Manic–depressive Illness: Bipolar Disorders Essay

Bipolar disorder was previously called manic depression, currently it is used to identify a mental disorder, which leads to the periods of depression, followed by the periods of abnormally elevated state of mood. The state of elevated mood also received the names of mania or hypermania, depending upon the fact of presence of psychosis symptoms. In the state of mania a person tends to feel energetic, irritable and even abnormally happy, he is inclined towards committed actions without proper consideration of the consequences. The manic phases are also characterized by lack of sleep.Manic–depressive Illness: Bipolar Disorders Essay.  Depression periods are characterized by negative perception of life, by poor establishment of eye contact with other individuals and in some cases by crying. People, suffering from bipolar disorder might commit suicide or do self-harm. There are also other mental health problems, including substance use disorder or anxiety disorder, which are associated with bipolar disorder by some patients. Bipolar disorder is a serious mental health problem, experienced by individuals in various countries of the world and characterized by mood swings between depression and mania.

Historically the cases of mood swings and variations of energy states were met quite often. Such concepts as mania or melancholia date back to the times of Ancient Greece. “The word melancholia is derived from melas (μέλας), meaning “black”, and chole (χολή), meaning “bile” or “gall”, indicative of the term’s origins in pre-Hippocratic humoral theory” (Liddell & Scott, 1980, p. 158). Mania was considered to result from the excess of yellow bile or the combination of black and yellow bile. There is no concrete data about the source of the concept of mania, but most probably it came from the term “manos”, used by Roman physician, when he described the state of excessive relaxing of human mind. The term “manic-depressive reaction” was for the first time mentioned in 1952. (Goodwin & Jamison, 2007, p. 8). Later, German psychiatrists Karl Leonhard and Karl Kleist worked out the concepts of unipolar and bipolar disorders, suggesting that these are two separate conditions. Manic–depressive Illness: Bipolar Disorders Essay.

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The major signs and symptoms of bipolar disorder include disruptions of normal functioning and mood of an individual, problems with his cognitive functions, circadian rhythm, and psychomotor activity. “Mania can present with varying levels of mood disturbance, ranging from euphoria that is associated with “classic mania” to dysphoria and irritability. The core symptom of mania involves an increase in energy of psychomotor activity. Mania can also present with increased self-esteem or grandiosity, rapid speech, the subjective feeling of rapid thoughts, disinhibited social behavior, or impulsivity.” (Akiskal, 2017, p. 182).

The causes of bipolar disorder could vary by different patients, and till the moment there is no universally accepted research results regarding the exact mechanism of development of bipolar disorder. Most of the researchers are convinced that genetic influences play important role for development of bipolar disorder. Statistically the heritability of the bipolar spectrum is estimated as 0.71. (Edvardsen, et. al., 2008, p. 230).  Manic–depressive Illness: Bipolar Disorders Essay.Thus the family members of an individual with bipolar disorder have an increased risk of development of it as well. At the same time at the moment there is no information about any gene, which could be considered responsible for bipolar disorder. One more cause of bipolar disorder is considered to be chemical imbalance in the brain. Noradrenaline, dopamine and serotonine are the neurotransmitters, which bear the responsibility for managing and control of functions of human brains. The lack of balance by one or several of them leads to development of bipolar disorder. In some cases stressful life situations and circumstances could also become triggers for the symptoms of bipolar disorder. The basic prevention strategies for bipolar disorder include focusing upon stress, which forces those individuals, who are biologically and genetically vulnerable towards bipolar disorder, be at risk.

