience delusions and hallucinations, and they also develop false beliefs about themselves (Sorento, 2013). For example, one may feel that at the moment, he/she is a famous Hollywood actor and that the paparazzi are going after him/her. As a result, they tend to talk fast and they become anxious over what they are thinking (Sorento, 2013). In other words, they develop their own reality that is different from what is actually happening.
Effects
The different symptoms of bipolar disorder also creates different serious effects. For instance, manic symptoms often have physical effects. As a result of too much excitement and energy over different ideas, people with bipolar disorder may lose appetite (Sorento, 2013). They may also find it hard to sleep because they keep on having different ideas about life (Sorento, 2013). On the other hand, depressive symptoms also result to negative effects. Due to extreme and often prolonged episodes of sadness, people may experience either loss of weight or weight gain, depending on how an individual tries to cope with low emotional states (Sorento, 2013). Physical symptoms may also include the lack of interest to connect with people. At the same time, it may also lead to fatigue and spending more time sleeping or the opposite, the inability to sleep (Sorento, 2013). If not treated or managed properly, it may even lead to suicidal tendencies. In addition, psychotic symptoms also have its own negative effects. Due to hallucination and delusions, people with bipolar disorder may find it hard to establish strong social connections. It may also cause conflict on the relationships that these people already have. For instance, a person with bipolar disorder may not be able to find and keep a job and they may also find it challenging to keep a lasting romantic relationship. In other words, bipolar disorder affects the lives of people in serious ways.
Causes
The exact and certain causes behind bipolar disorder remain unknown. However, several factors have been attributed with its occurrence.
Genetic Factors
There are several researchers who believe that bipolar disorder has genetic basis. Bloch and Naser (2006) state that “the chromosomes that transmit what becomes bipolar disorder include the X chromosome, and chromosome eleven.” With chromosomes playing a role in the development of bipolar disorder, it can be assumed that this condition can run in a family.
Imbalance in Brain Chemicals
Neurotransmitters, the chemicals involve in communication between neurons (known as the messengers in the brain) have also been identified to influence the development of bipolar disorder. Some commonly known neurotransmitters are dopamine, serotonin, and norepinephrine. The imbalance of these neurotransmitters causes the abnormal development of images and information in the brains of people with bipolar disorder (Bloch and Naser, 2006).
Biological Factor
Bipolar disorder also has biological basis. Bloch and Naser (2006) state that there is “30 percent more brain cells in certain areas of the brain that send messages to the other areas of the brain” of people with bipolar disorder. Through MRI or magnetic resonance imaging, pieces of evidence suggest that there are differences between the brains of bipolar people and those who do not have the disorder.
External Factor: Climate
Surprisingly, even climate has been attributed to the development of the condition. Some researchers suggest that colder climates increases the risk for bipolar episodes (Bloch and Naser, 2006). This does not mean that the areas where there are less sunshine have more people with bipolar disorder. It only means that in these areas, people with bipolar episodes tend to have more episodes of depression and mania.
Life Experiences
Certain events in life are also said to influence the development of bipolar disorder. For instance, women who have bipolar tendency become more at risk of the condition when they give birth (Bloch and Naser, 2006). In general, many women do develop postpartum depression after childbirth. However, many of these cases have been found to also have bipolar symptoms. Moreover, children and young adults who experience abuse also become at risk of bipolar disorder if they already have the tendency for it. According to Bloch and Naser (2006), “the trauma of the abuse might compel certain brain processes to realign themselves in ways that enable the inherent bipolar condition to emerge.” It can also be the other way around. Children with bipolar disorder display unwanted and excessive behaviors which may be too hard to handle by guardians, and this can result to abuse. As a result of the abuse, they may have more bipolar episodes.
Diagnosis
The diagnosis for bipolar disorder highly depends on the Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR). Specifically, the fourth edition includes ‘bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder not otherwise specified” (Hilty et al., 2006). Before a final diagnosis is made, careful examination is done to determine whether the presence of symptoms suggests bipolar disorder I or II. The difference is that in bipolar disorder I, the manic symptoms appear at least once while in bipolar disorder II, depressive and hypomanic symptoms both appear (Hilty et al., 2006). Due to the complexity of the disorder, it is quite challenging to diagnose. One of the reasons is that it resembles the symptoms of other disorders, such as schizophrenia and major depression. The clinical information used to determine bipolar disorder includes not only the assessment of the symptoms but by considering other factors as well (Hilty et al., 2006). For instance, a family history of other mood disorder or bipolar disorder provides a strong clue of having the same condition, considering that the person also shows symptoms of bipolar disorder I or II.
