Bipolar disorder, which was previously known as manic depression, is a condition characterized by mood swings. The disorder is a serious mental disease, yet fairly common, affecting approximately between one and five percent of Americans in all age groups. Unfortunately, despite being a serious illness, diagnosis usually takes a significant time period before it is made. Up to date, the cure of the disorder is not yet known. Bipolar disorder patients undergo a long-term mediation with support being offered regularly. With the help of family and friends, care providers and support groups, patients suffering from this disorder usually live satisfactory lives. The majority of bipolar patients are married, go to work, study, and have families. Together with advancements made in drug therapy, new approaches involving non-medical treatment promise a better future for the patients.
Bipolar Disorder
Today's view of bipolar disorder has its inspiration from the nineteenth-century psychiatric concept of the disorder. In the 19th century, Jean-Pierre and Jules Baillarger made independent descriptions of bipolar disorder in Paris to the Académie de Médicine. Hile Falret referred to this disorder as Folie circulaire which means circular insanity. Baillarger referred to bipolar disorder as folie à double forme which when translated to English it means dual-form insanity. According to Falret's observations, bipolar illness was common among certain families meaning that it could be passed down genetically from parents to offspring (Robins, Helzer, Croughan & Ratcliff, 1981).
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In the mid-20th century, bipolar disorder was commonly known as a manic-depressive disease, which later changed in the 1980s to the current term bipolar disorder or the bipolar affective disorder. The term “manic-depressive illness” was somewhat stigmatizing compared to the current term “bipolar disorder.” Surprisingly, people living with bipolar disorder, as well as some psychiatrists, have a preference for the term manic-depressive illness rather than bipolar disorder since they believe that it is the term that describes the accurate nature of the illness (Robins et al., 1981).
Pope, Sharma & Mazmanian (2014) explain that bipolar disorder is a mental illness that leads to unusual disturbances causing mood swings, shifts in one's energy, ability to carry out routine activities as well as activity levels. Although bipolar disorder is categorized into three types, they all involve unusual changes in activity level, energy, and moods. The main difference between the three types of bipolar disorders, namely bipolar I disorder, bipolar II disorder and cyclothymia also referred to as Cyclothymic disorder is their severity levels and the duration the disorder attack lasts. Manic episodes represent elated moods and energized behaviors, whereas hypomanic episode represents relatively less manic episodes. Depressive episodes are the extremely sad and hopeless periods when the patient is feeling down.
The symptoms of bipolar disorder are determined by the mood of the patient. In essence, every single extreme bipolar disorder episode is likely to last for a few weeks or longer. On the contrary, hypomanic episodes of this disorder may occur repeatedly and last for one to two years. However, still, bipolar disorder may be present even when mood swings seem normal or less extreme. That is why some patients will experience hypomania rather than mania. Patients may function normally, be highly productive and even feel energized and very good during hypomanic episodes. Unless friends or family members observe some mood swings and changes in the patient's energy or activity levels and recognize it as bipolar disorder, the patients may be feeling alright with nothing wrong. Failure to diagnose and treat patients with hypomania, they may develop either mania or depression (Pope, Sharma & Mazmanian, 2014).
On one hand, patients experiencing manic episodes are likely to experience related, high or up moods, feel extremely energized with increased activity levels, feel wired or jumpy, experience problems finding sleep, become touchy, irritable and agitated, become reckless and engage in risky activities. On the other hand, patients experiencing depressive episodes will feel very down, sad, hopeless or empty, have extremely low energy and decreased activities, either sleep too much or too little, usually feel worried and have problems with concentration, suffer from memory loss, either lose appetite or become ravenous, and develop suicidal thoughts and other dangerous behaviors (Hamrin & Iennaco, 2010).
In some scenarios, patients will experience mood episodes that are both depressive and manic. When this happens, the mood episodes are said to have mixed features. Bipolar disorder patients experience an episode of mixed features; they will feel extremely hopeless, empty or sad while at the same time feel extremely energized. Bipolar disorder patients experience other disorders; including eating disorders, substance abuse, and anxiety disorder, and sleep disorders. A proper diagnosis is, therefore, necessary to ensure there is no misdiagnosis. Bipolar disorder patients are also more susceptible to other illnesses such as obesity, diabetes, heart illnesses, thyroid disease, migraine headaches, and other physical diseases (Hamrin & Iennaco, 2010).
Although there is no single or exact known cause of the bipolar disorder, a majority of the scientists studying the possible causes of this illness agree that several factors either increase the risk of an individual to acquire the disease or trigger the illness. According to Pope, Sharma & Mazmanian (2014), the possible causes or risk factors include genetic factors, extreme stress, chemical factors, overwhelming problems, brain structure and functioning, life-changing events, and family history.