Bipolar disorder could be diagnosed by individuals during any stage of their life, however, most common period is the period of adolescence or early adulthood. Often it is difficult to distinguish between unipolar depression and bipolar disorder and sometimes there is a significant delay in diagnosis from the moment, when the first symptoms appear. The procedure of diagnostics starts from an appointment with the psychiatrist, who would ask questions with the aim to determine, whether an individual is at risk of having bipolar disorder.  Usually the patients are asked questions about their symptoms and their experiences during the episodes of mania and depression. Along with this psychiatrist would study the medical background of the patient and his family history in order to know, whether there were already any family members with this mental health problem. Sometimes psychiatrists prescribe underactive thyroid tests or overactive thyroid tests on the basis of current symptoms. In most cases patients are involved into discussion with psychiatrist regarding the issues of treatment and for obtaining of his or her informed decisions about the care.

Treatment of bipolar disorder could be performed with pharmacological and psychotherapeutic techniques. Sometimes patients are motivated to use self-help approach. Hospitalization is applied in cases of manic episodes in bipolar I, it could be either voluntary or involuntary. “Following (or in lieu of) a hospital admission, support services available can include drop-in centers, visits from members of a community mental health team or an Assertive Community Treatment team, supported employment and patient-led support groups, intensive outpatient programs. These are sometimes referred to as partial-inpatient programs.” (McGurk, et. al., 2007, p. 440). Manic–depressive Illness: Bipolar Disorders Essay.  Psychotherapy is applied for treatment of bipolar disorder in order to alleviate the symptoms, help to manage negative emotional expressions and episode triggers. Interpersonal and cognitive-behavioral therapies proved to be the most effective in treating depressive symptoms. Medications are also used for treatment of bipolar disorder. The best one at the moment is considered to be lithium, which is effective in treatment of acute manic episodes and bipolar depression. It is also known for its ability to prevent relapses and reduction of suicide risks or self –harm intentions. “Lithium and the anticonvulsants carbamazepine, lamotrigine, and valproic acid are used as mood stabilizers to treat bipolar disorder. These mood stabilizers are used for long-term mood stabilization but have not demonstrated the ability to quickly treat acute bipolar depression. Lithium is preferred for long-term mood stabilization” (Post, 2016, p. 22). Antidepressants are not used alone for treatment of bipolar disorder and are said to bring less benefits in comparison to mood stabilizers. Only few studies accept alternative medicine methods for treatment of this kind of mental health disorder on the basis of the suggestions that omega 3 fatty acids have the potential of reducing of depressive syndromes. Important is to note that they are useless for manic symptoms. Manic–depressive Illness: Bipolar Disorders Essay.

Bipolar disorder is considered to be one of the severe health problems in the whole world due to the increased rates of disability and mortality cases. The situation is worsened by under diagnosis, leading to delays in adequate treatment interventions. The health care specialists are challenged first by correct and timely diagnostics of this disorder and then by complete remission of all symptoms of it, as they tend to become stronger and more severe with time. Early diagnosis and treatment interventions allow making better prognosis for the patients with bipolar disorder.

Overall, bipolar disorder is one of the serious mental health problems worldwide, it is characterized by significant mood swings, the states of depression and mania, leading such risky behaviors as self-harm or even suicide.

References:

Akiskal, Hagop (2017). 13.4 Mood Disorders: Clinical Features. New York: Wolters Kluwer.

Goodwin F.K., Jamison K.R. (2007). Manic–depressive illness: bipolar disorders and recurrent depression. Oxford University Press

Edvardsen, J., Torgersen, S., Røysamb, E., Lygren, S., Skre, I., Onstad, S., Oien, P.A. (2008). Heritability of bipolar spectrum disorders. Unity or heterogeneity? Journal of Affective Disorders. 106 (3): 229–240. Manic–depressive Illness: Bipolar Disorders Essay.

Liddell H.G., Scott R. (1980). A Greek-English Lexicon (Abridged ed.). Oxford University Press

McGurk, S.R., Mueser, K.T., Feldman, K., Wolfe, R., Pascaris, A. (2007). Cognitive Training for Supported Employment: 2–3 Year Outcomes of a Randomized Controlled Trial. American Journal of Psychiatry. 164 (3): 437–441

Post, R.M, (2016). Treatment of Bipolar Depression: Evolving Recommendations. The Psychiatric Clinics of North America (Review). 39 (1): 11–33.