Treatments
Despite the symptoms associated with bipolar disorder which can greatly affect a person’s day to day activities, one can still manage to live a normal life with the help of the two types of treatments for the condition: pharmacological and non-pharmacological treatments.
Pharmacological Treatments
Pharmacological treatments for bipolar disorder can be classified into three: the mood stabilizers, the antipsychotics, and the antidepressants. The mood stabilizers come in different kinds. For instance, there is lithium which is used for acute mania and the prevention of recurring manic episodes (Hilty et al., 2006). For mixed mania and irritability, valproate is often prescribed. On the other hand, antipsychotic drugs are also given to treat severe mania or those who suffer from hallucinations and delusions. Few examples of this type of drug includes risperidone and olanzapine. Specifically, these drugs can help patients with psychosis and insomnia (Hilty et al., 2006). Another medications given to patients with bipolar disorder are antidepressants. This is only given during episodes of severe depression. However, there is a downside in using antidepressants. According to Hilty et al. (2006), “the addition of an antidepressant to the medication regimen for patients with bipolar depression raises special concerns, since antidepressants can provoke manic, mixed, cycling, or hypomanic symptoms.” Therefore, it is always best to assess the risk of taking antidepressants and other drugs for bipolar disorder.
Non-pharmacological Treatments
Aside from medications, patients with bipolar disorder can also benefit from different types of therapies. One of these is psychosocial therapy or psychosocial rehabilitation which can be in the form of cognitive-behavioral therapy or CBT (Ketter, 2010). This intervention is used to influence the thoughts, beliefs, behavior and the moods of patients. Another therapy is called electroconvulsive therapy. With the use of electric current, short seizures are induced to patients (Ketter, 2010). Although this procedure have been controversial due to public misconception, it has been helpful to patients who are suffering from severe mania, severe depression, and pregnant patients who are not responsive to other treatments.
Conclusion
Bipolar disorder is a serious condition that can only be understood by looking at its different aspects, such as its history, symptoms, effects, causes, diagnosis, and treatments. Due to the extreme and opposing symptoms of this condition, I came to realize how much it can effect not just the people who have it but those who love them, their families. On a personal standpoint, I find this condition alarming and terrifying at the same time when I discovered its manifestations and effects in life. This made me realize about the importance of diagnosing the condition early on in order for the affected people to get their much needed help. Although I do not have a personal encounter with anyone who has bipolar disorder, I was able to witness media representations of this condition. One of these is a documentary entitled Living with Bipolar Disorder, which features real cases of people who are living with the condition. One of the featured cases is the life of Denise, a woman who after giving birth started to have the symptoms of bipolar disorder. Instead of enjoying and celebrating her new life as a mother, she became angry and abusive over time (J. guru). She started having anxiety and panic attacks, which prompted her to take frequent trips to the hospital (J. guru). This impacted her finances as well. Through Denise’ life and the lives of the others featured in the documentary, it became clear to me that the symptoms of bipolar disorders and its effects are not the only ones that make their condition harder to bear. Most of them have also become victims of shaming and discrimination. All of these convince me that the issue being faced by people with bipolar disorder is more serious and complicated than it appears in the movies and other contemporary media representations. Indeed, the very first step in helping these people is by understanding their condition.
References
Bloch, J. & Naser, J. (2006). The everything health guide to adult bipolar disorder. Avon, MA: F+W Publications, Inc.
Healy, D. (2008). Mania a short history of bipolar disorder. Maryland, MD: The Johns Hopkins University Press.
Hilty et al. (2006). A review of bipolar disorder in adults. Psychiatry, 3 (9). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963467/
J. guru. (2013, April 29). Living with bipolar disorder [video file]. Retrieved from https://www.youtube.com/watch?v=ZAswgP5M6AE
Leonard, B. & Jovinelly, J. (2012). Bipolar disorder. New York, NY: The Rosen Publishing Group, Inc.
Marano, E. (2003). Managing bipolar disorder. Psychology Today. Retrieved from https://www.psychologytoday.com/articles/200311/managing-bipolar-disorder
National Institutes of Health (n.d.). Bipolar disorder among adults. National Institute of Mental Health. Retrieved from http://www.nimh.nih.gov/health/statistics/prevalence/bipolar-disorder-among-adults.shtml
Sorento, M. (2013). Bipolar disorder: Everything you need to know about bipolar disorder. Bloomington, IN: Booktango.
