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Abstract

Bipolar disorder is a serious mental sickness characterized by extreme shifts in moods and behavior that affect all people, from children and teenagers to adults. The topic under study was inspired by the zeal to learn more about Bipolar Disorder, how it is caused, its symptoms, diagnosis, and treatment. Bipolar Disorder affects 1-3 percent of people in a population with the effect distributed equally between men and women. Heredity and brain structure of people are connected to the causes of Bipolar Disorder, which are both environmental and biologically oriented. Gene mapping to identify the specific cause of Bipolar Disorder has been complicated due to differential expression from one person to another. There are three types of bipolar categorized on the extremities of behavioral change: Bipolar I, which is a manic episode, Bipolar II, which is a depressive episode and Cyclothymic Bipolar, which is neither manic nor depressive bipolar. Symptoms of a manic episode include talking too much, aggressiveness, racing thoughts, and lack of sleep, among others. The depressive episode shows fatigue, lack of desire to hang out with friends and family, suicidal thoughts, and feeling worthless, among others. Upon diagnosis, bipolar disorder is treatable using medicines, psychotherapy, or a combination of both. An example of a mood stabilizer is lithium, which is highly recommended by doctors; however, an alternative such as Electroconvulsive Therapy (ECT) can be applied.

Bipolar Disorder

The paper is about Bipolar Disorder (BD) which is a mental illness disorder under the category of bipolar and related disorders (Nuckols, 2013). The disease affects any person from children, to teenagers to adults. I chose this topic because a close friend has been diagnosed with it and I would like to know more about the disease, how a person is infected, the symptoms observed, the adverse effects it can cause, and how it can be treated.

For a proper understanding of BD, I will give details on what the disease is, and the symptoms infected people display. Additionally, I will discuss how BD is diagnosed by specialists such as psychologists and psychiatrists as well as state the DVM-5 criteria on the matter. Furthermore, the paper will provide a discussion on treatments used in BD.

Understanding Bipolar Disease

A myriad of people do not understand Bipolar Disorder and would confuse it with a regular change in behavior, whereas it is a severe mental illness. More often, people have a lapse in moods and behavior and end up controlling them back to normal. However, when those conditions become extreme, it becomes a medical issue hence the need to check in with professionals and experts. BD also known as manic-depression disorder is characterized by extremities in mood swings causing an unusual shift in energy, and activity levels as well as a decline in the ability to partake in daily activities (National Institute of Mental Health, 2009). In other research conducted by Parikh et al., (2013) and Hibar et al., (2016) BD affects 1-3 percent of the population, in that, most of the population is adults and both men and women are affected equally. BD is a medical complication; hence, feeling lonely and disserted should be avoided.

The causes of bipolar disorder are still unknown, though they have been connected to heredity and brain structure. In most cases, bipolar disease flows through families, making it a heritable disease, though people with specific genes are the ones vulnerable to the disease (National Institute of Mental Health, 2018). The issue of genes is still debatable, considering that one twin can be bipolar while the other is not. Mapping the specific gene responsible for bipolar has been hectic and practically difficult almost impossible because the phenomenon is heterogeneous and it varies from one person to the other in terms of severity and characteristics (Kassem, 2006). Moreover, the issue of brain structure plays a significant role in causing bipolar or creating an appropriate condition for the disease to invade. Researchers stipulate that understanding brain structure differences between ordinary and bipolar people aids in formulating treatment based on symptoms rather than the brain image itself (National Institute of Mental Health, 2018). Heredity and brain structure are linked to the causes of bipolar disorder.

Due to shifts in moods, activity, and energy, bipolar disorder is divided into three types; bipolar I, II, and cyclothymic disorder which can be called episodes. Bipolar I, also called manic episode, is characterized by elevated moods, and increased levels of activity, while bipolar II, which is a depression episode, is the parallel opposite in that the patient feels hopeless, inactive, and sad. Additionally, the cyclothymic episode involves a patient with less intense manic-depression episodes with reduced duration of persistence (National Institute of Mental Health, 2018). Other disorders that can co-occur with bipolar are psychosis which is severe bipolar disorder, Anxiety Disorders and Attention-Deficit Disorder (ADHD), which affects people with bipolar disorder, Drug Abuse in which bipolar patients are prone to alcohol and drug abuse; and Eating Disorders which is common in bipolar patients. According to DVM-5 criteria, bipolar acts as a bridge between schizophrenia spectrum and depressive disorders (Nuckols, 2013). Bipolar is wide, considering that other symptoms do not coincide with the known categories.

Symptoms of Bipolar Disorder

The episodes of bipolar disorder have characteristic traits that reveal the illness in a patient. In manic bipolar, the patient displays an irritable mood which is unpleasant to the surrounding. The patient also shows a lack of sleep, talks too much, has racing thoughts, aggressively approaches any activity and has poor judgment (Belmaker, 2004 & Farrell, 2017). Besides, patients with bipolar show exaggerated self-esteem, and sometimes hallucinations and delusions, which are psychotic characteristics (Parikh et al., 2013). People talking too much without pausing, and having weird ideas and thoughts, as well as insomnia, could be a symptom of bipolar disorder. Suffering from hypomania or cyclothymic bipolar has the same symptoms of the manic episode though less intense. Ignoring it can eventually lead to a full manic episode.