Bipolar is a condition known as manic-depressive disorder, which referred to as bipolar or manic depression, a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more abnormal episodes. An estimated 15-20% of patients who suffer from bipolar disorder and who do not receive medical attention commit suicide. Bipolar disorder is a very dangerous illness that is often over looked. Although many people may assume that bipolar disorder is just a person’s personality fluctuating between highs and lows, there is much more to this disease. Bipolar disorder is a complex physiological and psychological disorder that can influence and manipulate a person’s thoughts and actions in their daily life. Manic–depressive Illness: Bipolar Disorders Essay.

Bipolar elevated moods are symptoms of mania or milder hypomania. Individuals who experience manic episodes have both mania and depression present at the same time. These episodes are usually separated by periods of “normal “mood; but, in some individuals, depression and mania may rapidly alternate, which is known as rapid cycling. Feldman, R.S 2009.

In addition, extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. Depression phase of bipolar disorder include persistent feelings of sadness, anxiety, guilt, anger isolation, or hopelessness; disturbances in sleep and loss of appetite and interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or loss of interest in sexual activity, and chronic pain. John M. Grohol.Psy.D.

However, one of the possible causes of bipolar disorder is altered levels of neurotransmitters, chemicals that cause reactions in the brain. According to Psych-Central, neurotransmitters like serotonin and norepinephrine may be the cause of bipolar disorder, as these chemicals are associated with different moods. Manic–depressive Illness: Bipolar Disorders Essay. There are imbalances of certain neurotransmitters in the brain that causes the extreme mood changes associated with bipolar disorder, including severe depression and mania. However, a neurotransmitter imbalance is likely not the only cause of bipolar disorder. The Mayo Clinic 1998-2010 reports that environmental factors or hormonal changes may trigger this imbalance.

Another potential cause of bipolar disorder is altered brain structure. The Mayo Clinic1998-2010 reports that images taken of the brain of people with bipolar disorder are often structurally different from the brains of healthy individuals. The National Institute of Mental Health 1995-2010 reports that these structural changes are similar to those seen in people with other related mental health disorders, such as schizophrenia and multidimensional impairment. These changes in the brain’s structure may begin to develop as early as childhood. In fact, similar genetic factors are associated with both schizophrenia and bipolar disorder. Brain structure alone may not be the cause of bipolar disorder, but it can predispose a person to the mental illness.

The difficulties of bipolar disorder causes the brain to react differently, brain imaging studies reported that during periods of depression, the prefrontal cortex in the brain has shown to function abnormally in brain scan images. This was a dramatic change from the images of the brains of people in the manic phase of bipolar disorder, which showed an abnormally high metabolism throughout the whole brain. Over time, bipolar disorder may permanently affect the brain. However, people with bipolar disorder have extreme mood swings.Manic–depressive Illness: Bipolar Disorders Essay. They can go from feeling very sad, despairing, helpless, worthless, and hopeless (depression) to feeling as if they are on top of the world, hyperactive, creative, and grandiose (mania). Both mania and depression sometimes occur together that causes “mixed state bipolar disorder. The extremes of mood usually occur in cycles. In between these mood swings, people with bipolar disorder are unable to function normally, hold a job, and have a normal family life. The episodes of mood swings tend to become closer together with age. When a person is in the grip of this disease, chaos can occur. Bipolar disorder can cause major disruption of family and finances, loss of job, and marital problems.

Severe depression can be life threatening. It may be associated with thoughts of suicide, actual acts of suicide, and even acts of homicide in some cases. Extreme mania can lead to aggressive behavior, potentially dangerous risk-taking behaviors, and homicidal acts. A number of people with bipolar disorder may turn to drugs and alcohol to “self-treat” their emotional disorder, resulting in dependence for substance abuse.