According to research, the brain structure and functioning between bipolar disorder patients and the healthy individuals or those with other psychological disorders are different. Lessons learned from genetic studies together with other new revelations from recent information help psychiatrists and other medical practitioners understand these differences and therefore, can determine the best type of treatments that will be most effective for the patients. Goodwin & Consensus Group of the British Association for Psychopharmacology (2009) reveals that people who have a specific type of genes are at greater risk of developing bipolar disorder than others. However, genes are not the only risk factors for this illness. This fact explains why one twin may develop bipolar disorder while the other one remains healthy, despite the fact that identical twins have similar genes. Although bipolar disorder seems to run in families, most people having a family history of this disorder do not develop the disorder. However, for children with siblings or parents who have bipolar disorder, there is an increased risk of developing the disorder.
Bipolar disorder is a common disease in society with one adult being diagnosed with the illness in every group of one hundred adults at some point in life. Bipolar disease is known to develop at any age. However, most people who develop the disorder falls in the age brackets of between fifteen to nineteen years with rare cases for people above forty years. Both men and women are equally at risk of bipolar disorder regardless of their backgrounds. However, there is a significant pattern variation of mood swings amongst people suffer from bipolar disorder. For instance, some patients may be stable and only experience a few episodes of the disorder throughout their lives, whereas some people will experience several bipolar episodes (Edition, 2013).
Bipolar disorder treatment aims at reducing the number and the severity of the mania and depression episodes to allow the normal living as much as possible. When gone untreated, manic bipolar episodes will last for about three to six months. Usually, depression episodes last longer that mania episodes for a period of between six to twelve months. However, when treated effectively, bipolar episodes will improve within three months (Hamrin & Iennaco, 2010).
Luckily, there are several treatments that can be combined to treat bipolar disorder, including treatments such as medication aimed at treating the major symptoms of mania and depression whenever they occur. There are mood stabilizers which are taken on a daily and on a long-term basis aim at preventing hypomania, mania, and depressive episodes. There also therapies including other psychological treatments help bipolar patients handle depression and provide them with advice on how they can improve their relationships; and finally, lifestyle advice including improving one's diet, exercising regularly, and getting enough sleep (Edition, 2013). Most of the bipolar disorder treatments are offered on an outpatient basis where the patient only visits the health institution occasionally without being admitted. Nevertheless, under special situations such as when the patients' symptoms become severe, or when the patient is under the Mental Health Act treatment, treatments will be offered on an inpatient basis since the patient can harm himself or other people.
According to Hamrin & Iennaco (2010), several bipolar disorder medications are available to help patients stabilize their mood swings. Mood swings stabilizers include antipsychotic medicines, anticonvulsant medicines, and lithium carbonate. When a patient is under any of the three medications and continues to develop depression, then, your caregiver must ensure that the patient is taking the correct dose as prescribed. In case your caregiver realizes that the patient's dose is incorrect, they will change it. Hamrin & Iennaco (2010) explain that the use of antidepressants alone in the treatment of bipolar disorder and especially when treating depression episodes is known to cause a hypomanic relapse. Therefore, during the treatment of bipolar disorder, episodes of depression require slightly different treatment. Most psychiatric guidelines suggest that when treating depression in bipolar disorder, antidepressants must never be used alone, but used alongside antipsychotic or mood stabilizers. When a psychiatrist advises that a patient should cease using the bipolar disorder medication, the patient should gradually reduce taking the dose. The reduction should be within a period of not less than four weeks, and even up to three months in case the patient was using lithium or antipsychotic medication. In any case, when a patient stops using lithium for whatever reason, then the patient should discuss with their doctor about using valproate or antipsychotic instead.
In conclusion, the whole family is affected by bipolar disorder when one of them gets diagnosed with the disease. For that reason, healthcare providers should include family members and close friends in the care and treatment plan. As noted earlier, the consequences involving a diagnosis of this disorder may lead to socialization disruption with close acquaintances and family. In essence, therapies will involve family members and close friends. The patient history is to be considered when deciding on the best treatment option. Lack of no known cure for this disorder requires support groups, caregivers and family remain informed of new developments regarding treatment and therapy.
References
Edition, F. (2013). Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishing.
Goodwin, G. O., & Consensus Group of the British Association for Psychopharmacology. (2009). Evidence-based guidelines for treating bipolar disorder: revised second edition—recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 23(4), 346-388.
Hamrin, V., & Iennaco, J. D. (2010). Psychopharmacology of pediatric bipolar disorder. Expert Review of Neurotherapeutics, 10(7), 1053-1088.
Pope, C. J., Sharma, V., & Mazmanian, D. (2014). Recognition, diagnosis, and treatment of postpartum bipolar depression. Expert Review of Neurotherapeutics, 14(1), 19-28.
Robins, L. N., Helzer, J. E., Croughan, J., & Ratcliff, K. S. (1981). National Institute of Mental Health diagnostic interview schedule: Its history, characteristics, and validity. Archives of General Psychiatry, 38(4), 381-389.