Depression occurs to a countless number of people, but when the condition worsens and becomes extreme, the issue becomes bipolar. Specialists can only conclude a diagnosis of a depressive episode after two weeks, where each day depression displays itself. Patients with depressive episodes of BD show decreased appetite and loss in weight, fatigue, feelings of worthlessness, and lack of desire to be with friends and family (Belmaker, 2004 & Dr Phil Staff, 2006). Such symptoms of severe measures can lead to deadly consequences after that. According to Parikh et al., (2013), a depressive episode is accompanied by a lack of concentration and an inability to make decisions, due to unworthiness some patients would think of suicide, and energy loss is observed as well. Other research shows that depression can lead to dwindling interest in most daily activities like hobbies, making someone sleep too much or sometimes too little, restlessness as well as slowness (Farrell, 2017). If those symptoms persist, it is advisable to see a specialist.

Diagnosis of Bipolar Disorder

The initial step in bipolar disorder diagnosis involves the individual visiting a doctor when symptoms persist. The doctor will complete a physical examination of the patient, interviews, as well as laboratory tests (National Institute of Mental Health, 2018). Since blood tests and cerebral scans cannot be conclusive on BD, the doctor uses the results to either refer the patient to a mental specialist who conducts a complete diagnosis; or conducts other tests to rule out the illness. The specialist can be a psychiatrist or a psychologist who is professionally trained to handle mental disorders. After confirmation, the specialist prescribes medication for the disease to the patient. Some of the reasons that interfere with BD diagnosis are that BD can co-occur with other disorders like schizophrenia and psychosis, which are confusing. Noticing the symptoms and ignoring them could lead to late diagnosis as well as other non-mental health issues that harden the diagnosis from the doctors.

Treatment of Bipolar Disorder

A bipolar disorder, like other medical conditions, is treatable, where doctors use medications, psychotherapy, or combining those treatments. In severe manic episodes, the doctors introduce lithium and an antipsychotic drug while for acute manic conditions, doctors prescribe lithium as a monotherapy (Hirschfeld et al., 2002). Other medications for manic episodes are available at the doctors prescription. According to the National Institute of Mental Health (2018), doctors prescribe mood stabilizers like lithium to lower the risks of severe conditions like suicide. The presence of hypomania condition requires treatment with antipsychotic medications such as lithium as used in manic episodes. Doctors have well-established guidelines for how medicine is induced. In depressive episodes, an antidepressant is not advisable; rather, the doctors prefer the simultaneous use of both lithium and antidepressant at some incidents. In severe cases of depressive episodes such as suicide or psychosis, specialists can prescribe the use of an alternative like Electroconvulsive Therapy (ECT) which is also utilized during pregnancy (Hirschfeld et al., 2010). Depressive episodes are treated with antipsychotic medications unless there is an alternative that the specialists know better.

Through psychotherapy, the patient can identify behavioral, emotional, and thoughtful change. In addition to that, it offers education on the disorder about what to do, how to react, and how to express yourself. Also, it gives support, skills, and how to strategically handle bipolar people and their families (National Institute of Mental Health, 2018). In most cases, psychotherapy treatment is combined with medications like mood stabilizers such as lithium. Other treatments for bipolar include physical exercises and keeping life charts.

Summary

Bipolar disorder is a severe mental illness and should be handled with seriousness like other disorders. The causes of BD are unknown, but they are linked to heredity and brain structure, however, no specific gene has been mapped as the carrier of the disease. Manic, depressive, and hypomanic episodes of bipolar have particular symptoms, though manic and hypomania have similar symptoms. Manic is characterized by talking too much, lack of sleep, and aggressiveness while depressive episode has symptoms like a lack of desire to connect with family and friends as well as persistent thoughts of suicide. Bipolar disorder is treatable after a successful diagnosis in time with various treatments like psychotherapy and the use of medicines. In my opinion, bipolar disorder is as severe as other mental diseases, and people should report such symptoms to specialists at early stages to avoid recurrent episodes and other effects.

References

Belmaker, R. H. (2004). Bipolar disorder. New England Journal of Medicine, 351(5), 476-486.
Dr Phil Staff. (2006). Symptoms of bipolar disorder. Retrieved from https://www.drphil.com/advice/symptoms-of-bipolar-disorder/
Farrell, H. M. (2017). What is a bipolar disorder? TED-talks. [Video file]. Retrieved from https://www.ted.com/talks/helen_m_farrell_what_is_bipolar_disorder#t-111754
Hibar, D. P., Westlye, L. T., Van Erp, T. G., Rasmussen, J., Leonardo, C. D., Faskowitz, J., … & Dale, A. M. (2016). Subcortical volumetric abnormalities in bipolar disorder. Molecular psychiatry, 21(12), 1710.
Hirschfeld, R., Bowden, C. L., Gitlin, M. J., Keck, P. E., Suppes, T., Thase, M. E., & Perlis, R. H. (2002). Practice guidelines for the treatment of patients with bipolar disorder. American Psychiatric Association.
Kassem, L., Lopez, V., Hedeker, D., Steele, J., Zandi, P., Bipolar Disorder Consortium, N. G. I., … & McMahon, F. J. (2006). Familiality of polarity at illness onset in bipolar affective disorder. American Journal of Psychiatry, 163(10), 1754-1759.
National Institute of Mental Health. (2009). Bipolar Disorder. U.S. Department of health and Human Services. Pdf.
National Institute of Mental Health. (2018). Bipolar Disorder. U.S. Department of health and Human Sciences.
Nuckols, C. (2013). The Diagnostic and statistical manual of Mental Disorders, fifth edition (DSM-5). American Psychiatric Association. Washington, DC.
Parikh, S., Parker, C., Cooke, R., Kruger, S., McIntire, R., Kusznir, A.& Zetes-Zanatta, L. (2013). Bipolar Disorder: An Information Guide. Center for Addiction and Mental Health. Revised edition. Canada.

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