Most people start showing signs of bipolar disorder in their late teens (the average age of onset is 21 years). These signs are dismissed as “growing pains” or normal teenage behavior. On occasion, some people have their first symptoms during childhood, but the condition can often be misdiagnosed at this age and improperly labeled as a behavioral problem. Bipolar disorder may not be properly diagnosed until the sufferer is 25-40 years of age, at which the time pattern of symptoms may become clearer.

Consequently, bipolar disorder occurs in both men and women. About 5.7 million people in the United States have the disorder. Because of the extreme and risky behavior that goes with bipolar disorder, it is very important that the disorder be identified. With proper and early diagnosis, this mental condition can be treated. Bipolar disorder is a long-term illness that will require proper management for the duration of a person’s life.1 Bipolar I Disorder involves one or more manic or mixed episodes, and often one or more major depressive episodes. A depressive episode may last for several weeks or months. Between episodes, a person may function normally. Manic–depressive Illness: Bipolar Disorders Essay.

Bipolar II Disorder involves one or more major depressive episodes along with at least one hypomania episode. Hippomanic episodes have symptoms similar to manic episodes, but are less severe. Between episodes, a person may function normally. Symptoms may also be related to seasonal changes the same as bipolar I. However, multipolar disorder is a mental disorder, which includes a broad range of intense and sometimes violent emotions. Multipolar disorder is marked, by frequently reoccurring episodes of catatonia, melancholia, psychotic depression, mania, and hypomania. Characteristics of Multipolar disorder are intensity and frequency of emotional outbursts and grandiose behavior. This disorder is the classic high/low pattern, alternating frequently between emotional extremes to the point of delusion.

In addition, Grandiosity is a multipolar personality who feels extreme love and goodness one minute and intense anger the next minute. These frequent and intense emotional episodes take their toll on family, friends, and co-workers. The intensities of emotion in the multipolar personality can lead to extreme behavior patterns and addictions. These may include but are not limited: heavy drinking, drug abuse, high-risk promiscuous sex, over-eating, spending sprees, workaholic, and fighting in general. The course of bipolar II disorder is different from that of bipolar I disorder or multipolar depression, with distinct differences in rates of recovery, clinical features, and number of episodes.

The risk of suicide appears to be particularly elevated. High rates of co morbid disorders have been reported, including substance abuse dependence, and, anxiety disorders or personality disorders. Manic–depressive Illness: Bipolar Disorders Essay. Few definitive studies exist on which to base conclusions about the differential efficacy of various treatment strategies in bipolar II disorder and bipolar I disorder. Preliminary studies suggest that the newer anticonvulsants may be of benefit for patients with bipolar II disorder, while other psychologist suggests that there may be a greater role for antidepressant medications.

However, medical evidence has shown that patients with bipolar disorder have higher death rates from suicide, heart problems, and death from all causes. Patients who get treatment, however, experience great improvement in survival rates. The risk for suicide is very high in patients who suffer from bipolar disorder and who do not receive medical attention. Between 10 – 15% of patients with bipolar disorder commit suicide, with the risks being highest during episodes of depression or mixed mania. Some studies suggest that the risk for suicide in patients with bipolar disorder II is even higher than it is for those with bipolar disorder I. Patients, who also suffer from an anxiety disorder, are also at greater risk for suicide.

Many pre- and early adolescent children with bipolar disorder are more severely ill than adults with the disease. According to a 2001 study, 25% of children with bipolar disorder are seriously suicidal. They have a higher risk for mixed mania, multiple and frequent cycles, and a long duration of illness without well periods. Therefore, patients do not manifest their negative behaviors such as spending sprees or even becoming verbally or physically abusive. They have a direct effect on others around them. Manic–depressive Illness: Bipolar Disorders Essay. It is very difficult for even the most loving of families or caregivers to be sympathetic with an individual who periodically and unexpectedly creates chaos around them. Many patients and their families find it difficult to accept that these episodes are part of an illness and are not normal, characteristics. Patients who are highly articulate, and who can intelligently justify their destructive behavior, not only to others, but also to themselves, often strengthen such denial. Family members may also feel socially alienated by the fact of having a relative with this mental illness, and feel forced to conceal this information from their acquaintances.

