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Bipolar Disorder: Description, Episodes, and Types
Introduction
It is important to note that bipolar disorder or BD is a serious mental condition that affects ones ability to retain mental stability and well-being in a negative way. The condition has two major types and less common types. Medical experts diagnose and treat it differentially, but both involve changes in mood and transitions in activity levels. BD is a multifactorial problem that has its roots in ones mental health, genetics, environment, and brain alterations.
Bipolar Disorder Description
One of the key characteristics of BD is the fact that its different types have varying phases and transitions. One can define BD as a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks (The National Institute of Mental Health, 2022, para. 1). Kerner (2014) states that the disorder impacts approximately 5.7 million American adults, or 2.6 percent of the US population aged 18 years and older in any given year (p. 33). In other words, the condition is not rare and affects many individuals, which is why addressing the problem is of paramount importance.
Episodes
In order to properly distinguish between different types of bipolar disorder, it is critical to identify and define each symptomatic element of the condition. These include manic, hypomanic, and major depressive episodes (Dunleavy, 2022). One can characterize a manic episode by at least a one-week duration of mood persistence, where an individual is energetic and irritable, and he or she must experience at least three of the behaviors, such as decreased need for sleep, increased or faster speech, uncontrollable racing thoughts and quickly changing ideas, distractibility, increased activity, and increased risky behavior (American Psychiatric Association, 2022, para. 8). A hypomanic episode is similar to a manic one but significantly less intense and lasts only for four consecutive days. The major depressive episode must last at least two weeks, and an individual must experience at least five of the symptoms, such as intense sadness or despair, loss of interest in activities, feelings of worthlessness or guilt, fatigue, increased or decreased sleep, increased or decreased appetite, restlessness, difficulty concentrating, and thoughts of suicide (American Psychiatric Association, 2022, para. 13). Therefore, each episode has a clearly determined set of symptoms and duration.
Types
On the basis of the information presented above, one can differentiate between various types of bipolar disorder. National Alliance on Mental Health (2022) states that Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, but the depressive episode is irrelevant for the diagnostic process (para. 16). When it comes to Bipolar II Disorder, it is a subset of bipolar disorder in which people experience depressive episodes shifting back and forth with hypomanic episodes, but never a full manic episode (National Alliance on Mental Health, 2022, para. 17). However, it is important to state that bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis (Mayo Clinic, 2022, para. 10). In other words, the second type lacks a manic episode but has shifted between hypomanic and depressive episodes.
Another lesser-known type is cyclothymia or cyclothymic disorder, where affected people experience hypomania and mild depression for at least two years, and normal periods cannot last more than eight weeks to be diagnosed (National Alliance on Mental Health, 2022, para. 18). Lastly, the unspecified type of BD includes people who do not fit into the previous three descriptions but still experience abnormal mood shifts. One should be aware that the current system of diagnosis is not perfect, which is why it might need to incorporate spectrum-based approaches (Mason, Brown, & Croarkin, 2016).
BD and Science
One of the key aspects of bipolar disorder is the fact that causes are not well-known, which makes it important to consult academic sources to identify the most plausible and evidenced causal candidates. Evidence shows that there is a complex array of neuropsychological impairments in patients with bipolar disorder, which reveals how multidimensional the condition is compared to single-cause mental health issues (Clark & Sahakian, 2008, p. 160). In other words, BD manifests a wide range of brain circuitry changes, which are not universal in all BD patients. Another study showcases the evidence on causal genetic factors of BD, where Orrù & Carta (2018) suggest that genetic factors could significantly contribute to the development of BD, with heritability estimates of up to 85% (p. 37). There are specific genetic factors that make BD more likely to develop, as well as determine its intensity and type.
In addition to genetic and circuitry changes, there are also physical alterations in the brain of BD patients. Maller, Thaveenthiran, Thomson, McQueen, and Fitzgerald (2014) report that there was significantly reduced regional brain volume and thickness among the BD subjects, but also between BD Type I when compared to Type II (p. 118). Therefore, brain size elements were different between healthy people with BD. Another structural change manifests in the fact that white matter integrity also differed between the groups and BD severity correlated significantly with regional brain volume and thickness (Maller, Thaveenthiran, Thomson, McQueen, & Fitzgerald, 2014, p. 118).
Conclusion
In conclusion, BD is a serious mental health condition that affects millions. There are four types of BD, which include Bipolar I Disorder, Bipolar II Disorder, cyclothymia, and unspecified type. The causes are unknown, but there is evidence supporting genetic and circuitry factors as well as physical changes in the brain.
References
American Psychiatric Association. (2022). What is bipolar disorder? Web.
Clark, L., & Sahakian, B. J. (2008). Cognitive neuroscience and brain imaging in bipolar disorder. Dialogues in Clinical Neuroscience, 10(2), 153163. Web.
Dunleavy, B. P. (2022). Bipolar disorder: Symptoms, types, causes, treatment, and more. Everyday Health. Web.
Kerner, B. (2014). Genetics of bipolar disorder. The Application of Clinical Genetics, 7, 3342. Web.
Maller, J. J., Thaveenthiran, P., Thomson, R. H., McQueen, S., & Fitzgerald, P. B. (2014). Volumetric, cortical thickness and white matter integrity alterations in bipolar disorder type I and II. Journal of Affective Disorders, 169, 118127. Web.
Mason, B. L., Brown, E. S., & Croarkin, P. E. (2016). Historical Underpinnings of Bipolar Disorder Diagnostic Criteria. Behavioral Sciences, 6(3), 14-33. Web.
Mayo Clinic. (2022). Bipolar disorder. Web.
National Alliance on Mental Health. (2022). Bipolar disorder. Web.
Orrù, G., & Carta, M. G. (2018). Genetic variants involved in bipolar disorder, a rough road ahead. Clinical Practice and Epidemiology in Mental Health: CP & EMH, 14, 3745. Web.
The National Institute of Mental Health. (2022). Bipolar disorder. Web.
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