Consequently, Bipolar disorder tends to run in families. Researchers have identified a number of genes that may be linked to this disorder, suggesting that several different biochemical problems may occur in bipolar disorder. Like complex inherited disorders, bipolar disorder only occurs in a fraction of the individuals at genetic risk. For example, if an individual has bipolar disorder and his or her spouse does not, there is only a one in seven chance that their child will develop it. The chance may be greater if you have a greater number of relatives with bipolar disorder or depression. Manic–depressive Illness: Bipolar Disorders Essay.

On the other hand, Bipolar disorder can look very different in certain people. The symptoms vary widely in their pattern, severity, and frequency. Some people are more prone to either mania or depression, while others alternate equally between the two types of episodes. Some have frequent mood disruptions, while others experience only a few over a lifetime. Signs and symptoms of mania, manic phase of bipolar disorder, feelings of heightened energy, creativity, and euphoria are common. People experiencing a manic episode often talk a mile a minute, sleep very little, and are hyperactive. They may also feel like they are all-powerful, invincible, or destined for greatness.

However, mania feels good at first; it has a tendency to spiral out of control. People often behave recklessly during a manic episode: gambling away savings, engaging in inappropriate sexual activity, or making foolish business investments. For example. They may also become angry, irritable, and aggressive-picking fights, lashing out when others do not go along with their plans, and blaming anyone who criticizes their behavior. Some people even become delusional or start hearing voices. In the past, bipolar depression was lumped in with regular depression. Manic–depressive Illness: Bipolar Disorders Essay. However, a growing body of research suggests that there are significant differences between the two, especially when it comes to recommended treatments. Most people with bipolar depression are not helped by antidepressants. In fact, there is a risk that antidepressants can make bipolar disorder worse triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.

Despite many similarities, certain symptoms are more common in bipolar depression than in regular depression. For example, bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings, and feelings of restlessness. People with bipolar depression also tend to move and speak slowly, sleep a lot, and gain weight. In addition, they are more likely to develop psychotic depression-a condition in which they have lost contact with reality-and to experience major disability in work and social functioning. Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood is a particularly high risk of suicide

Therefore, Bipolar disorder requires long-term treatment. Since bipolar disorder is a chronic, relapsing illness, it is important to continue treatment even when you are feeling better. Most people with bipolar disorder need medication to prevent new episodes. There is more to treatment than medication. Medication alone is usually not enough to fully control the symptoms of bipolar disorder. The most effective treatment strategy for bipolar disorder involves a combination of medication, therapy, lifestyle changes, and social support. Manic–depressive Illness: Bipolar Disorders Essay.

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In addition, it is best to work with an experienced psychiatrist; bipolar disorder is a complex condition. Diagnosis can be tricky, and treatment is often difficult. For safety reasons, medications should be closely monitored. A psychiatrist who is skilled in bipolar disorder treatment can help you navigate these twists and turns. If you spot the symptoms of bipolar depression in yourself or someone else, do not wait to get help. Ignoring the problem will not make it go away; in fact, it will almost certainly get worse. Living with untreated bipolar disorder can lead to problems in everything from your career to your relationships or to your health. Diagnosing the problem as early as possible and getting treatment can help prevent these complications.

In conclusion, if you are unwilling to seek treatment because you like the way you feel when you are manic; remember that the energy and euphoria come with a price. Mania and hypomania often turn destructive, hurting you and the people around you. Bipolar disorder is a complex physiological and psychological disorder that can influence and manipulate a person’s thoughts and actions in their daily life. Manic–depressive Illness: Bipolar Disorders Essay.